Diabetes

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					Title:
Diabetes

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1047

Summary:
Diabetes is a disease affecting the manner in which the body handles
digested carbohydrates. If neglected, diabetes can cause extremely severe
health complications, ranging from blindness to kidney failure.

Around eight percent of the population in the United States has diabetes.
This means that around sixteen million people have been diagnosed with
the disease, based only on national statistics. The American Diabetes
Association estimates that diabetes accounts for 178,00...


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Article Body:
Diabetes is a disease affecting the manner in which the body handles
digested carbohydrates. If neglected, diabetes can cause extremely severe
health complications, ranging from blindness to kidney failure.

Around eight percent of the population in the United States has diabetes.
This means that around sixteen million people have been diagnosed with
the disease, based only on national statistics. The American Diabetes
Association estimates that diabetes accounts for 178,000 deaths, as well
as 54,000 amputees, and 12,000-24,000 cases of blindness annually.
Blindness is twenty-five times even more common among diabetic patients
in comparison with nondiabetics. If current trends continue, by the year
2010 complications of diabetes will exceed both heart disease and cancer
as the leading cause of death in America.

Diabetics have a high level of blood glucose. Blood sugar level is
regulated by insulin, a hormone secreted by the pancreas, which releases
it in response to carbohydrate consumption. Insulin causes the cells of
the body to absorb glucose from the blood. The glucose then serves as
fuel for cellular functions.

Traditional diagnostic standards for diabetes have been fasting plasma
glucose levels greater than 140 mg/dL on 2 occasions and plasma glucose
greater than 200 mg/dL following a 75-gram glucose load. However, even
more recently, the American Diabetes Association lowered the criteria for
a diabetes diagnosis to fasting plasma glucose levels equal to or higher
than 126 mg/dL. Fasting plasma levels outside the normal limit demand
further testing, usually by repeating the fasting plasma glucose check
and (if indicated) initiating an oral glucose tolerance test.

The many symptoms of diabetes include excessive urination, excessive
thirst and hunger, sudden weight loss, blurred vision, delay in healing
of wounds, dry and itchy skin, repeated infections, fatigue and headache.
While suggestive of diabetes, these symptoms can also be caused by other
factors, and therefore anyone with symptoms suspicious of the disease
should be tested.

There are 2 different varieties of diabetes.
Type I Diabetes (juvenile diabetes, also known as insulin-dependent
diabetes): The cause of type I diabetes starts with pancreatic inability
to make insulin. This causes 5-10% of cases of diabetes. The pancreatic
Islet of Langerhans cells, which secrete the hormone, are destroyed by
the patient's own immune system, probably because it mistakes them for a
virus. Viral infections are believed to be the trigger that sets off this
auto-immune disease. Type I diabetes is most prevelant in the caucasian
population and has a hereditary component.

If untreated, Type I or juvenile diabetes can lead to death within two to
three months of the onset, as the cells of the body starve because they
no longer receive the hormonal prompt to absorb glucose. While a great
majority of Type I diabetics are young (hence the term Juvenile
Diabetes), the condition can develop at any age. Autoimmune diabetes is
diagnosed by an immunological assay which shows the presence of anti-
insulin/anti-islet-cell antibodies.

Type II Diabetes (non insulin dependent diabetes, also known as adult
onset diabetes): This diabetes is a consequence of body tissues becoming
resistant to the effects of insulin. It accounts for 90-95% of cases. In
many cases the pancreas is producing a plentiful amount of insulin,
however the cells of the body have become unresponsive to its effect due
to the chronically high level of the hormone. Finally the pancreas will
exhaust its over-active secretion of the hormone, and insulin levels fall
to beneath normal.

A tendency towards Type II diabetes is hereditary, although it is
unlikely to develop in normal-weight individuals eating a low- or even
moderate-carbohydrate diet. Obese, sedentary individuals who eat poor-
quality diets built around refined starch, which constantly activates
pancreatic insulin secretion, are prone to develop insulin resistance.
Native peoples like North American Aboriginals, whose traditional diets
never included refined starch and sugar until these items were introduced
by Europeans, have very high rates of diabetes, five times the rate of
caucasians. Blacks and hispanics are also at higher risk of the disease.
Though Type II diabetes isn't as immediately disastrous as Type I, it can
lead to health complications after many years and cause serious
disability and shortened lifespan. As with Type I diabetes, the condition
develops primarily in a certain age group, in this case patients over
forty (which is why it's typically termed Adult Onset Diabetes); however,
with the rise in childhood and teenage obesity, this condition is being
seen for the first time in school children as well.

If treatment is neglected, both Type I and Type II diabetes can lead to
life-threatening complications like kidney damage (nephropathy), heart
disease, nerve damage (neuropathy), retinal damage and
blindness(retinopathy), and hypoglycemia (drastic reduction in glucose
levels). Diabetes damages blood vessels, especially smaller end-arteries,
leading to very severe and premature atherosclerosis. Diabetics are prone
to foot problems because neuropathy, which afflicts about ten percent of
patients, causes their feet to lose sensation. Foot injuries, common in
day-to-day living, go unnoticed, and these injuries cannot heal because
of atherosclerotic blockage of the microscopic arteries in the foot.
Gangrene and subsequent amputation of toes, feet or even legs is the
result for many elderly patients with poorly-controlled diabetes. Usually
these sequelae are seen sooner in Type I than Type II diabetes, because
Type II patients have a small amount of their own insulin production left
to buffer changes in blood sugar levels.

Type I diabetes is a severe disease and there is no known permanent cure
for it. Nonetheless, the symptoms can be controlled by strict dietary
monitering and insulin injections. Implanted pumps which release insulin
immediately in response to changes in blood glucose are in the testing
stages.

In theory, since it induced by diet, Type II diabetes should be
preventable and manageable by dietary changes alone. However, as so often
happens, clinical theory is defeated by human nature in this case, as
many diabetics (and many obese people without diabetes) find it
personally impossible to lose weight or even stick to a diet free of
starchy, sugary junk food. So Type II diabetes is frequently treated with
drugs which restore the body's response to its own insulin, and in a few
cases injections of insulin.

Please note that this article isn't a subsitute for medical advice. If
you suspect you have diabetes or even are in a high risk demographic
group, please see your doctor.