What is the Diabetes?

What is the diabetes

There is a big chance you'll meet someone with diabetes, possibly someone who needs to take insulin every day to control the disease. Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin (Type 1), or when the body can not effectively use the insulin it produces (type 2).

The hyperglycemia, or increased blood sugar, is a common effect of diabetes control without which, over time, leads to serious damage to various systems of the body, especially nerves and veins. The name "diabetes" means "sweet urine" and comes from ancient Greece, where the doctors tried the urine of patients as part of the diagnosis.

It affects 246 million people worldwide, according to World Health Organization, and has status of an epidemic aggravated by the increasing cases of obesity in adults and in children. Because of this, the organization chose the theme of the first global campaign against the disease, on November 14, 2007, "Diabetes in Children and Adolescents." Starting this year, the date shall be considered as the World Day to Combat Diabetes.

According to WHO, within 18 years the number of people living with diabetes must come to 380 million. The incidence among children is alarming. The type 1 diabetes grows about 3% per year among children and adolescents, and about 5% annually, among children of preschool age. The incidence is higher in children in Southeast Asia and Europe. Brazil occupies the seventh position in the ranking of countries with the largest number of diabetics, with 6.9 million registered cases. In 2025, it is estimated that the country will occupy the fourth position with 17.6 million people with diabetes.

In 2007, it is estimated that diabetes causes 3.8 million deaths around the world - about 6% of total deaths worldwide, almost the same as HIV / AIDS and malaria combined.

The losses by death or disability caused by the disease reaches 25 million years of life per year, according to the WHO, and 23 million years of life per year, respectively, according to the International Diabetes Federation. That is, no longer lived or experienced properly, according to the death or disability caused by diabetes, about 48 million years of life. The biggest problem of diabetes is diagnosed late or the wrong diagnosis. And the impact is even greater because, although people can live with the disease, the cause of death is often recorded as heart disease and kidney failure.

In poorer countries, people with diabetes and their families spend what they can with medical treatment. In India, for example, the poorest people with diabetes spend on average 25% of their income with treatment. And yet, with treatments to keep them alive. In Latin America and the Caribbean, the families pay for their own pockets 40% to 60% of the cost of diabetes - half of them only with regulated drugs to keep the blood sugar levels. Left very little for the purchase of drugs that prevent kidney failure, heart attacks, stroke and amputations.

Especially considering the effects of premature mortality, the WHO estimates that diabetes, diseases of the heart and stroke, combined, will cost (between 2005 and 2014):

U.S. $ 555.7 billion in China

U.S. $ 303.2 billion in Russia

U.S. $ 336.6 billion in India

U.S. $ 49 million in Brazil

U.S. $ 2.5 billion in Tanzania

Spending world with the treatment of diabetes are growing as fast as the world's population. In 2007, the world spent U.S. $ 232 billion to treat and prevent diabtes and its complications. In 2025, these expenses should ultrapssar the $ 302.5 billion.

Facts of the epidemic

  • Each year, 7 million people develop diabetes
  • Each year, 3.8 million deaths are directly linked to the disease
  • Every 10 seconds a person dies of diabetes or disease-related causes
  • Every 10 seconds, two people develop the disease

In the ranking of the ten countries with highest number of diabetics, seven are developing countries

More than 70% of diabetics in the world have between 40 and 59 years of age

Source: International Federation of Diabetes

To understand diabetes, you must first learn how your body uses a hormone called insulin to deal with glucose, a simple sugar that is its main source of energy. In diabetes, the body does not produce insulin or is not sensitive to it. Therefore, the body produces high levels of glucose in the blood producing the symptoms of the disease.

In this article we examine this serious disease. We will see how your body deals with glucose. Discover what is insulin and what she does, as the lack of it or insensitivity to it affects the functions of the body, producing symptoms of diabetes. We will see how well the disease is treated now and what will be the future treatment of diabetes.

Insulin, glucagon and blood glucose

Insulin, glucagon and blood glucose

Because diabetes is a disease that affects the body's ability to use glucose, we will start seeing what is glucose and how to control his body. Glucose is a simple sugar that provides energy for every cell of your body. The cells capture the glucose from the blood and breaks for energy. Some cells such as brain cells and red blood cells, depend only on glucose for fuel. The glucose from the blood comes from the food you eat.

