The Biology of Diabetes
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Research shows that about 85% of the diseases that are contacted by humans result from their own negligence. This shows that unhealthy lifestyles can be responsible for deaths of numerous people, through the diseases that they contact. Current paper delves into the issue of negligence and unhealthy lifestyle as the main factors contributing to diabetes. The illness is reviewed from the cellular level to the processes of its development, as well as its physical manifestation. The essay also provides information on those individuals in the vulnerable group and the ways in which they can acquire it. However, it is vital to remember that the main issue that the essay intends to cover is the biology of diabetes, because it will ensure absolute exhaustion of the issue and, therefore, provide all vital information.
The Biology of Diabetes
Diabetes mellitus, commonly known as diabetes is a combination of metabolic diseases, where a person has a high level of sugar. The symptoms witnessed in occurrence of diabetes include frequent urination, increased hunger and increased thirst. The known types of diabetes are three, depending on how it is acquired. These types are diabetes mellitus 1, diabetes mellitus 2 and gestational diabetes. If untreated, experience has shown that diabetes can cause serious complications. To fully understand the disorder, it is vital that each type of diabetes is covered separately.
The Biology Behind Diabetes Mellitus
One of the major disorders that are affecting most people in the world is diabetes. The reason behind this is that most people are ignorant of the fact that they have to learn more about a disorder, if they are top be in a position to counter it. This makes people to remain unaware of the harm that it can cause to them. As a result, the whole burden is left to the doctors and other health practitioners. Since people are not willing to learn more about their health, they become poor preventers of such disorders. Therefore, they learn of the harm that a disorder can cause through experience. For some of these disorders, like diabetes, it might be too late to find out that one already has them. In 2013, it was established that 382 million people, of the world wide population, have diabetes. Diabetes mellitus 2 was responsible for about 90% of these cases (Draznin 1994).
As mentioned above, it is clear that diabetes is high blood sugar level in the body. Therefore, there is a need to look into how this may occur. The blood sugar level is normally controlled by insulin. It is a hormone produced by the beta cells of pancreas. When the blood sugar level is above what is required, insulin causes the skeletal muscles and fat tissues to absorb this excess glucose. The counter hormone for insulin is known as glucagon. It is a hormone that promotes the increase of the blood sugar level in the body. Therefore, nature provides a balancing act between these two hormones. This means that each of them performs its duties, as per the sugar level in the body. However, if one of them fails, that is how a disorder develops (Matthews & Dyson 2008). For example, glucagon may be produced to cause the breakdown of fats to increase the sugar level. However, insulin may be caused to inhibit production of glucagon in the pancreas produces. Insulin also ensures that glucose is converted to other substances such as fats and glucagon. This regulates the blood sugar level. The discussion of insulin can go for long since it is an extremely vital hormone in the body, for which a lot of research has been conducted. However, for the sake of this essay, this can be regarded as enough information to help in the development and achievement of the required task.
The increase in the level of blood sugar cannot be associated with the low or high production of glucagon hormone. However, insulin can be used to account for this because it is the one with the role of countering the functioning of glucagon. Therefore, it is vital to look at the ways how to reduce the insulin level in the body. First, if the pancreas fails in its function, this would mean that there is underproduction of insulin. When this happens, the role that insulin is supposed to play in the body is hindered. Therefore, the blood sugar level does not have a regulator. This may cause it to go high, maybe to levels that may even be fatal. The second way in which the blood sugar level may go low is with special regards to the responsiveness of body cells. Sometimes, the body cells may fail to be responsive to the released insulin. This may mean that the insulin level is still intact. However, insulin does not have ability to regulate the blood sugar level because the cells in the body are not responsive to its presence. In such cases, the cells may still be responsive to glucagon. This would mean that there is a hormone that is increasing the blood sugar level, while there is none regulating the same. Therefore, this causes high blood sugar level (Kudlow 1988).
