Type 1 and Type 2 Diabetes Mellitus

Introduction

Diabetes mellitus refers to a metabolic disease that is characterized by elevated blood sugar in the body. Diabetic patients develop symptoms such as a frequent urge to urinate, increased hunger and thirst. Medical experts have warned that, if diabetes is left untreated, then it can cause other serious health complications such as heart diseases, eye problems and kidney failure, among others (Joseph, Svartberg, Njølstad & Schirmer, 2011; Menke, Orchard, Giuseppina, Bullard, Mayer-Davis & Cowie, 2013). There are two types of diabetes (Joseph et al., 2011). First, type 1 diabetes mellitus occurs when the body cannot produce enough insulin, resulting in insulin deficiency. Menke and colleagues (2013) assert that approximately 10% of all cases of diabetes are type 1. This type is more common in children than in adults. This explains why medical practitioners always refer to it as juvenile diabetes. Patients diagnosed with type 1 diabetes mellitus may have to be injected with insulin on a daily basis in order to remain healthy. They may also need a special diet, besides having regular tests to confirm whether or not they have normal glucose levels (Joseph et al., 2011).

Second, Porth (2011) argues that type 2 diabetes occurs when body cells resist insulin. This condition results in reduced secretion of insulin. Doctors have always associated this metabolic condition with defects of insulin receptors. When insulin receptors in the body develop a problem, it becomes difficult for the cells to respond to insulin, a fact that increases sugar levels in the body. Genetic and lifestyle factors have been associated with type 2 diabetes mellitus. It could imply that a person whose parents suffered from this disease may easily be affected by it. One may also acquire it from various lifestyle choices, especially those who do not engage in physical exercises or do not observe healthy eating lifestyles (Joseph et al., 2011; Porth, 2011).

Pathophysiology of the disease

Insulin is the main hormone that regulates the body’s uptake of glucose from the bloodstream into the cell (Duckworth et al., 2009; Joseph et al., 2011; Porth, 2011). Glucose is important because it is metabolized to provide the energy needed by the body. When there is a limited supply of insulin within the human body, the individual develops diabetes mellitus. The same could also happen in cases where insulin receptor cells become insensitive. It is also important to note that insulin is responsible for the conversion of glucose in the body into an inactive form of glycogen. Glycogen can easily be stored in the muscle cells or liver so that it could be used in future metabolic reactions that result in the production of energy. It also controls the reverse process of converting glycogen into glucose whenever cells require energy. When there is a problem with regard to the functions of insulin, the conversion process may not be effective, resulting in excess glucose in the blood. This situation leads to body complications (Porth, 2011).

Porth (2011) asserts that insulin is pivotal in the conversion of bidirectional metabolic processes. In cases where body cells develop resistance to insulin, these processes are affected. When insulin is insufficient in the body, or when cells fail to respond to insulin, glucose is not utilized by the human body to yield energy. It will neither be absorbed by the body cells nor converted into glycogen for the purpose of storage in the muscles or liver. This condition results in a constant increase in the level of glucose in the blood, reduced synthesis of fat and glucose in the body, and a series of other problems in metabolic processes. If the concentration of glucose in the blood increases beyond the renal threshold, then its re-absorption in the proximal renal tubule becomes incomplete (Valde, 2011). It could imply that some glucose molecules could remain in the urine. This leads to a condition that is known as glycosuria. This means that the fluid inside the kidney nephron will have a higher osmotic pressure than the body cells, a fact that would inhibit the process of absorption of water by the kidney. This is what causes an increased urge for urination in a patient. Increased rates of urination could negatively impact an individual by causing loss of fluids (Porth, 2011).

The increased demand for water in the body cells for metabolism results in a condition in which water in cells within the body and other compartments is forced out through osmosis, leading to the patient’s dehydration and a feeling of thirst. Based on this pathophysiology analysis, some symptoms of the 49-year old patient strongly suggest that she was suffering from diabetes. The recorded BMI of 34 indicates that she could be suffering from diabetes. Most diabetic patients have a BMI of over 30. The patient in this case has a dry mucous membrane and soft bowel sound, which are symptoms of dehydration of the body. High blood sugar levels and increased cholesterol in the urine further demonstrate that the patient was suffering from diabetes (Porth, 2011).