A molecule of glucose

When you eat a food, glucose is absorbed by the intestines and distributed through the bloodstream to all cells of the body. His body tries to maintain a constant supply of glucose to cells, maintaining a constant level of glucose in the blood, otherwise the cells would have more glucose than necessary immediately after the meal and will be left without anything between meals and overnight. So when you have an excessive supply of glucose, the body stores the excess in the liver and muscle glycogen manufacturing, which is made of long chains of glucose. When the reserves of glucose are low, your body mobilizes the glucose stored as glycogen and / or encourages you to eat. The important thing is to maintain a constant level of glucose in the blood.

To maintain a constant level of glucose in the blood, your body depends on two hormones produced in the pancreas that have opposing actions: insulin and glucagon.

The pancreas has many islets that contain beta cells producing insulin and glucagon-producing cells alpha

Pancreas

His pancreas is located in the abdomen, below the stomach. It produces digestive enzymes that break down many foods (exocrine function) and hormones (endocrine function) that regulate the glucose in the blood.

Insulin is made and secreted by beta cells of pancreatic islets, small islands of endocrine cells in the pancreas. Insulin is a hormone protein that contains 51 amino acids. It is necessary for almost all cells of the body, but its main targets are the cells of the liver, fat cells and muscle cells. In these cells, the insulin does the following:

  • stimulates the cells of the liver and muscles to store glucose in the form of glycogen;
  • stimulates the fat cells to form fats from fatty acids and glycerol;
  • stimulates the cells of the liver and muscles to make proteins from amino acids;
  • prevents the cells of the liver and kidneys to make glucose from intermediate compounds of metabolic pathways (gluconeogenesis).

Thus, insulin stores the nutrients right after a meal, thereby reducing the concentration of glucose, fatty acids and amino acids in the bloodstream.

The insulin and glucagon have opposite effects on the liver and other tissues in controlling levels of blood glucose

Glucagon

In high concentrations, usually above the levels found in the body, the glucagon can act on the fat cells degrading the fats in glycerol and fatty acids, releasing the fatty acids in the bloodstream. However, this is not a physiological and pharmacological effect.

So what happens when you do not eat? When is fasting, the pancreas releases glucagon so that your body can produce glucose. The glucagon is another protein hormone made and secreted by cells of pancreatic islets alpha. The glucagon acts in the same cells that insulin, but have opposite effects:

  • stimulates the liver and muscles to break the glycogen stored (glycogenolysis) and release glucose;
  • stimulates gluconeogenesis in the liver and kidneys.

Unlike the insulin, glucagon mobilizes the reserves of glucose from inside the body and increases the concentration of glucose in the bloodstream, otherwise the glucose in your blood drops to dangerously low levels.

And as your body know when to secrete insulin and glucagon? Normally, levels of insulin and glucagon are balanced in the bloodstream. For example, soon after eating a meal your body is ready to receive the glucose, fatty acids and amino acids absorbed from food. The presence of those substances in the intestine stimulates the beta cells of the pancreas to release insulin in the blood and prevent the cells from pancreatic alpha secreted glucagon. The levels of insulin in the blood begin to rise and act on the cells (especially the liver, fat and muscle) to absorb the molecules of glucose, fatty acids and amino acids that are coming. This action of insulin prevents the concentration of glucose in the blood (as well as the concentrations of fatty acids and amino acids) increase substantially in the bloodstream. That way, your body maintains a constant level of blood glucose in particular.

On the other hand, when you are between meals or sleeping, your body is essentially in starvation. Your cells need a supply of glucose from the blood to continue working. During these periods, small drops in blood sugar levels stimulate the secretion of glucagon by pancreatic alpha cells and inhibit the secretion of insulin from beta cells. The levels of glucagon in the blood increases. He acts on the tissues of the liver, kidneys and muscles to raise from glucose or glycogen to glucose in the blood that is released. This action prevents the concentration of glucose in the blood drops dramatically.