After the pancreas has released insufficient insulin, or the blood cells have become unresponsive to it, the sugar cannot be absorbed properly in the body cells. This means that it may be stored inappropriately in the muscles, as well as in the liver. This can lead to numerous effects that can be seen in the symptoms after a long time. Some of these effects may include persistent high blood sugar level, poor synthesis of proteins, as well as other metabolic derangements. These may include acidosis. The moment the glucose level goes above 9-10 mmol/L (especially if it is not required by the condition of the individual for cases such as pregnancy), it is said to have passed the renal threshold. This means that the glucose has gone above the maximum glucose that should be transported for re-absorption at the kidney. In the kidney, glucose is reabsorbed at the proximal convoluted tubule. When the glucose level is higher than is required, this re-absorption becomes incomplete. This means that there is still glucose that is left in the urine. Such condition is known as glycosuria. As a result, the urine acquires a high concentration, as opposed to the blood. This means that it is able to achieve a high osmotic pressure (Okamoto 1990).
When this has happened, another process is inhibited. At the distal convoluted tubule of the kidney cells, there is the re-absorption of water. This occurs when the blood has a higher osmotic pressure than the glomerular filtrate and water re-absorption becomes minimum. This means that the urine that is produced by the individual contains a lot of water. This condition referred to as polyuria. The volume of water in the blood that is lost has to be replaced. This water is obtained from body cells. In its turn, the body cells are deprived of the water that they need. This amounts to dehydration and explains why diabetic people are always thirsty while at the same time urinate frequently. Loss of glucose through the urine explains the symptom of hunger. As a result, the person needs to take in more food to ensure that the lost glucose is recuperated. The above explanations have generalized the discussion on the biology of diabetes. However, it is vital to study the three types of diabetes mellitus. This will ensure that the essay provides an all-round description of the disorder. It will also ensure a deeper understanding of how the three types can be distinguished. However, current paper will pay particular attention to type 2 diabetes since this type is the most common one (Okamoto 1990).
Diabetes Mellitus Type 2
This type of diabetes is also referred to as noninsulin- dependent diabetes (NIDD). It was also formerly known as adult- onset diabetes. In this type of diabetes, hyperglycemia is caused by the resistance of blood cells to insulin. This results to relative lack of insulin which is different from diabetes type 1, caused by the absolute lack of production of insulin (Belfiore 1998). This insulin resistance develops mostly in fat tissue, muscles and the liver. The reason as to why insulin is located in the liver is obvious. Glucose is released in the liver. This means that if there is to be a regulating factor of the same, it should be located in the liver. There, insulin suppresses the release of glucose. However, if there is resistance to insulin, this amounts to inappropriate release of glucose into the blood. Subsequently, the blood sugar level goes on the rise. The condition is different for every single person that may suffer the disorder, because the level of insulin resistance in the body is extremely different among people. There are some people that have a problem with the secretion of insulin. However, there are others that basically have the resistance to this hormone.
There are other mechanisms associated with type 2 diabetes mellitus. First, the increased breakdown of lipids within the fat cells is considered as one cause of this disorder. Lipids are one of the conversions that can be made to glucose to ensure that it is stored in the forms that cannot increase the blood sugar level (Okamoto 1990). However, there are many occurrences when this fat is needed for generation of energy. This fat has to be converted into glucose, to allow for its absorption in the blood to assist in the yielding of energy. The over-conversion of these lipids to glucose may ensure that there is a high level of sugar in the blood. It is one case that can account for type 2 diabetes mellitus. The other issue that is normally connected to the disease is the increase of levels of glucagon in the blood. As mentioned above, glucagon is used to convert substances to glucose. This means that it performs the counter function of insulin (Belfiore 1998). When a lot of glucagon is released, this means that more and more glucose will be present in the blood. In a case where insulin levels still stay as usual, this would yield the same result as that of the lack of insulin. Since the regulating hormone has no much influence on the blood sugar level there is a possibility that most health practitioners view when diagnosing the disorder.
