How this cycle is affected by type 1 diabetes
As Beta cell within the pancreas becomes damaged as explained earlier, there is less production of insulin. This means that there won’t any insulin to move glucose into muscles and liver cells. This means that blood glucose levels will be severely high leading to the outcome of hyperglycaemia. As a result of this overload of high blood sugar level most of the glucose is left out of the body via urine.
Symptoms
These are warning signs that progress very early after the being affected by type 1.
- Frequent urination (in children, a recurrence of bed-wetting after toilet training has been completed)
- Unusual thirst, especially for sweet, cold drinks
- Extreme hunger
- Sudden, sometimes dramatic, weight loss
- Weakness
- Extreme fatigue
- Blurred vision or other changes in eyesight
- Irritability
- Nausea and vomiting (acute symptoms)
Alongside these symptoms a more fatal and severe symptoms could be resulting in a diabetic coma also as a first sign or an early caused symptom of type 1.
Solutions:
Artificial Insulin is currently the most common, effective and ideal for a strict blood glucose levels which is crucial for type 1. Alongside the uses of insulin regimens of intensive insulin treatment or course is recommended to follow for example:
This table would be useful for patient with type 1 as the person will be able to follow and monitor the expected blood glucose level throughout the day and track whether or not they are meeting these expectations and goals. By maintaining their blood glucose levels they will be able to resist the possible symptoms of type 1.
There many types of insulin, but here are just two types that have been looked into more depth:
Solution 1
Fast-Acting insulin:
An example of fast- acting insulin would be Insulin Lispro (Humalog), which lowers blood glucose level rapidly within 5 minutes approximately after injection, it is mostly recommended for it to be taken in 15 minutes prior to meal or within 30 minutes after the meal. This insulin works by the sequence switch of two beta-chain amino acids. Normal human insulin is a protein made of two polypeptide linked chains A and B. However the reason why insulin Lispro acts faster is because there is a reverse in these chains proline at B-28 and the lysine at B-29.
http://www.rxlist.com/humalog-drug.htm
This as a result to a more rapid dissolution of this insulin to a dimer and then to a monomer that is absorbed more quickly after instant injection, the graph shows this comparison:
From this we graph we can see that insulin Lispro begins to exert its effects within 15 minutes of administration, patients must eat within this time period. Compared with insulin Lispro, regular human insulin has a slower onset of action. Insulin peaks in about 3 hours and continues to work for about 4 more hours. From this we can understand why its dosages are to be taken in short time period before and after meal intakes. This woulb be useful and effective for someone with diabetes as it means there would be a faster rate in the control of blood glucose levels
Solution 2
Long-Acting (Ultralente) Insulin:
Long-acting insulin, such as insulin glargine (Lantus), is released slowly. Insulin glargine matches parts of natural human insulin and maintains stable activity for more than 24 hours. Insulin glargine differs from human insulin by the substitution of glycine for alanine at position 21 of the insulin A-chain plus the addition of two extra amino acids – both arginines – at the end of the insulin B-chain, extending it from its usual length of 30 amino acids to 32 amino acids. This is the reason why its activity is prolonged than normal human insulin.
The graph below demonstrates the activity of insulin glargine in comparison to other types of insulin:
From this we can see how it peaks around 5 hours after injection and continues in a long and consistent glucose infusion rate up until 20 hours where it starts to fall in its rate.
Implications of Solutions:
Both the insulin are useful for their outcomes and its purpose Insulin Lispro allows rapid action which reduces the risk for hypoglycaemic events after eating (postprandial hypoglycaemia) and it is considered easier to monitor due to its short intake time periods, also especially useful for meals with high carbohydrates amounts. Also insulin glargine, which Studies suggest that it poses less of a risk for hypoglycaemia and weight gain.
Social implications:
The most significant social implication of using Insulin would be the fact that they will be able to stop and cure the hundreds and thousands of diagnosed patients with type 1, in reaching their most critical stage and finally facing death. Along with early death there are many other complications that someone with type 1 diabetes is open to for example:
- Cardio vascular disease
- Kidney disease or nephropathy
- Eye disease more specifically retinopathy
- Amputation
- Depression
- Neuropathy
- Erectile dysfunction in men
- Complications in pregnancy
- Reduced life expectancy
Therefore the use of insulin would prevent most perhaps all of these complications from developing causing further pain and difficulties for those who are already facing the enough issues of just diabetes type 1.
Economic implications:
One of the economic implications of the usage of insulin as a solution would be the cost of treatment and hospitalized care in result of not using insulin as a solution. This is because it is estimated that around £10 billion is spent by the NHS towards diabetes in general which is calculated to be approximately 10% of NHS entire budget. Additionally
The total cost (direct care and indirect costs) associated with diabetes in the UK currently stands at £23.7 billion and is predicted to rise to £39.8 billion by 2035/6. Now if this data shows the current spending in the UK involving all possible solutions i.e. all types of insulin then you could imagine the even more amount of money hospitals would have to spend on the numerous amount of people as treatment and hospitalized care.
Prevalence of diabetes in the WHO South-East Asia Region
However they would a negative economic implication for the use of insulin, for example in places where poverty is at its largest and where the spending towards insulin would be perhaps very less. Such as in country suppose India where in the year 2000 we can see that the population of people diagnosed with diabetes is around a staggering amount of 31,705,000. We would assume that the countries spending towards diabetes would be quite high however that it was third of the world’s poorest country. The graph below shows:
From these statistics we can come to a judgement on how although insulin is a cheaper alternative than regular hospital treatment it would still remain useless in poverty stricken countries such as Indian where insulin would not be financially capable for a household.