As you can see, the exchange between the secretion of insulin and glucagon during the day helps keep the concentration of glucose in your blood, getting around 90 mg per 100 ml of blood (5 milimoles).

Glucose tolerance test

The glucose tolerance test is a screening test for diabetes. After spending the night in fasting, you pick a fasting plasma glucose and gets to drink a solution with high concentration of sugar (75 g of glucose) is harvested and new blood glucose after 2 hours. The test tolerĂȘncia oral glucose is considered positive when the glucose level is above 200 mg / dl after 120 minutes. Normally, the glucose goes up a lot and not returned to normal after two to three hours. In a diabetic, the blood glucose is generally higher after fasting, rises more after ingesting the solution of glucose and takes four to six hours to descend.

Diabetes

Now that you know how your body deals with glucose using insulin and glucagon is ready to understand diabetes. Diabetes is classified into three types: Type 1, Type 2 and gestational.

Animal models

Scientists can study the type 1 diabetes in rats or mice injecting them an antibiotic called streptozotocin, which destroys the beta cells to produce diabetes. The type 2 diabetes can be imitated in a genetically modified strain of mice that become obese and diabetic patients with their age.

Type 1, also called juvenile diabetes or insulin-dependent diabetes, is caused by a lack of insulin. This type is found in 5% to 10% of diabetes and usually occurs in children and adolescents. The type 1 diabetes have a glucose tolerance test positive and fasting plasma glucose levels. In type 1 diabetes, the beta cells of pancreatic islets are destroyed, possibly by the individual's own immune system or by genetic or environmental factors.

Type 2, also called the adult diabetes or insulin-dependent diabetes not, occurs when the body does not respond to its own insulin (insulin resistance). The Type 2 occurs in 90 to 95% of diabetics and usually in adults over 40 years, most often between 50 and 60 years of age. The type 2 diabetes have a glucose tolerance test positive and high fasting plasma glucose. In type 2 diabetics the insulin resistance is linked to obesity, probably by a change in sensitivity and the number of insulin receptors. Some studies suggest that the number of insulin receptors in cells of the liver, fat and muscle is reduced, while others suggest that the intracellular pathways activated by insulin in these cells are altered.

Gestational diabetes can occur in some pregnant women and is similar to type 2 diabetes. The gestational diabetes have a glucose tolerance test positive and fasting plasma glucose. During pregnancy, several hormones partially block the action of insulin, thus leaving the woman less sensitive to its own insulin. She develops a diabetes that can be treated with a special diet and / or additional injections of insulin. Generally, the problem disappears after the baby is born.

Regardless of the type of diabetes, the diabetic patients display several, but not necessarily all of the following symptoms:

  • excessive thirst (polydipsia)
  • frequent urine (polyuria)
  • extreme hunger (polyphagia)
  • unexplained weight loss
  • presence of glucose in urine (glycosuria)
  • tiredness or fatigue
  • changes in vision
  • numbness or tingling in the extremities (hands and feet)
  • take to heal wounds and bruising
  • frequency of infections higher than normal

These symptoms can be understood when observed as a deficiency of insulin or insulin resistance affects the physiology of the body.

The insulin ineffective

The insulin ineffective

Now that you recognize the symptoms of diabetes (high blood glucose, hunger and excessive thirst, frequent urine) let's see what happens to your body during diabetes. To facilitate the discussion, suppose you have a diabetes was not diagnosed and therefore is not being treated.

The high level of blood glucose in diabetes produces glucose in urine and makes a person urinate frequently by the osmotic effect of kidney

Let's see how the lack of insulin or insulin resistance affects your body to produce the clinical signs and symptoms of diabetes.

- Directly cause high levels of glucose in the blood during fasting and after a meal (low glucose tolerance).

- Your cells do not absorb glucose from the bloodstream, which means that you have high levels of glucose in the blood.

- How has no glucose from the blood into cells, the body "thinks" that is starving.

- Your alpha cells of the pancreas to secrete glucagon and glucagon levels in the blood increases.

- Glucagon acts in the liver and muscles breaking the glycogen stored and releasing glucose in the blood.