Reduced secretion of incretin is also considered as a notable cause for occurrence of diabetes mellitus. Incretin is a gastrointestinal hormones group that causes great reduction in the blood sugar level. However, they are not able to perform this task directly. Insulin is still the hormone that takes part in the actual regulation. However, incretin is responsible for increasing the amount of insulin that is produced in the islets of langerhans, by the beta cells. This is mostly after eating, where eth blood sugar levels can be elevated to levels that may be unhealthy. Therefore, when incretin release reduces, this would mean that the amount of insulin that is produced could also reduce. This results in lack of regulation of blood sugar level and the subsequent increase of the same in the blood (Okamoto 1990). The central nervous system (CNS) is involved in all the activities that occur in the body including regulation of metabolism. Therefore, sometimes it may fail to regulate metabolic processes. These processes would include the breakdown of substances to form glucose. When this happens, a lot of glucose may be produced in the liver. This may raise the blood sugar level causing an development of diabetes mellitus 2. In the same light, it is vital to point out that not all people who have insulin resistance can develop diabetes because this resistance has to be accompanied by impairment in secretion of insulin. It is only then that the body can develop the disorder.
In most cases diabetes is genetically predisposed. For example, the case of identical twins can account for occurrence of the disease. When one of the identical twins had diabetes mellitus type 2, while the other does not have, the probability of the other developing the condition during the lifetime is about 90%. For non-identical siblings, if one has the disorder, the probability of the other developing the same ranges from 25-50%. According to a research conducted in2011, more that 36 genes can be said to be a large contributor to type 2 diabetes mellitus. This means that the probability of this gene being transmitted down the generations is extremely high (Okamoto 1990).
However, the research shows that all of these genes only contribute 10% of the probability that the genes will be transmitted from one generation to the next. For example, TCF7L2 allele is responsible for increase of the probability of developing diabetes by about 1.5 times. It is also vital to note that most of the genes that have a connection with diabetes are involved in functions of the beta cell. Although, diabetes is mostly caused by combination of many genes, there are some cases in which it may be caused by one gene. These are known as monogenic diabetes forms. However, it is important to point out that these are rare cases including maturity onset diabetes of the young (MODY), Rabson- Manodenhall syndrome, Donohue syndrome, etc. The diabetes of the young (MODY) is said to account for about 1-5% of the diabetes that is experienced by young people (Kudlow 1988).
Symptoms and Signs
A number of symptoms show that an individual acquired type 2 diabetes mellitus. The first sign is polyuria which is the word used to represent frequent urination. Polydipsia is also another symptom. This is where the individual is, almost always, thirsty. Polyphagia, which is increased hunger, is also a symptom that may be considered as an indication that an individual has this disorder. An individual might also suffer massive weight losses to indicate the presence of the same. These are the signs that can be directly explained as above because they are the direct causes of increase in the blood sugar level. However, there are other symptoms that may also indicate the same (Kudlow 1988). These may include recurrent vaginal infections, itchiness, blurred vision, peripheral neuropathy and frequent fatigue. However, most people have no signs within the first few years. There may also be the symptom of hyperosmolar hyperglycemic states; that is where an individual may have extremely lower levels of consciousness, as well as low blood pressure. Therefore, when an individual experiences any of the above symptoms, there is a need to see a medical practitioner who might be in a position to diagnose them appropriately (Belfiore 1998).
Prevention and Diagnosis
In the study of the biology of type 2 diabetes, it is not right to leave out the ways in which it can be prevented. First, the prevention part is of the essence. The onset of this type of diabetes can be delayed or prevented through the use of proper nutrition, as well as regular exercise. When an individual realizes that he might have the gene for diabetes, he should take intensive measures. These can be responsible for reducing the risk by over 50%. These benefits that come from healthy lifestyles are not dependent on the weight loss of a person. However, one should not only adjust their diet. Research shows that this cannot be an effective method on its own because it has to be a total adjustment of the whole lifestyle of the individual. Otherwise, effectiveness of dietary adjustments may be much reduced. Medical practitioners claim that lifestyle interventions have been proven to be much more effective than metformin (Novartis Foundation 2008).
