The ‘lousy’ killer (1)

The scene

Mr HY used to be a happy man until about 8 months ago when a sudden twist of events turned his world upside down. The outset was gradual, starting with having to visit the rest room repeatedly, of course this set tongues wagging in his office; one said ‘’na gonorrhea’’ another said ‘’it’s urine infection or STD’’!  He also takes water excessively and eats gluttonously but ironically lost weight despite the excessive eating. The weight loss was really marked and continued to worsen over time, so are the other symptoms of frequent/excessive urination, excessive water intake and excessive eating. The tale bearers continued to have a field day; ‘’it’s AIDS’’  ‘’na cancer’’ ‘’na conc. Yellow fever’’ ‘’na typhoid’’

He was offered all sorts of ‘’remedy’’ but didn’t get better…what could this be?

What is diabetes mellitus?

Hypertension is globally known as a silent killer majorly because many people with high blood pressure don’t even know they have it. Often the signs and symptoms are misunderstood. But not so for Diabetes, it comes announcing its presence, though the person might not know exactly what is wrong but he/she knows that something is wrong! Hence the ‘’lousy’’ designation which is entirely that of yours faithfully.

Diabetes mellitus is a chronic (long term) non communicable disease in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body.

Blood sugar and health

Sugar (glucose) is an important source of energy

What is eaten is absorbed into the blood

Insulin is produced by the pancreas when the blood sugar is high

Insulin keeps blood sugar level within the normal range for health

The genesis

Every cell in the human body needs energy in order to function.

The body’s primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches).

Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas (an organ located behind the stomach). Insulin bonds to a receptor site on the outside of cell and acts like a key to open a doorway into the cell through which glucose can enter. Some of the glucose can be converted to concentrated energy sources like glycogen or fatty acids and saved for later use. When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather entering the cells.

The body will attempt to dilute the high level of glucose in the blood (a condition called hyperglycemia) by drawing water out of the cells and into the bloodstream in an effort to dilute the sugar and excrete it in the urine. It is not unusual for people with undiagnosed diabetes to be constantly thirsty, drink large quantities of water, and urinate frequently as their bodies try to get rid of the extra glucose. This creates high levels of glucose in the urine.

At the same time that the body is trying to get rid of glucose from the blood, the cells are starving for glucose and sending signals to the body to eat more food, thus making patients extremely hungry.

To provide energy for the starving cells, the body also tries to convert fats and proteins to glucose.

The breakdown of fats and proteins for energy causes acid compounds called ketones to form in the blood. Ketones also will be excreted in the urine. As ketones build up in the blood, a condition called ketoacidosis can occur.

Types

Type 1 diabetes

In this form of diabetes, the body produces little or no insulin.

Sometimes, begins most commonly in childhood or adolescence.

It is characterized by sudden onset

   

Type 2 diabetes

The more common form of diabetes

It is characterized by slow onset

People who have migrated to Western cultures are more likely to develop Type II diabetes than those who remain in their original countries.

Also regarded as Adult-onset diabetes

It is considered a milder form of diabetes

Gestational diabetes

Another form of diabetes called gestational diabetes can develop during pregnancy and generally resolves after the baby is delivered.

How common is diabetes?

There is an increasing prevalence worldwide. Over 5 million people suffer from the disease in Africa and the number is expected to jump to 15 million by 2025. According to data published in 2006 by the International Diabetes Federation, the number of people suffering from diabetes worldwide in 2007 is ~246 million. It is projected that by 2025 this number will rise to >380 million, with most of the increase occurring in developing countries. Type 2 diabetes mellitus represents ~90–95% of cases

Causes

The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors passed on in families) and environmental factors involved.

In Type I diabetes, the immune system, (the body’s defense system against infection), is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin.

In Type II diabetes, age, obesity, and family history of diabetes play a role.

Individuals who are at high risk of developing Type II diabetes mellitus include people who are;

obese (more than 20% above their ideal body weight) 

have a relative with diabetes mellitus   

belong to a high-risk ethnic population (African-American, Native American, Hispanic, or Native Hawaiian) 

have been diagnosed with gestational diabetes or have delivered a baby weighing more than 4 kg

have high blood pressure (140/90 mmHg or above)

  have had impaired glucose tolerance or impaired fasting glucose on previous testing

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