Diabetes Mellitus

Diabetes mellitus, or sugar diabetes, is a disorder in which the body is unable to make use of sugars and starches in a normal way. A key element in the proper use of sugar and starches is the hormone insulin, which is secreted by special cells (beta cells) in the pancreas; these cells are known as the islets of Langerhans.

Diabetes results from either a lack of insulin or an inability of the body to use the insulin properly, but the cause of diabetes is not known. Persons may inherit a tendency toward diabetes. Obesity may also be a factor in the onset of diabetes.

There are two major forms of diabetes mellitus. Type I, sometimes called insulin-dependent, or juvenile-type diabetes; and Type II, sometimes called noninsulin-dependent, maturity onset, or adult-type, diabetes. One is usually found in persons under age 25; the other, in persons over age 40.

Causes of the Imbalance In Blood Glucose Levels

Normally, food digested in the body releases glucose, a form of sugar, into the blood. This increase in blood glucose level cause beta cells in the pancreas to release insulin, which aids in transporting glucose from the blood to storage in such tissues as the liver and muscle. In persons with Type I diabetes, the pancreas is unable to produce insulin. In Type II diabetes, the pancreas produces some insulin, but the tissues do not respond to it properly. As a result, in both cases, high concentrations of sugar build up in the blood after eating (hyperglycemia). A vicious cycle then begins. The fatty acids released from tissues throughout the body are converted by the liver into biochemicals called ketone bodies. These also pour into the bloodstream causing a condition in which the blood becomes dangerously acidic (ketoacidosis). This can lead to diabetic coma and, if untreated, to death.

Symptoms & Treatment

The general symptoms of diabetes include increased frequency of urination and persistent thirst. In Type I diabetes these symptoms are often accompanied by weakness and increased appetite.

A physician can diagnose diabetes by testing for sugar in the urine and blood. A glucose tolerance test determines how well the body uses and stores sugar.

Any diabetic who has lapsed into a coma requires immediate emergency medical attention and must be hospitalized.

Type I diabetics need daily injections of insulin. A physician determines the correct dosage, and patients administer insulin themselves. The technique is simple, even for children. Some diabetics use a portable pump that delivers insulin directly to the body through and artificial opening.

A strict diet is important in controlling diabetes to keep the levels of insulin and glucose in the blood from fluctuating too wildly. Careful regulation of activity, food intake and insulin is also necessary to prevent insulin shock (hypoglycemia), in which the insulin levels rise too high and blood glucose level drops too low.

The first sign of insulin shock are mild hunger, dizziness, sweating, and heart palpitations; then follows mental confusion and coma. Diabetics can stop insulin shock by consuming some substance high in sugar or candy. It is advisable for diabetics to have identification card, tag, or bracelet so that they will receive emergency care.

Type II diabetes is much easier to control. Some cases are treated with diet alone, others with diet plus antidiabetic drugs. Some cases are treated with insulin. Most Type II diabetes can be controlled with diet alone, at least at the onset of the illness, if the patient maintains proper body weight.



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Complications

Diabetics have increased fatty acids in their blood. This predisposes diabetics to atherosclerosis, a type of arteriosclerosis, which may lead to heart disease and damage to small and large blood vessels.

Diabetics often have blurred vision or diabetic retinopathy leading to other eye problems, and reduced resistance to infections of all types. Generally, the longer the diabetic condition exists, the more prone the patient is to complications, such as retinopathy and kidney disease. Maintaining proper body weight is the best precaution for an individual with a family history of diabetes, especially if a glucose tolerance test reveals that the person's glucose=processing mechanism is not normal.

Trained Glycemia Alert Dogs Afford Significant Improvements to Owner Well-being

Recently, the dog has been suggested as a “biocompatible and patient friendly alarm system” for hypoglycemia. Case studies have indicated that pet dogs can spontaneously exhibit specific behaviors when their owner's blood sugars decrease, most commonly vocalising, nuzzling, licking, biting, jumping up and staring at their owner. Reports describe individual dogs alerting their owners during nocturnal episodes (which can be especially dangerous and are particularly feared: repeatedly reacting to hypoglycemia while their owner is driving and consistently responding to hypoglycemia in a non-diabetic owner. Previous studies have suggested that some pet dogs respond to their owners' hypoglycemic state. Trained glycemia alert dogs placed with people living with diabetes result in significant improvements to owner well-being. Dogs reliably respond to their owners' hypoglycemic state and owners experience facilitated tightened glycemic control, and wider psychosocial benefits. Since obtaining their dog, all people studied reported positive effects including reduced paramedic call outs, decreased unconscious episodes and improved independence. Dogs alerted their owners, with significant, though variable, accuracy at times of low and high blood sugar.

References

  1. Acquired lymphedema: an urgent need for adequate animal models.Hadamitzky C, Pabst R. In: Cancer Res. 2008 Jan 15;68(2):343-5
  2. Investigation into the Value of Trained Glycemia Alert Dogs to Clients with Type I Diabetes



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