Insulin Dependent Diabetics example essay topic

Stand on a street corner and ask people if they know what insulin is, and many will reply, 'Doesn't it have something to do with blood sugar?' Indeed, that is correct, but such a response is a bit like saying 'Mozart? Wasn't he some kind of a musician?' Insulin is a key player in the control of intermediary metabolism. It has profound effects on both carbohydrate and lipid metabolism, and significant influences on protein and mineral metabolism. Consequently, derangements in insulin signaling have widespread and devastating effects on many organs and tissues.

To our surprise, insulin was the first hormone identified (late 1920's) which won the doctor and medical student who discovered it the Nobel Prize (Banting and Best). They discovered insulin by tying a string around the pancreatic duct of several dogs. When they examined the pancreas of these dogs several weeks later, all of the pancreas digestive cells were gone (died and were absorbed by the immune system) and the only thing left was thousands of pancreatic islets. They then isolated the protein from these islets and behold, they discovered insulin. Note that there are other hormones produced by different types of cells within pancreatic islets (glucagon, , etc) but insulin is produced in far greater amounts under normal conditions making the simple approach used by Banting and Best quite successful. Insulin is a hormone.

And like many hormones, insulin is a protein. Insulin is secreted by groups of cells within the pancreas called islet cells. The pancreas is an organ that sits behind the stomach and has many functions in addition to insulin production. The pancreas also produces digestive enzymes and other hormones. Carbohydrates (or sugars) are absorbed from the intestines into the bloodstream after a meal. Insulin is then secreted by the pancreas in response to this detected increase in blood sugar.

Most cells of the body have insulin receptors which bind the insulin which is in the circulation. When a cell has insulin attached to its surface, the cell activates other receptors designed to absorb glucose (sugar) from the blood stream into the inside of the cell. Without insulin, you can eat lots of food and actually be in a state of starvation since many of our cells cannot access the calories contained in the glucose very well without the action of insulin. This is why Type 1 diabetics who do not make insulin can become very ill without insulin shots. Insulin is a necessary hormone. Those who develop a deficiency of insulin must have it replaced via shots or pumps (Type 1 Diabetes).

More commonly, people will develop insulin resistance (Type 2 Diabetes) rather than a true deficiency of insulin. In this case, the levels of insulin in the blood are similar or even a little higher than in normal, non-diabetic individuals. However, many cells of Type 2 diabetics respond sluggishly to the insulin they make and therefore their cells cannot absorb the sugar molecules well. This leads to blood sugar levels which run higher than normal. Occasionally Type 2 diabetics will need insulin shots but most of the time other methods of treatment will work. Therefore, the chief feature of diabetes is the lack of insulin.

Diabetes is a circumstance in which a break down occurs in the metabolism of the food into power for the human body. It is a serious disorder that effects millions and millions of people each year. Diabetes is one of the oldest diseases known to this date. Since the Ancient days, scientist have made many medical discovers that helps treat diabetes. (Dolger and Seeman 14). Accordingly, diabetes is a chronic, genetically determined, debilitating disease that affects every organ system.

There are two major types of diabetes: Type I and Type II. Type I or insulin dependent diabetes (IDDM), is caused by the autoimmune destruction of the insulin producing cells of the pancreas and is usually, but not always diagnosed in childhood. People with type I diabetes must take insulin shots in order to survive. Type II diabetes or non-insulin dependent diabetes (NIDDM), are usually diagnosed in adulthood. They produce insulin, but their bodies do not use it effectively or properly. While many modern diseases plague society, diabetes has been known for many centuries (Juvenile Diabetes Foundation, 1-3).

Type I diabetes is usually diagnosed in children and young adults and was previously known as juvenile diabetes. In type I diabetes, the body does not produce insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. When sugar builds up in the blood instead of going into cells, it can cause two problems: cells may be starved for energy, and over time, high blood sugar levels may hurt your eyes, kidneys, nerves, or heart.

Type 1 Diabetes usually develops due to an autoimmune disorder. This is when the body's immune system behaves inappropriately and starts seeing one of it's own tissues as foreign. In the case of Type 1 Diabetes, the islet cells of the pancreas that produce insulin are seen as the 'enemy' by mistake. The body then creates antibodies to fight the 'foreign' tissue and destroys the islet cells ability to produce insulin. The lack of sufficient insulin thereby results in diabetes.

It is unknown why this autoimmune diabetes develops. Most often it is a genetic tendency. Sometimes it follows a viral infection such as mumps, rubella, , measles, influenza, encephalitis, polio or Epstein-Barr virus. Certain people are more genetically prone to this happening although why this occurs is not know. Thus, two people may be infected with the same virus and only one of them who is genetically prone will go on to develop diabetes.

