The Pathophysiology Behind Diabetes
By: Lisa Kim
Many know that diabetes is a chronic illness where one’s blood sugar levels are abnormally high, but how exactly do our bodies regulate blood sugar levels? Normally, when food is consumed, it is broken down into sugar, or glucose, to provide energy for our cells. These glucose molecules are carried through our bloodstream before cells absorb them. Thus, once glucose levels in the bloodstream rise, our body signals the pancreas to secrete insulin. The pancreas is an organ near our stomach and liver, and it is responsible for digesting food as well as releasing insulin. Within the pancreas, insulin is produced by beta cells of pancreatic islets. Once insulin is released into the bloodstream, it is responsible for helping cells, specifically muscle and fat cells to absorb the glucose molecules for energy. As a result, glucose is removed from our bloodstreams which lowers blood sugar levels, and the cells are given the necessary energy to carry out important cellular processes. However, this balanced cycle is not the case for people with diabetes. In this article, we will explain the pathophysiology behind type 1 and type 2 diabetes that prevents glucose from being removed from one’s bloodstream.
Type 1 diabetes is diagnosed more often in children and young adults, and affects roughly 5-10% of people diagnosed with diabetes (CDC). In type 1 diabetes, pancreatic islet beta cells are accidentally destroyed by immune cells which results in little to no insulin being produced. As a result, there is no insulin to remove the glucose in bloodstreams which allows glucose to accumulate and rise abnormally high. Due to this, people with type 1 diabetes must receive insulin daily either through an injection or pump (Kindred Healthcare).
On the other hand, people with type 2 diabetes are able to produce insulin but either do not produce enough or experience insulin resistance. Insulin resistance occurs when one is unable to effectively utilize the insulin produced by their bodies. When there is a high concentration of glucose in one’s bloodstream, insulin is secreted by the pancreas but the cells do not respond to the insulin. At that point, the pancreas begins to overproduce insulin so that the cells can take up the glucose in the bloodstream. Eventually, the accumulation of insulin causes muscle cells to absorb as much glucose as they can but any leftover glucose is stored by fat cells as body fat (CDC). Thus, it is important for people with type 2 diabetes to eat healthy and exercise regularly.
In conclusion, diabetes prevents blood sugar levels to be lowered but the pathophysiology behind type 1 and type 2 diabetes differs slightly. In type 1 diabetes, insulin is unable to be produced at all while in type 2 diabetes, insulin can be produced but does not work properly.
Diabetes Mellitus
By: Truc Le
Causes
There are many types of Diabetes Mellitus (DM) which are prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. However, in this writing, the focus would be type 1 and type 2 diabetes. Type 1 diabetes (formerly called insulin-dependent diabetes or juvenile-onset diabetes) is an autoimmune disease in which the immune system attacks and destroys cells in pancreas where insulin is made (Watson 2020). Therefore, the pancreas produces little or no insulin to move glucose from the bloodstream into the cells. The causes of this type are usually genes or viruses that trigger the immune system attack. Children or teenagers who have parents or siblings with the same condition are more likely to be diagnosed with this type.
Type 2 diabetes is caused by family genetics or living lifestyle. Our body’s cells do not allow insulin to work as effectively as it is supposed to do. The condition is known as insulin resistance. Although the pancreas produces more insulin (usually at the beginning of the disease stage), there is not enough insulin for the body and, therefore, glucose builds up in the bloodstream. When type 2 diabetes continues, the pancreas will gradually lose the ability to produce insulin. Overweight people usually have a higher risk of developing type 2 diabetes because obesity causes insulin resistance. Moreover, this condition also runs in families and is more common with age.
Symptoms
There are many symptoms varying in different types of DM. The most common general symptoms are increased thirst, hunger, and urination. Moreover, patients also experience blurred vision, drowsiness, weight loss, tiredness, and decreased endurance during exercise. With type 1 diabetes, symptoms are usually dramatic and develop quickly. Type 1 diabetes patients can also develop a serious condition called diabetic ketoacidosis (DK) in which the body produces excess acid (Manual, 2020). DK can cause nausea, vomiting, fatigue, and abdominal pain, especially in children. Patients’ breath is usually deep and rapid since the body tries to adjust the blood’s acidity, and the breath smells fruity and like nail polish remover. Without treatment, diabetic ketoacidosis can develop into coma and death in a short time.
On the other hand, type 2 diabetes patients do not develop symptoms quickly. In the first couple of months, they may not have any symptoms at all. One of the first symptoms is increased thirst and urination which is mild at first but worsen after weeks or months. Moreover, sores, cuts, or injuries are slow to heal. Type 2 patients have to keep track of their blood glucose level frequently in order to avoid severely high blood glucose level which is bad for their organs, especially kidneys.
Prevention and Treatments
There is no prevention for type 1 diabetes since it is an autoimmune disease. However, there are some drugs that can be prescribed at an early stage but they are not very recommended due to their side effects. On the contrary, type 2 diabetes can be prevented by adjusting lifestyle and diet. One of the first things is losing weight if you are obesed. Moreover, maintaining regular exercise and eating a healthy diet, like cutting saturated and trans fats, along with refined carbohydrates and focusing more on fruits, vegetables, and whole grains products, are essential in the type 2 diabetes prevention process. Furthermore, quitting smoking, lowering stress, having enough sleep, and keeping track of blood sugar are also helpful and necessary.
Diabetes treatment depends on your type of diabetes, your blood glucose level, and your other health conditions. The only treatment for type 1 diabetes is taking insulin everyday since the pancreas is longer to produce insulin. With type 2 diabetes, besides taking medication (not only for supporting pancreas produce insulin but also improving other risk factors for diabetes), changes in lifestyle and diet are also helpful and important. Many treatments are the same as prevention for type 2 diabetes people. Patients should monitor blood glucose level regularly, do exercise, have a healthy diet, and maintain healthy body weight as their treatment.
Word Cited
The Pathophysiology Behind Diabetes
Centers for Disease Control and Prevention. “Insulin Resistance and Diabetes.” Centers for Disease Control and Prevention, 10 August 2021, https://www.cdc.gov/diabetes/basics/insulin-resistance.html. Accessed 13 November 2021.
Centers for Disease Control and Prevention. “What is Diabetes?” Centers for Disease Control and Prevention, 11 June 2020, https://www.cdc.gov/diabetes/basics/diabetes.html. Accessed 12 November 2021.
Kindred Healthcare. “Pathophysiology of Diabetes Mellitus.” Kindred Hospitals, 7 November 2013, https://www.kindredhealthcare.com/resources/blog-kindred-continuum/2013/11/07/pathophysiology-of-diabetes-mellitus. Accessed 12 November 2021.
Diabetes Mellitus
“Diabetes Statistics.” National Institute of Diabetes and Digestive and Kidney Diseases, 17 Apr. 2021, http://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics.
“Diabetes: Types, Risk Factors, Symptoms, Tests, Treatments & Prevention.” Cleveland Clinic, 28 Mar. 2021, my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview.
Merck Manuals. “Diabetes Mellitus (DM).” Merck Manuals Consumer Version, Sept. 2020, www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism
“National Diabetes Statistics Report, 2020 | CDC.” Centers for Disease Control and Prevention, 2020, www.cdc.gov/diabetes/data/statistics-report
Watson n, Stephanie. “Everything You Need to Know About Diabetes.” Healthline, 26 Feb. 2020, http://www.healthline.com/health/diabetes.
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