Diagnostics and Treatments

The first step in the diagnosis of diabetes would be recording the symptoms that the patient has been experiencing for the past few days or weeks. One should be keen to observe symptoms such as increased rates of urination, frequent urge to drink water, and difficulties in breathing. After the first step, a number of laboratory tests would need to be carried out. One of the best ways of diagnosing the disease is by investigating the sugar and cholesterol levels in the urine. People with diabetes always have glucose levels of more than 200 mg/dl two hours after the ingestion of 75 g oral glucose. Another approach that can be used to determine whether one is suffering from diabetes is to determine the body mass index (BMI). The BMI for people who are suffering from diabetes is always above 30. The patient in this study has a BMI of 34, a strong indication that she could be suffering from metabolic disease.

If the tests confirm that the patient is suffering from the disease, then it would be essential to provide medications. Metformin could be the most appropriate first-line treatment to be offered to the patient. The patient should be provided with ACEI tablets for regular intake. It could also be necessary to inject the patient with insulin at regular intervals. In addition, the patient may need a complete change of lifestyle in order to manage the disease (Duckworth et al., 2009; Porth, 2011).

Diabetes Education

Education with regard to diabetes should be offered in schools, hospitals and churches, among other targeted areas (Valde, 2011). Mass and social media could be utilized to create awareness of the causes, symptoms, medications, management, and the prevention of the disease. According to Menke and colleagues (2013), many Americans (about 90% of the population) do not have sufficient information about diabetes. Conducting an awareness campaign could help members of the society to avoid lifestyle choices that would put them at risk of developing the disease (Valde, 2011). Patients suffering from metabolic disease should be helped to know how to manage their delicate conditions in order to avoid instances that endanger their lives. This would not only reduce the deaths caused by the disease but also significantly improve the healthcare outcomes of many citizens.

Nutritional Implications

Patients who have been diagnosed with diabetes mellitus should understand that their nutrition may need to be changed in order for them to remain healthy. For those whose weight has been affected by the disease, it would be necessary to have good nutrition in order to achieve a normal BMI (Duckworth et al., 2009; Valde, 2011). Patients should be encouraged to increase their intake of glucose-rich foods, which would enable body cells to produce adequate energy required for essential metabolic processes. Thus, glucose would be maintained at the required levels at all times.

Conclusion

Diabetes mellitus is an unhealthy condition, which results from the inability of the body to produce enough insulin, or when body cells develop resistance to insulin. This condition impairs the process of conversion of glucose to glycogen for storage. It also limits the process of conversion of glycogen into glucose when the cells need energy. Patients suffering from diabetes have elevated levels of blood. The condition affects other metabolic processes. Patients suffering from this disease are characterized by higher glucose levels in their urine. Their BMI levels also tend to be higher than 30. Metformin is the recommended first-line treatment of the disease. Regular injection of insulin may also be necessary. The patient may also need a complete change of lifestyle.

References

Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D.,… & Huang, G. D. (2009). Glucose control and vascular complications in veterans with type 2 diabetes. New England Journal of Medicine, 360(2), 129-139.

Joseph, J., Svartberg, J., Njølstad, I., & Schirmer, H. (2011). Risk factors for type 2 diabetes in groups stratified according to metabolic syndrome: a 10-year follow-up of The Tromsø Study. European journal of epidemiology, 26(2), 117-124.

Menke, A., Orchard, T., Giuseppina, I., Bullard, K., Mayer-Davis, E., & Cowie, C. (2013). The Prevalence of Type 1 Diabetes in the United States. Epidemiology, 24(5), 773-774.

Porth, C. (2011). Essentials of pathophysiology: Concepts of altered health states. Philadelphia, PA: Lippincott Williams & Wilkins.

Valde, G. (2011). Community Program to Prevent Diabetes in School Children. Journal of Community Health Nursing, 28(4), 215-222.