Other less common (very rare) causes of Type 1 Diabetes include injury to the pancreas from toxins, trauma, or after the surgical removal of the majority (or all) of the pancreas. Type II diabetes is the most common form of diabetes. In type II diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Type II diabetes accounts for 90 to 95% of diabetes. Type II diabetes is nearing epidemic proportions, due to an increased number of older Americans, and a greater prevalence of obesity and sedentary lifestyles (Hoffman, 34-49). Diabetes is the leading cause of death.

It is the leading cause of kidney failure, adult blindness, and non-traumatic amputations. People who have diabetes are two to four times more likely to have a heart attack or a stroke. Life expectancy of people who have this disease, on the average is fifteen years, less than that of people who do not have the disease. It is also the leading cause of nerve damage (Hoffman, 34-49). IDDM can cause problems that should be prepared for. The three key problems: Hypoglycemia, or low blood sugar.

This occurs when blood sugar drops too low. To correct this, all that is needed is some sugar. Hyperglycemia, or high blood sugar. Occurs when blood sugar is too high.

It can be a sign that diabetes is not controlled very well. And, or diabetic coma, is very serious and should be taken care of by a healthcare practitioner (Hoffman, 34-49). Signs and symptoms of IDDM include: high levels of sugar in the blood, high levels of sugar in the urine, frequent urination, extreme hunger and thirst, extreme weight loss, weakness and tiredness, feeling edgy and having mood changes, and feeling sick to your stomach and vomiting. Signs and symptoms of type II diabetes: One is that it develops very slowly. Most people that get NIDDM have an increased thirst and an increased need to urinate.

They also feel edgy, tired, and sick to their stomach. Some have an increase in appetite, but do not gain weight. Other signs and symptoms may include: repeated or hard to heal infections of the skin, gums, vagina, or the bladder. Impotence, blurred vision, tingling or loss of feeling in the hands pr feet, and dry, itchy skin. These symptoms are very mild and are not easily connected to diabetes. Older people confuse these signs with aging and do not seek medical attention early enough.

Since this disease is genetically determined, anybody can get it. Diabetics live with this disease forever. It never goes away, even when all of the treatments available. Diet and exercise are the two most important things in a diabetic's life.

People who have diabetes can live a happy and healthy life. The key is to keep blood sugar levels as normal as possible all of the time. Testing their blood sugar levels regularly is very important; testing lets them know if their diabetes is under control. Diabetes is a disruption of carbohydrates, fat, and protein metabolism resulting from hypo secretion or inaction of insulin. It is the most widespread disorder of the endocrine system.

Blood and urine tests to confirm diabetes reveal hyperglycemia, glycosuria, and ketonuria (Saladin, 654-655). A little knowledge of kidney physiology is necessary to understand why glycosuria and occur. The kidneys filter blood plasma and process the filtrate to produce urine. The kidney tubules remove all glucose from the filtrate and return it to the blood. There is little or no glucose in the urine of a healthy person.

By osmosis, the tubules reclaim most of the water in the filtrate (Saladin, 655). The glucose transporters of the kidney tubules have a transport maximum. In DM, glucose enters the tubules so fast that it exceeds the transport maximum and the tubules cannot reabsorb it fast enough. The excess passes through into the urine. Glucose and ketones in the tubules raise the os molarity of the tubular fluid and cause osmotic diuresis. Water remains in the tubules with these solutes, so large amounts of water are passed in the urine.

This accounts for the, dehydration, and thirst of diabetes. Diabetics pass 10 to 15 L of urine per day, compared with 1 to 2 L in a healthy person (Saladin, 655). Diabetes leads to long-term degenerative cardiovascular and neurological diseases. Chronic hyperglycemia activates a metabolic reaction cascade that leads to cellular damage in small to medium blood vessels and peripheral nerves. Nerve damage is the most common complication of diabetes, and can lead to impotence, incontinence, and loss of sensation from affected areas (Saladin, 656).

The last effect makes a patient dangerously unaware of major injuries, which can fester from neglect and contribute to gangrene and the necessity of amputation. Many diabetics lose their toes, feet, or legs to the disease. The cardiovascular effects include degeneration of the small arteries of the retina and the kidneys, leading to blindness and kidney failure as common complications. People with type I diabetes are more likely to die of kidney failure than those with type II diabetes. Diabetes also promotes, the blockage of blood vessels with fatty deposits, causing poor circulation. In type II diabetes, the most common cause of death is heart failure stemming from atherosclerosis of the coronary arteries.