Alternative treatments:
Diabetes diet (Blood sugar management)
- A suggested treatment that reduces the chance of diabetes either occurring or becoming more severe would be to continue a diet plan that helps weight loss where blood sugar is kept on a monitored and regular check. This is because it helps to improve insulin resistance for patients with pre- diabetes (type 1). In addition the American Diabetes Association (ADA) identified how resisting as much as possible Carbohydrate and fat intakes will help to increase the rate of weight loss.
-
Moreover the intake of omega-6 fatty acids which can found in for example sunflower, safflower, corn, and soybean oils as well as nuts and seeds help reduces the risk of the problems and outcomes of type 1 diabetes. This is because theses fatty acids are known to be polyunsaturated fatty acids which are overall good for the heart (reduces the build of cholesterol as these fats can be broken down) and the overall health. Also the ADA confirmed from their research and analysis how the intake of omega-6 fatty acids also improves insulin resistance.
Although this form of treatment is very natural and cost-effective, it’s is only effective in sense to reduce the chances of major complications, symptoms and problems that occurs after being affected diabetes, therefore the it is not very beneficial in actually reducing the chances of diabetes occurring.
Insulin pump
An insulin pump helps to improve blood glucose control and hypoglycaemic episodes than multiple injections. The pump comes into action during the sudden rise of blood glucose in the morning and allows quick reductions of blood glucose levels for specific situations, such as exercise. It does this by the catheter, at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes; delivering a varied dose of fast-acting insulin continually throughout the day and night, at a rate that is pre-set according to the body’s needs and the situation. Although this form of treatment helps to regulate and control blood glucose levels in the most effective way; the pumps are more expensive than insulin shots and occasionally have some complications, such as blockage in the device or skin irritation at the infusion site, hence not making it the most cost-effective and comfortable choice of treatmentfor a patient.
Supplementary drugs for hyperglycaemia
An example of this drug would be Pramlintide (Symlin), this drug is injected into the body before the intake of a meal and it takes action within the body approximately 3 hours after the meal intake. This drug helps the sudden rise in blood sugar levels after the intake of a meal, in other word it is used for improved blood glucose level control. Pramlintide and insulin are the only two drugs approved for treatment of type 1 diabetes; also Side effects may include nausea, vomiting, abdominal pain, headache, fatigue, and dizziness. This means the drug isn’t a very common drug as it has only been approved recently so patients maybe quite unsure to use it as a treatment, but also as the drug has more side effects in comparison to insulin, so it wouldn’t be the safest choice of a treatment.
Conclusion:
Thousands of patients including both children and adults are diagnosed with type 1 diabetes all over the countries including both more economically developed countries such as Britain and the U.S.A to less economically developed countries such as India and Bangladesh, out of which most experiencing the severe problems of the diseases even the most fatal outcome of death. There are several treatments for this disease ranging from treatments such as insulin that has been available since the very beginning of the diseases up until new formed drugs such as Pramlintide (Symlin), however alongside the fact that either the treatments aren’t very cost- effective e.g. insulin pumps or isn’t the most effective or safest such as Pramlintide (Symlin); there hasn’t been a treatment that completely stops type 1 diabetes from occurring or cures it after the patient becomes affected by it. All the treatment mentioned above only help to regulate blood sugar levels, by improving the resistance and control of insulin within the body for a type 1 diabetes patient or helps to reduce the chances of major fatal outcomes and complications that the disease can lead to. Therefore although there are treatments currently available which effectively treats diabetes and helps to reduce the chances of major complications of the disease to develop; ultimately there is no developed cure for the disease that can either fully stop it from taking place within the body or cure once the persons developed it.
Bibliography
-
-
- Source 1 is from an online website set up by a large charity organisation called Diabetes UK. This is the source from which most of my key statistics and data towards diabetes and the figures of people diagnosed with and other data within the investigation was collected from. The organisation collects and records the data from major health services and organisations such as NHS as well as international data from larger organisations such as International diabetes federation – Diabetes Atlas, who record collective data from regions of countries, hence making sure that the data that I am using is reliable and accurate. Additionally the information and data is updated every year in order to ensure that data matches the matches the current times and situations, hence also increasing the accuracy of the data.
-
Source 5 is from a educational website and it is where i have collected and gathered my partial information on the symptoms, causes and risks of type 1 diabetes alongside the possible treatments and how they work within the body. This source would be reliable as it referenced by A.D.A.M (American Accreditation HealthCare Commission) which is an incorporation that follows rigorous standards of quality and accountability on health information and data, additionally the information within the website has been reviewed by qualified teachers and professors of medicine e.g. Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts, hence increasing the reliability. However the possible downfall of the source would be that it was last reviewed on: 5/5/2009, so the data does not match the current times. However the source was still useful and accurate because I only gathered my knowledge on qualitative data on how insulin works and the symptoms of diabetes and not quantitative data such as statistics which is affected by data at which it was collected.
- Finally source 2 is from an online encyclopaedia and is where I attained my diagrams in relevance to the human body and internal organs plus their functions. The reason why the source is reliable as it updated and referenced by David Darling himself who is a qualified astronomer who has also collected the data of other encyclopaedias written by famous scientists and biologist, hence increasing the reliability of the source. Additionally the source was last updated on: 12/08/12, therefore this means that the data would be more accurate as it was updated until the most current year and situations.