- The glucagon also acts in the liver and kidneys to produce and release glucose through gluconeogenesis.

The two actions of glucagon further increase the levels of glucose in the blood.

The high level of glucose in the blood makes it appear glucose in your urine:

  • high levels of glucose in the blood increases the amount of glucose filtered by your kidneys;
  • the amount of glucose filtered exceeds the amount that the kidneys can eliminate;
  • the excess of glucose in urine is lost and can be detected by measuring glucose in strips. See How about the kidney filtration and reabsorption.

The high level of glucose in the blood gets you urine frequently:

  • The high level of glucose in the blood increases the amount of glucose filtered by the kidneys;
  • as the filtered load of glucose in the kidneys exceeds the amount that these can absorb the glucose stays within the tubular lumen;
  • glucose in the tubule retains water, which increases the flow of urine through the duct;
  • increasing the flow of urine gets you urine frequently.

The lack or insulin resistance acting on many organs, producing a variety of purposes

The high level of glucose in the blood and increase the flow of urine do you get constantly thirsty:

  • high levels of glucose in the blood increase the osmotic pressure of the blood and stimulate the receptors directly to headquarters in his brain;
  • the increase in the flow of urine makes you lose sodium body, which also stimulates the receptor thirsty;
  • you are constantly hungry. It is unclear exactly what stimulates hunger of the centers of the brain, possibly, a lack of insulin or the high levels of glucagon;
  • you lose weight despite being eating more frequently. The lack or insulin resistance directly stimulate the degradation of fat in fat cells and proteins in muscles, leading to weight loss;
  • the metabolism of fatty acids leads to the production of ketone bodies released (ketoacidosis), which can lead to respiratory problems, smell of acetone on your breath, irregularities in his heart and central nervous system depression, which leads to coma;
  • you feel tired because their cells are unable to absorb glucose, leaving them without fuel for energy;
  • the high levels of blood glucose increase the osmotic pressure of their blood;
  • osmotic pressure increased attracts water tissue, causing become dehydrated;
  • the water from your blood is lost in the kidneys through urine, which decreases the blood volume;
  • a reduction in blood volume makes your blood thicker (higher concentration of red blood cells), with a consistency similar to the syrup and more resistance to flow (poor circulation);
  • the poor circulation of blood causes numbness in hands and feet, changes in vision, the wounds slow to heal and you have frequent infections. The high level of glucose in the blood may also depress the immune system. Finally, this can lead to gangrene and members of blindness.

Fortunately, you can deal with those consequences correcting the high blood glucose through diet, exercise and medication, as discussed below.

TREATMENTS - DIABETES

Treatments

To date there is no cure for diabetes, but the disease can be treated and managed successfully. The key to treating diabetes is to carefully monitor and control the levels of glucose in the blood through exercise, diet and medication. The treatment regimen depends on the exact type of diabetes.

Blood-glucose meters

To monitor blood glucose, glucose meters for many on the market. The test is done reacting to a test strip with a drop of blood (taken from the fingertip). The glucose from the blood chemically reacts with an enzyme of the strip to test called a glucose oxidase. The product of the reaction, gluconate, it combines with another chemical so that the strip is blue. The device measures the change in color and show to determine the concentration of glucose in the blood sample. Currently, there are more modern equipment available by law to use insulin to diabetics in the SUS that from a drop of blood, estimate the value of blood glucose with high precision. They call themselves glicosĂ­metros.

A blood-glucose meter commercial

If you have type 1 diabetes, lacks insulin and need to inject it several times a day. The injections of insulin are usually planned next meals to handle the load of glucose from digestion. You need to monitor their blood glucose levels several times a day and adjust the amounts of insulin that spits in accordance with the results. This prevents the concentration of glucose in the blood fluctuate too much.

Preventing diabetes

The type 2 diabetes can be prevented or reduced by regular physical exercises and taking care of the weight, especially as you get older. Get tested for diabetes risk (in English) to determine their risk of developing the disease.