Atherosclerosis also contributes to renal failure and gangrene. A person with Type I diabetes depends on insulin, therefore, they must acquire shots of insulin every day from a syringe. This type of diabetes typically affects a person before they turn thirty. Their pancreas do not produce the insulin that is required to turn sugar into energy. A person with Type II diabetes is not dependent on insulin shots. They can produce insulin, but not fast enough to maintain high intakes of foods with high sugar counts.

The main treatments for this type of diabetes is a firmly restricted diet and exercise. This type of diabetes generally occurs in seriously overweight adults over the age of thirty. There is not a cure for diabetes. Fortunately, several treatments for the disease have been discovered. The most significant development in treatment for diabetes was the discovery of insulin.

'Insulin was discovered in 1921 by Sir Frederick Banting, Charles H. Best, and John James Rickard Macleod' (Encyclopedia Britannica). 'Insulin is a hormone normally produced in the organ of the body called the pancreas' (Web MD). Inside of the pancreas are cells called the islets of Langerhans (Dolger and Seeman 16). Inside of the islets of Langerhans are specialized cells called beta cells.

These cells produce the body's insulin. The function of insulin is necessary for the body to metabolize sugar (Alois 16). Glucose is the sugar that the body uses. There are many different types of sugars.

For example, Sucrose is the sugar of which honey is made and Fructose is a sugar found in fruits. Our bodies make the glucose that we need for energy and metabolize into glucose the certain foods that we eat. Foods that are high in carbohydrates and starches are the primary sources for glucose. 'Typical carbohydrates and starches are potatoes, breads, and pasta' (Alois 16-17).

The energy used by each cell of our body comes from oxidizing, or burning, glucose. As the cells consume glucose, the blood sugar level drops. We eat food, carbohydrates and starches that are digested and metabolized into glucose and the glucose then enters the blood stream. The pancreas senses the increase of blood sugar and it starts producing insulin.

Glucose enters the cell with the help of insulin. The function of insulin is to attach itself to a glucose molecule so that the glucose can fill the cell membrane. Another major advancement in the treatment of diabetes is the ability to manufacture insulin. All 'artificial human' insulin is made from either beef or pork pancreas (Dolger and Seeman 88). It consists of solution or suspensions of insulin proteins in water (Danowski 70). In order to function normally, every human being needs to maintain a certain level of sugar in their blood.

'The normal blood sugar range is between 80 to 120 mg of glucose per 100 ml of blood. If this level of sugar rises too high, they cannot function normally ' (Dolger and Seeman 97). A Type I diabetic needs artificial insulin in order to survive. The insulin-dependent diabetics receive life-supporting insulin though a syringe injection. ' The first person to receive an insulin injection was Joe Gilchrist on February 11, 1922' (Dolger and Seeman 74).

Up until then, anyone who was diagnosed with Type I diabetes was usually given only a short time to live. With the discovery of artificially produced insulin combined with the use of hypodermic needles, the Type I diabetics were given a longer life. The injections, even though they are essential to maintaining one's health, nevertheless, are painful and unpleasant. 'Pills and capsules that can be taken orally are out of the question. Insulin is a protein substance, which can not be swallowed and absorbed into the body's system with out being destroyed by the digestive juices. ' Nasal sprays can not reliably deliver the appropriate dosage of insulin.

The tough nature of our skin makes body patches an effective way to deliver the protein based hormone (Dolger and Seeman 104). People with Type I diabetes are required to take insulin injections at the same time every day. 'This dictates the need to have a fixed schedule of eating meals. No meals should ever be postponed or skipped. A person must take the insulin shot about half -hour before eating so that the insulin can be absorbed into the bloodstream' (Alois 104).

The timing of the injection correlates to the time it takes the body to digest the meal. The materials needed for the injection is a hypodermic syringe and a bottle of insulin. A person must always be sure that the materials are sterilized. The insulin shot can be taken in many places of the body. 'Some places are the front or side of thigh, upper part of the arm, upper area of buttock, or the abdomen' (Alois 101). These sites of injection must be changed to prevent skin problems.

If a person gives the injection at the same site every time they get a lump known as hypertrophy. If this develops the insulin will not absorbed through that site (Alois 103). A recently developed treatment for diabetes is the use of the insulin pump. The insulin pump is a machine that repeatedly pumps insulin into the body.

It is about the size of a pager and is worn on the outside of the body. The pump consists of a syringe connected to a servomotor that applies constant pressure to the plunger. This dispenses an accurate amount of insulin. A microprocessor monitors the flow of insulin.

