Diabetes


 * Name of disease: ** Diabetes

According to the root causes, two main types of diabetes are known, which are referred to as Type 1 (T1DM) and Type 2 diabetes (T2DM). Type 1 diabetes has been fully characterized and is well understood. It is due to insulin deficiency caused by an autoimmune destruction of the beta cells of the pancreas (Delli et al. 2010) which produce insulin, the hormone that facilitates the transport of glucose (sugar) from the blood stream into cells. Within the cells (muscle, liver, fat), glucose is metabolized to provide energy that the cells need to perform the many vital processes required for the healthy life of the cells and the organism. In type 1 diabetes an autoimmune disease the body’s immune system attacks and destroys the beta cells. Beta cell destruction may take place over several years, but symptoms of the disease usually develop over a short period of time. Type 1 diabetes typically occurs in children and young adults, though it can appear at any age. In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus. In addition, heredity plays an important part in determining who is likely to develop type 1 diabetes. Genes are passed down from biological parent to child. Genes carry instructions for making proteins that are needed for the body’s cells to function. Many genes, as well as interactions among genes, are thought to influence susceptibility to and protection from type 1 diabetes.
 * Root cause of disease: **

The root cause for Type 2 diabetes is a disease process in one body known as insulin resistance. Therefore, insulin resistance is the underlying problem for the great majority of diabetic patients. Furthermore, the disease, once rare in youth, is becoming more common in overweight and obese children and adolescents. Scientists think genetic susceptibility and environmental factors are the most likely triggers of type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a person’s risk for developing the disease. The role of genes is suggested by the high rate of type 2 diabetes in families and identical twins and wide variations in diabetes prevalence by ethnicity. Genes can also increase the risk of diabetes by increasing a person’s tendency to become overweight or obese. An imbalance between caloric intake and physical activity can lead to obesity, which causes insulin resistance and is common in people with type 2 diabetes. Central obesity, in which a person has excess abdominal fat, is a major risk factor for insulin resistance and type 2 diabetes.

As stated before, people with diabetes have a lack of insulin in their blood. Insulin is made in an organ called the pancreas. Insulin is important to allow glucose also known as blood sugar to get into the cells of the body. In other words, insulin opens the door to let blood sugar to enter most cells in the body. Blood sugar is a food for the body’s cells. If insulin is low or absent in the blood, then the cells do not get fed the blood sugar they need. As the blood sugar increases and cannot get into the body’s cells it has the effect of drawing water out of the cells and shrinks them up making them even less healthy.
 * Affected cell types/tissues/organs/systems: **

The nerves in the body are also affected, but not the same way. Nerve cells will allow blood sugar in without insulin, however with no insulin present the sugar is not used by the nerve cell properly and the sugar accumulates in the cell. Over time this will damage the nerve cell and cause the nerve to die. Blood vessels are also made up of cells. As the sugar builds up in these cells it swells them up and this causes a narrowing of the blood vessel. This causes a decrease in the circulation to the feet, the kidneys and the eyes. This is why people with diabetes often lose their legs, their eye sight, and kidney function also known as complications of diabetes.

Diabetes mellitus is a metabolic disorder in which a person has abnormally high blood sugar concentration. It is an important cause of death worldwide. According to the World Health Organization more than 80% of deaths as a result of diabetes, cardiac disease, respiratory disease and cancer in 2005 occurred in developing countries. Individuals most affected were people in the productive phase of life. Type 2 diabetes, the most prevalent kind of diabetes, is affecting approximately 90% of people with diabetes in the world. It is still ill understood, being characterized by complex interactions between both genetic factors and environmental factors. It is a heterogeneous metabolic disorder resulting from defects in both insulin production and insulin action (Vaxillaire and Frogeul, 2010). Studies have shown that variants of the TCF7L2 gene increase susceptibility to type 2 diabetes. For people who inherit two copies of the variants, the risk of developing type 2 diabetes is about 80 percent higher than for those who do not carry the gene variant. However, even in those with the variant, diet and physical activity leading to weight loss help delay diabetes.
 * Historical Background: **



