Diabetes is currently the sixth cause of death in the US resulting to more than 70,000 deaths annually (Colwell, 2008). This number is understated because diabetes is often a secondary cause of death, leading to; fatal renal failure, cardiovascular disease and cerebral vascular disease. Diabetes has compounded effects on the American population. The cost of treating diabetes in 2007 was approximated at 174 billion dollars (ADA, 2007). Diabetes also has various unrelated health costs including reduced work productivity (ADA, 2007). Diabetes is more prevalent among minority populations and the poor who rarely have adequate access to healthcare facilitates (ADA, 2007).The rate of diabetes has steadily doubled in the last decade and is expected to continue escalating (Colwell, 2008). Currently, more than twenty five million Americans have diabetes. This accounts for a significant eight percent of the entire American population (Colwell, 2008). More than half of all diabetes cases are still undiagnosed. Most of these cases are diagnosed too late for any effective preventive or control measures often resulting to death.
Diabetes is a collective term referring to a number of diseases characterized by increased levels of blood glucose. This is as a result of abnormalities in the production of insulin or the mechanism of action of the insulin produced (NIDDK, 2008). A significant percentage of patients have defects in both the production and the action of insulin (Colwell, 2008). Insulin is a hormone produced by the pancreas and it converts blood glucose to a storable form of carbohydrates called glycogen (NIDDK, 2008). Failure in this homeostatic pathway leads to extremely high blood glucose levels. The fasting plasma glucose level test is the most reliable test used to diagnose diabetes. A blood glucose level of more than 126mg/dl is usually indicative of diabetes (NIDDK, 2008).
There are various types of diabetes depending on the cause. The most common types are; gestational, type 1 and type 2 diabetes. Gestational diabetes refers to glucose intolerance in pregnant women (D'Adamo, J & Whitney, 2005). It is more common among minority populations (D'Adamo, J & Whitney, 2005). Research has indicated a higher probability of women diagnosed with gestational diabetes developing type 2 diabetes (Poretsky, 2008).
Type 1 diabetes refers to persistently elevated blood glucose levels as a result of an abnormality in the production of insulin (Colwell, 2008). Type 1 diabetes normally results after the pancreatic cells which produce insulin are destroyed by autoimmune antibodies (NIDDK, 2008). The patient has to rely on continuous insulin injections to supply the body with insulin (NIDDK, 2008). There is no known cause of type 1 diabetes but scientists have attributed it to heredity due to increased familial aggregation (Colwell, 2008).
Type 2 diabetes is the most prevalent form of diabetes in America, afflicting more than 95% of the entire population with diabetes (NIDDK, 2008). It refers to elevated blood glucose levels as a result of insulin resistance. The body is unable to use the produced insulin properly. This results to an overworked pancreas that may be destroyed requiring direct insulin intake (Poretsky, 2008). Type 2 diabetes is commonly associated with adults but there has recently been increased prevalence in children and teenagers with type 2 diabetes (Poretsky, 2008). This diabetes is mostly caused by a sedentary lifestyle and poor eating habits (Colwell, 2008). It is most common in minority groups especially; African Americans, Latino Americans and American Indians and researchers have concluded that there is also familial aggregation (NIDDK, 2008). Type 2 diabetes is often associated with obesity and hypertension (D'Adamo, J & Whitney, 2005).
Most cases of diabetes are diagnosed when it is too late to apply any meaningful corrective measures. In early diagnosis, diabetes can be effectively addressed and corrected with a change in lifestyle (D'Adamo, J & Whitney, 2005). It is therefore imperative that the entire American population understands the onset of diabetes so that they are able to seek necessary medical and behavioral interventions to avoid diabetes complications.
The earliest symptom of diabetes is the increased tendency to produce urine and increased thirst (Colwell, 2008). The elevated blood glucose spills into the urine causing glucose in urine. This in turn causes increased water re absorption at the kidneys, leading to increased urine output and thirst (Poretsky, 2008). The uncontrollable fluctuation in blood glucose causes blurred vision (Colwell, 2008). Diabetes may also lead to loss of body weight. The inability of insulin to metabolize blood sugar interferes with carbohydrate, fat and protein metabolism (D'Adamo, J & Whitney, 2005). Diabetes patients may also experience; increased fatigue and nausea. Undiagnosed cases may also cause bladder, vaginal and skin infections (Poretsky, 2008).
The mode of therapeutic intervention of diabetes depends on the type of diabetes. Diabetes can lead to various health complications. The elevated blood glucose levels leads to destruction of the micro vascular system which causes renal failure and blindness (Colwell, 2008). It may also cause macro vascular damage resulting to; coronary thrombosis, stroke, comma and lower limb amputations (Poretsky, 2008). These complications can however be avoided by an early diagnosis and implementing controls to manage blood; glucose, pressure and lipid levels.
Patients with type 2 diabetes, who comprise 95% of the entire diabetes population in America, can prevent complications of diabetes by applying relevant changes in lifestyle and taking oral medication. These interventions usually entail; proper diet, exercise and loosing excessive weight. Some type 2 patients with destroyed pancreas also use insulin injections (Poretsky, 2008). Individuals with type 1 diabetes depend on direct delivery of insulin. This is either done through injections or an insulin pump (Colwell, 2008).
For both type 1 and type 2 diabetes, the medication may change over the course of the disease. Due to the effect of insulin on lipid, carbohydrate and protein metabolism, most of these patients also take medication to control cholesterol levels and hypertension (D'Adamo, J & Whitney, 2005). Effective address of diabetes largely depends on self management. After diagnosis, the patient is charged with the task of implementing the necessary self care behaviors which include; appropriate healthy eating, blood glucose monitoring and physical exercise.
With the steadily increasing prevalence, mortalities and the high costs associated with managing and controlling diabetes; preventing diabetes among the American population has become a national agenda. Researches have advocated giving increased focus to people who are at increased risk (Colwell, 2008). This includes minority populations and patients with pre-diabetes and gestational diabetes. Studies have indicated that individuals with pre-diabetes, who implement the right self management care strategies including the right diet and exercise, are able to prevent or delay the onset of diabetes (D'Adamo, J & Whitney, 2005). These self management interventions among individuals with diabetes are more cost effective and efficient than medication (D'Adamo, J & Whitney, 2005).
In conclusion, diabetes is Americas leading silent killer disease. More than half of all diabetes cases are undiagnosed and remain unaddressed until it is too late for meaningful preventive and control strategies. More than seventy thousand annual mortalities are directly caused by diabetes in America. Many more patients however die from complications caused by diabetes. This is either due to retinopathy, cerebral and coronary complications and nephropathy. These figures are undocumented. The link between type 2 diabetes and obesity means that more than half of the entire American population is at increased risk of diabetes. Minority groups and especially African American males are at an increased risk for diabetes. More than 95% of the diabetes patients in America have type 2 diabetes. This type can be effectively prevented and controlled by implementing the appropriate lifestyle changes. This includes; adequate exercise and dietary changes. Researchers have advocated targeting people with pre diabetes as an effective and cost efficient way of delaying and preventing the onset of type 2 diabetes.
American Diabetes Association (ADA). (2008). Economic costs of diabetes in the US in 2007. Diabetes Care March 1,596-615
Colwell, A. (2008). Diabetes. New York: Elsevier Publishers.
D'Adamo, J & Whitney, C. (2005). Diabetes: fight it with the blood type diet. New York:Berkley Books.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2008). National Diabetes Statistics, 2007 fact sheet. Bethesda: National Institutes of Health. Retrieved on March 23, 2010 from http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#pre-diabetes.
Poretsky, L. (2008). Principles of diabetes mellitus. New York: Springer