In the U.K
An estimated 1.4 million people in the UK are known to have diabetes, with possibly up to a million more undiagnosed.
An estimate of the costs of insulin dependent type 1 diabetes in England and Wales put the direct costs at £96 million and the indirect costs at £113 million.
Overall, estimates suggest that diabetes costs the NHS at least £2 billion every year - 8 per cent of total hospital spending. More than half of this sum is spent treating the complications of the disease, and 10 per cent of hospital beds are occupied by people with diabetes.
Insulin and glucagon and how it works . . .
Insulin and glucagon have opposite effects on the liver for controlling blood glucose levels. When you eat food, glucose gets absorbed from your intestines and spread around the body by the bloodstream to all of the cells in your body.
The hormones insulin and glucagon are produced by the islets of Langerhans in the pancreas. Insulin is produced by beta cells and glucagon is produced by alpha cells.
Insulin is secreted when the level of glucose in the blood rises above normal. The insulin stimulates the liver to remove glucose from the blood by changing the glucose into glycogen. The glycogen is then stored in the liver and muscles.
Glucagon is secreted when the level of glucose in the blood drops below normal.
The glucagon makes the liver to break down the glycogen and to release glucose back into the blood. Glucose is a simple sugar that provides energy to all of the cells in your body.
The causes . . .
Type 1 diabetes
Type 1 Diabetes usually develops when the body's immune system behaves incorrectly and starts seeing one of its own tissues as foreign. In the case of Type 1 Diabetes, the islet cells of the pancreas that produce insulin are seen as the foreign tissue by mistake. The body then creates antibodies to fight the so called foreign tissue and makes the islet cells incapable to produce insulin. Not having enough insulin results in diabetes. It is unknown why this diabetes develops. Most often it is a genetic trend. Sometimes it follows a viral infection such as mumps, rubella, measles, influenza or polio. Some people are more genetically prone to this although why this occurs is unknown. Other rare causes of Type 1 Diabetes include injury to the pancreas from toxins, trauma, or after the surgical removal of the majority (or all) of the pancreas.
Type 2 diabetes
Development of Type 2 diabetes seems to be due to a number of issues to. Genetic susceptibility seems to be the strongest factor. Obesity and high caloric intake seem to be another. Twenty percent of people with this Type 2 Diabetes have antibodies to their islet cells which are obvious in their blood resulting in the expected low levels of insulin, suggesting the possibility of incomplete islet cell damage. These patients often tend to respond early to oral drugs to lower blood sugar but may need insulin at some point. Insulin is normally
The symptoms . . .
Type 1 . . .
- Dry mouth
- Always really thirsty
- Needing the toilet a lot, especially at night
- Weight loss
- Weakness or fatigue
- Blurry vision
Type 2 . . .
- Blurry vision
- Cuts or sores that take a long time to heal
- Itching skin infections
- Always thirsty
- Dry mouth
- Needing the toilet a lot, especially at night
- Leg pain
Diabetes tests . . .
There are three possible different tests for diabetes: Random glucose test is where glucose levels are taken at a random time (which could be as soon as you wake up in the morning or could be just before you go to bed) on two occasions. Any figure above 11.1mmol/l is a diagnosis of diabetes. Fasting glucose test is where the glucose level is measured after an overnight fast and on two different days. Above 7.0mmol/l is a diagnosis of diabetes. Finally a Glucose tolerance test can be carried out if the above tests are unclear. This is where a glucose drink is given containing a standard amount of glucose (75g). Blood samples are taken before the drink is given and another one two hours later. You may only need to give one blood sample if you have other symptoms of diabetes. The test is done after an overnight fast. A two-hour blood glucose level above 11.1mmol/l is a diagnosis of diabetes.
A level below 7.8mmol/l is normal.
How is diabetes treated . . .
The basic aim of diabetes treatment is to keep blood glucose as normal as possible. This is achieved in two main ways:
- A combination of healthy diet and exercise
- Medication with tablets or insulin
Controlling blood sugar levels not only reduces the symptoms of diabetes, but also helps to prevent the long term harm that raised blood sugar can do to the kidneys, eyes, nerves and circulation.