For the most part, people with type 2 diabetes do not have any symptoms. When symptoms do occur, they are often ignored because they may not seem serious. However, symptoms in type 1 diabetes usually come on much more suddenly and are often severe. These symptoms include excessive thirst and appetite, increased urination sometimes as often as every hour, unusual weight loss or gain, fatigue, nausea, perhaps vomiting, blurred vision, frequent vaginal infections in women, yeast infections in both men and women, dry mouth, slow healing sores or cuts, itching skin especially in the groin or vaginal area.
 * Common Symptoms: **

Type 1 diabetes treatment involved in a lifelong commitment. It includes: taking insulin, exercising regularly and maintaining a healthy weigh, eating healthy foods, monitoring blood sugar. People with type 2 diabetes need to maintain healthy lifestyle choices including diet, exercise and weight control. However, they may need medications to achieve target blood sugar levels. Sometimes a single medication is effective. In other cases, a combination of medications works better. Some medications include: meglitinides, sulfonylureas, biguanides, and the list goes on. These medications can be confusing, so one will need to learn about these drugs, their side effects, what they can do before taking them. Overall, one needs to pay really close attention to their blood sugar level when treating diabetes. The goal is to keep it as close to normal as possible to delay or prevent complications.
 * Standards Treatment: **

The American Diabetes Association seeks to expand the field of diabetes research through increasing support and by filling the research pipeline with investigators to accelerate progress toward improved treatments and a cure. Furthermore, researchers are trying to find out how different age groups are affected by diabetes.
 * Current Research: **

1. Delli, A. J., Larson, H. E., Ivarsson, S., and Lernmark, A. (2010). Autoimmune Type 1 Diabetes. Chapter 9 in “Textbook of Diabetes”, 4th Edition; edited by Holt R.IG., Cockram, C.S., Flyvbjerg A., and Goldstein, B. J... Wiley-Blackwell.
 * References:**

2. SD, R., M, I., MZ, H., B, C., S, B., S, H., & JP, O. (2011, February 1). An FTO variant is associated with Type 2 diabetes in South Asian populations after accounting for body mass index and waist circumference. Diabetic Medicine, 28, 673-680.

3. Shaw, J. E., Sicree, R. A., & Zimmet, P. Z. (2009, November 6). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and clinical practice, 87, 4-14.

4. Vaquero, A. R., Ferreira, N. E., Omae, S. V., Rodrigues, M. V., Teixeira, S. K., Krieger, J. E., & Pereira, A. C. (2012). Using gene-network landscape to dissect genotype effects of TCF7L2genetic variant on diabetes and cardiovascular risk. Physiological Genomics, 44(19), 903-914.

5. Vaxillaire, M. & Froguel, P. (2010). The Genetics of Type 2 Diabetes: From Candidate Gene Biology to Genome-wide Studies. Chapter 12 in “Textbook of Diabetes”, 4th Edition; edited by Holt R.IG., Cockram, C.S., Flyvbjerg A., and Goldstein, B. J... Wiley-Blackwell.

6. http://diabetes.niddk.nih.gov/dm/pubs/causes/#type2

7. https://www.google.com/search?q=flow+chart+for+diabetes&bav=on.2,or.r_qf.&bvm=bv.46751780,d.dmQ&biw=1366&bih=664&um=1&ie=UTF-8&hl=en&tbm=isch&source=og&sa=N&tab=wi&ei=RT-dUY3pGaLn0wG624DIBQ#imgrc=SnkwARCT2AOz6M%3A%3B80fVfDmmD74RIM%3Bhttp%253A%252F%252Fwww.wilsonssyndrome.com%252FAssets%252FImages%252FFlowChartDiabetesTypeII.gif%3Bhttp%253A%252F%252Fwww.wilsonssyndrome.com%252FProducts%252FFlowChartDiabetesTypeII.htm%3B387%3B465