For the diagnosis, there are standard ways that have been put forward by WHO (World Health Organization). The diagnosis of both types of diabetes is for glucose readings that are raised. First, the fasting plasma glucose should not be above 7.0 mmol/l (126 mg/dl). Also, a glucose tolerance test should be conducted. After two hours since the oral dose, the plasma glucose should not exceed 11.1 mmol/l (200 mg/dl). Glycated haemoglobin (HbA1c) of greater than 6.5% is also an additional method that can be used to diagnose the presence of diabetes in an individual (Matthews & Dyson 2008). The threshold of the diagnosis of diabetes is on the basis of the relationship between fasting glucose, tolerance tests, retinal problems, as well as (HbA1c). Since most people normally ignore the symptoms, it is crucial that the diagnosis for this disease should be carried out before acute stages are reached. In the long run, a lot of damage is caused by high blood sugar level. (Novartis Foundation 2008).
Diabetes Mellitus Type 1
This type of diabetes is also known as insulin dependent diabetes. Its nature can be deduced from its name. This type of diabetes results from the destruction of the beta cells that produce the insulin hormone which means that the pancreas does not release enough insulin for the purpose of regulation of the blood sugar level. When untreated, this type of diabetes can prove to be ultimately fatal. However, the use of insulin supplement has been proven as a sufficient method to control the disease. The therapy of insulin must be conducted indefinitely if a person is to survive this disease (Matthews & Dyson 2008). However, there is no general way in which this disease can be controlled. This means that patients are trained on how to control this disease independently.
As a result of this, every person with the disease should make necessary adjustments, in terms of their medical lives to ensure that they are in a position to diagnose and prevent fatalities. Type 1 diabetes can be differentiated from type 2 by autoantibody testing – glutamic auto antibodies acid decarboxylase (GADA), insomnia- associated antibodies, zinc transporter auto antibodies and islet cell antibodies. In type 1 diabetes, there are several of complications that may arise from low blood sugar or high blood sugar level. Both of these are a result of the process how the insulin is released and replaced. Low level of sugar in the blood may result to occurrences of unconsciousness in individuals. This may require immediate treatment. In the short term, this disease may lead to the acquisition of diabetic ketoacidosis. In the long term, this may lead to organ damage, eye damage and other complications in the body (Kudlow 1988).
Prevention and Diagnosis
At the moment, diabetes mellitus type 1 is unpreventable. However, the fact that it is fatal has caused most researchers to look into the matter and try to come up with a solution. In their quest, they discovered that there could be prevention. However, it has not yet been verified or proven. They stated that during latent autoimmune stage, it is possible to prevent this disease, before it starts destroying the beta cells. This can be achieved by healthy lifestyles that do not leave an individual prone to most of the diseases that get a chance. However, unhealthy lifestyles can be a tool to ensure that this disease consumes the individual faster that it should have, if they had been diagnosed in the right way (Belfiore 1998). Persistent hyperglycemia is the main condition accounted in the diagnosis of type 1 diabetes mellitus. The fasting plasma glucose level should not go above 7.0 mmol/l. If it does, this is a way to diagnose type 2 diabetes mellitus. The plasma glucose should also not be above 11.1 mmol/l. the causal plasma glucose should also not exceed 11.1 mmol/l. Lastly, Glycated haemoglobin should also not exceed 6.5. However, this has not yet been accepted by the World Health Organization (Kudlow 1988).
For individuals with type 1 diabetes, dietary changes and healthy lifestyles are not efficient due to high fatality risk of the disease. Therefore, injection of insulin is vital for these people. The fact that the essay requires only the biology part of diabetes does not exclude that fact that there is a great need to find out how this biology can be countered by individuals who are suffering from the same. Even though dietary management is not sufficient, it should also be carried out by these individuals, even as they receive the insulin injection. Some of the dietary management practices that they should be involved in are keeping serious and careful follow of the carbohydrate content of the foods, careful monitoring of the levels of blood glucose by the use of glucose meters, as well as others that may be recommended by the doctor (Kudlow 1988).
In the present, the most common insulin is a biosynthetic product. It is produced using techniques of genetic recombination. In the past, the insulin of pigs, a well as cattle was used.. Insulin with durations of action time is now produced by companies to ensure that there are many ways in which patients can be diagnosed. Injection of insulin helps to increase the level of the latter in the body; though just for some time. After the insulin has been used, the blood sugar level of the individual may rise again (Kudlow 1988). When this happens, there is a need for the patient to go for another injection. Thus, the insulin therapy could be indefinite. On the other hand, it ensures that an individual is always safe. The advantage of this treatment is that it does not affect the routine of an individual.