Monitoring blood sugar levels is an important aspect of treatment, especially for those with Type 1 diabetes who can experience rapid changes in blood glucose levels.
Diet and exercise can help all types of diabetes, but has a direct effect on controlling .
It's now believed a normal well-balanced diet is best for diabetes. The principles of healthy eating are:
- Eat regular meals (to prevent dips and spikes in blood sugar)
- Cut down on high sugar foods
- Reduce fat intake
- Cut down on salt
- Eat at least five portions of fruit and vegetables a day.
Regular exercise helps all types of diabetes and provides many benefits, including reducing your risk of cardiovascular disease.
Many people with Type 2 diabetes are overweight and find it difficult to lose weight. If diet and exercise don’t produce sufficient weight loss, your doctor may consider prescribing an anti-obesity medicine.
Insulin treatment
For people with , and some with Type 2 diabetes, insulin treatment is needed to increase the insulin level in the blood and bring down the blood glucose level.
There are various types of available:
- Those that act quickly and last for a short time
- Those that act more slowly and provide control of blood glucose levels throughout the day.
The amount of insulin used needs to be balanced against the amount you eat and how much exercise you do.
Insulin can’t be taken by mouth because the digestive enzymes in the gut break it down. Oral insulin is presently being researched but it is not available for routine clinical use. As it cannot be taken orally insulin is usually delivered by a simple injection. This may sound scary but it is part of daily life for those suffering from diabetes.
Genetic engineering . . .
Genetic engineering is a technique where you can isolate genetic material from organisms, then cut and rejoin it to make new combinations, multiplying copies of the recombined genetic material and transferring it into organisms. Genes can be exchanged between species that would never interbreed in nature. E.g. spider genes can end up in goats, human genes in plants and mice, and bacterial genes in plants.
Microorganisms can be genetically engineered to make different medicines, such as insulin. Doing this makes insulin accessible in large amounts to treat people who are diabetes sufferers.
There are advantages and disadvantages of genetically engineering insulin. These are shown below:
Advantages
- It is a perfect match to your body if your own cells are replicated, rather than using animals
- You are a lot less likely to have an allergic reaction
- It can be made in larger quantities
- Strict vegetarians can use it because no animals are involved
Disadvantages
- It isn’t natural
- There are side effects of using genetically modified insulin like weight gain and memory loss.
History . . .
Supposedly diabetes started approximately 1550 BC. An Egyptian papyrus mentions a rare disease that causes someone to lose weight rapidly and need to go to the toilet all the time. This is thought to be the first reference to the disease.
By early 19th Century, chemical testing found a way where it was possible to detect excess sugar in urine. Despite therapies being proposed it proved unsuccessful due not having a cause. It was not until the Franco-Prussian War, when finally a French Physician realised that a healthy diet helped sufferers.
Close to this period microscopic studies by a medical student had revealed composition of the pancreas. He identified tiny island cells but the function was unknown.
It was then not until 1920 that an American called Moses Barron linked the Langerhans cells with the basics of diabetes mellitus.
Picking up on the research of Barron, a doctor called Frederick Banting who then done some experiments linking the pancreas and diabetes. He discovered an essential hormone called insulin, named after the ‘islands’ of cells described by Langerhans.
Throughout the 20th century, treatment of the disease has advanced significantly. Although prevention remains difficult, the life of an average diabetic is becoming both longer and easier all the time.
But before all the discoveries it was very hard to cope with diabetes.
Critique . . .
The target audience my leaflet is for all people over 10 that are suffering with diabetes or the families that are living with a sufferer. If the leaflet was for anyone under the age of 10 I think they would find it confusing. I think all but one of the websites I used were trustworthy, I know that they were trustworthy because I crossed referenced them with at least one other website. The one website I thought wasn’t 100% trustworthy was because I was unable to find another website to cross reference it with any other websites. In relation to this project I talked quite a lot to one of my mum’s patients who are suffering from diabetes. Although I didn’t use much information from her in my leaflet I wanted to have an understanding of what it is like to be suffering from a life threatening disease.