The pump can be programmed to deliver various amounts of insulin on a twenty-four hour basis. The syringe has a long tube with a needle on one end of it that attaches into the skin. The needle site has to be changed every three days. There are many advantages to having the pump. The major advantage is that the diabetic doesn't have to give him or herself four injections every day. The pump also gives a person the flexibility of eating whenever they want.

Plus, a person can eat some foods outside of the proper diet because the pump can be easily programmed to accept the deviation (Insulin Pumpers U K). Diet and exercise are two things a diabetic must do. 'The diet should consist of moderate amounts of carbohydrates, sugars, starches, and fats' (Danowski 20). 'A person's body still needs insulin even when a person doesn't eat; because carbohydrates are stored in the body's tissues. Also, certain cells of the liver continue to produce glucose from the body's protein and other materials. ' Any excess sugars from the diet must be taken into account.

Extra ingested sugars means more insulin is required. If the sugar intake and insulin are not in balance, the blood sugar level goes awry (Danowski 46). Exercise is important because it increases the flow of blood and oxygen to the muscles. Also it lowers blood glucose levels and it enhances the effectiveness of insulin (Alois 143).

How to cure and prevent diabetes or any other disease involves knowing the cause. The doctors today still debate the cause of diabetes (Long). Some believe diabetes is a genetic malady. Others think it is a viral infection.

Whatever is the cause, the insulin producing cells of the pancreas are destroyed and not replaced (Long). Anybody can get diabetes. 'It does not matter of a person's age, race, or sex. ' It can appear gradually or suddenly (Dolger and Seeman 45).

Diabetes is a life long daily procedure. People with diabetes can live a normal and healthy life. But to do so requires daily attention to their diet and their blood sugar level. 'The diabetics should learn how to take care of themselves as soon as possible' (D ogler and Seeman 57).

People who have diabetes are more likely to have other problems than people without diabetes. 'They are twice as prone to heart disease and stokes. Five time as prone to develop arterial disease of the limbs. Diabetes is characterized by accelerated vascular disease. Approximating 75% of death among diabetic are due to cardiovascular disease' (Alois 264). ' The early symptoms of diabetes are increased thirst, increased urination, weight loss, fatigue, nausea, vomiting, and blurred vision' (Wed MD).

Other symptoms of diabetes as determined by clinical test are sugar and ketones in the urine (Alois 41). Except for some extremely rare diseases, sugar in the urine denotes the presence of diabetes. Ketones are chemical byproducts of fats being burned by the body for energy. Normally the body will convert the fat to a sugar; then use insulin to metabolize the sugar into energy. The presence of ketones denotes that the body is using a back-up system to produce energy it needs (Alois 66). The most recognizable side affect of diabetes is insulin shock.

'Insulin shock is when a person's blood sugar drops so low that the body functions are adversely affected ' (Dolger and Seeman 120). Insulin shock is very dangerous and shouldn't be taken lightly. It is easily to correct by giving the person sugar. 'If the person is conscious the sugar can be in the form of candy or juice' (Dolger and Seeman 129). If the person is unconscious a glucose shot must be given directly into a person's vein (Danowski 117). 'If insulin shock is not treated it can lead to brain injury and permanent damage ' (Danowski 119).

'The symptoms leading up to insulin shocks are: mild hunger, sweating, dizziness, noticeable mood swings, tingling of the skin, and pale skin ' (Dolger and Seeman 124) Another repercussion of diabetes is the diabetic coma. This is a hazard faced by all diabetics who allow the disease to get out of control. It happened to people who are insulin-deficit. The coma is slow to develop. 'It may take up to twenty-four hours or more to manifest itself' (Dolger and Seeman 120). 'Coma develops from an abnormal rise in blood sugar due to not enough insulin activity.

The symptoms of diabetic coma are: constant thirst, flushed, dry skin, weakness, fatigue, drowsiness, deep breathing vomiting and the most important unconsciousness' (Dolger and Seeman 127). People with diabetes can lead normal and healthy lives. Diabetics must learn to live with the disease. They must control it or face serious side affects immediately or as they grow older. They must monitor their blood sugar daily and adjust their sugar and insulin intake accordingly (Danowski 21).

All people with diabetes should wear a medical alert band to state they have diabetes (Danowski 119). Some day, we will find a cure for diabetes. But until then, all we can do is treat the symptoms on a daily basis.

Bibliography

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Dolger, Henry and Bernard Seeman. How to Live with Diabetes. New York: Norton, 1977.
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What is an Insulin Pump's ept ember 27, 2000.
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