In this condition whereby, women, who were not diagnosed previously with diabetes, exhibit high glucose levels in their sugar during pregnancy. This is especially evident in their third trimester of the gestation period. In this condition, it is the insulin receptors that fail and cease to function properly. Pregnancy related factors can be said to be the major cause of this malfunction. These may include human placental lactogen which may interfere with the insulin receptors. In turn, the blood sugar levels of the woman become inappropriately elevated. Women whose gestational diabetes is not managed are at a risk of acquiring type 2 diabetes mellitus. Their children may also be in a position to attain child obesity when they are born, because there is a lot of glucose in the blood (Novartis Foundation 2008). With the use of modified diet, as well as regular moderate exercise, some women are able to manage the blood sugar levels. This way, they are able to keep their babies safe from obesity and other disorders that may result. After, the pregnancy, they are also able to prevent themselves from being in the risk of acquiring type 2 diabetes mellitus. Therefore, the issue of healthy lifestyles also comes in handy. The same case has been witnesses for the two other forms of diabetes because every individual with the disorder has to ensure that his diet is well balanced since the blood sugar comes from the products people eat. Even though people may not be in a position to control the activities within them, they can control those that take place in their environment. In doing this, they are able to ensure that they do not fall victim to diseases that would have easily been prevented (Novartis Foundation 2008).
This type of diabetes is the one that poses a threat to the mother and the child. Therefore, there is a great need to look into the ways in which medications can be used to deal with the disease. First of all, the mother should have regular check ups to ensure that the insulin levels are constantly monitored. Alternatively, the blood sugar level can be monitored on a regular basis. After this has taken place, the doctor is able to tell if the blood sugar level has gone low. If this is the case, there might be a need for insulin injection. This way, the high blood sugar level can be corrected. Injection of insulin can be tight or normal. Either way, more injections allow better control b since they ensure that the mother is at zero risk of acquiring the disease (Kudlow 1988). For people who have suffered the disease in the past, this should be an eye opener, for the sake of the subsequent pregnancies. When the mothers near their third trimester in the gestation period, they should go to see the doctor and start taking the insulin injection. This would ensure that the blood sugar level is regulated, even before it can start causing gestational diabetes. However, waiting until the symptoms are worse may lead to the worsening of the situation. This risk is not worth taking as it may result to death of the mother or obesity in the child. Mothers should also be acknowledged about the symptoms of this disease. This way, it would be easier to identify it, even before it reaches the stages in which it becomes dangerous (Kudlow 1988).
The essay above can be used for numerous purposes. It can be used as an eye opener for most people who did not have an idea of the biology behind diabetes. Therefore, they can be in a position to adjust their lifestyles accordingly. Also, the essay can be used by people who may develop interest in such disorders, therefore, increasing awareness in the society. Therefore, it can be concluded that the objective of the essay has been achieved with utmost completion.
- Belfiore, F. (1998). Molecular and cell biology of type 2 diabetes and its complications
- Karger Medical and Scientific Publishers.
- Draznin, B. (1994). Molecular biology of diabetes. Totowa, N.J.: Humana Press.
- Kudlow, J. E. (1988). Biology of growth factors: Molecular biology, oncogenes, signal transduction and clinical implications : [proceedings of the Triennial Symposium of the Banting and Best Diabetes Centre on Biology of Growth Factors, held June 17-19, 1987, in Toronto, Canada]. New York: Plenum Press.
- Matthews, D., Meston, N., & Dyson, P. (2008). Diabetes. Oxford: Oxford University Press.
- Novartis Foundation. (2008). The biology of extracellular molecular chaperones: Novartis foundation symposium, Issue 291 John Wiley & Sons.
- Okamoto, H. (1990). Molecular biology of the islets of Langerhans. Cambridge: Cambridge University Press.