A few of insulin infusion pumps, implantable that let you push a button and gives insulin. If you inject too much insulin, can lower their level of blood glucose to below normal (hypoglycemia). This can cause dizziness and shivering because their brain cells are not getting enough glucose (mild episodes can be relieved sucking taking a bullet or a juice). If the blood glucose really fall too much, you may want to eat (as hypoglycemic), a condition that can be fatal. In addition to the injections of insulin, you need to watch your diet to control content in carbohydrates and fats and precise practice frequently. Such treatment continues for the rest of his life.

If you have type 2 diabetes, can deal with it by reducing body weight through a diet and exercise. You will need to monitor blood glucose daily or only when you visit your doctor. Depending on the severity of his diabetes, you may need to take medications that help to control blood glucose. Most drugs for type 2 diabetes are oral medications and action falls into the following categories:

  • stimulate the pancreas to release more insulin to help reduce glucose in the blood;
  • interfere with the absorption of glucose by the intestine, thus preventing the entry of glucose in the bloodstream;
  • improve sensitivity to insulin;
  • reduce the production of glucose by the liver;
  • help to degrade or metabolize glucose;
  • supplement the insulin directly into the bloodstream through injections.

As with type 1 diabetes, the type 2 diabetic treatment remains that the rest of their lives.

Research on diabetes

Researchers from Duke University Medical Center announced in June 2001 that "insulin-producing cells of the pancreas of pigs, especially encapsulated, have kept a diabetic baboon without needing insulin for more than nine months." Since the treatment, levels of insulin from the baboon have remained normal and the animal did not need additional therapy with the cells of pancreatic islets.

According to the head of the transplant of cells of pancreatic islets of the University, Dr. Emmanuel Opara, they have hope that this finding to end insulin injections for millions of people take daily for the treatment of type 1 diabetes. The research may also benefit a small number of type 2 diabetics who require daily injections of insulin because they are unable to process insulin properly.

A good number of alternative treatments for diabetes. These alternative treatments are not widely accepted, mainly because of the lack of scientific research regarding the effectiveness or lack of scientific consensus. These treatments include:

acupuncture - this is an oriental medical treatment, where needles are inserted into several centers of the body to release natural painkillers, which can help deal with the pain caused by damage to nerves that occur in diabetes;

biofeedback - this technique involves the use of psychological meditation, relaxation and stress-reduction methods to address and alleviate the pain;

chrome - an addition of chromium in the diet to help your body to produce a glucose tolerance factor that helps improve the action of insulin. However, scientific information on the supplementation of chromium in diabetes are inadequate and there is no consensus about;

Magnesium - the diabetics tend to be deficient in magnesium, which may worsen complications of diabetes, especially type 2. The exact nature of the relationship between magnesium and diabetes is still being investigated and not reached a consensus;

Vanadium - the vanadium can normalize the blood glucose in animals with diabetes Type 1 and 2 but not enough information available to humans. This area is currently being investigated.

Note: none of these treatments are proven. The acupuncture and biofeedback can improve the pain but not treat the disease. The diabetes should be treated with diet and medications already cited in the text.

Like any medical treatment, you should discuss the options with your doctor. For more information on alternative treatments, see the newsletter of the NIDDK (organ of American health linked to diabetes and other diseases) Alternative therapies for diabetes (in English).

One of the most promising developments for future treatments and perhaps standing of Type 1 diabetes is the transplantation of pancreatic islets. In this technique, the islets are removed from the pancreas of a dead donor and injected through a thin tube (catheter) within the liver of a diabetic patient. After some time, the islet cells bind to new blood vessels and begin to release insulin. Although the initial studies have shown some success, the rejection of donor tissue is a major problem. The search continues in that field because of its great potential in the treatment of diabetes.

To learn more about diabetes and related topics, check out the links on the next hubpage.

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Comments 2 comments

BkCreative profile image

BkCreative 7 years ago from Brooklyn, New York City

Quite thorough - thanks.

I'm convinced Americans have the highest rate of diabetes - much of it related to our very poor diet and obesity. It's epidemic here!


Home Remedies 6 years ago

The biggest problem of diabetes is diagnosed late or the wrong diagnosis. And the impact is even greater because, although people can live with the disease, the cause of death is often recorded as heart disease and kidney failure.

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