Diabetes

Diabetes is a chronic condition which occurs when the body is unable to properly use the insulin it produces or cannot produce adequate insulin. Diabetes results in high glucose levels which are can damage the nerves, blood vessels, and organs. The body depends on insulin as a source of energy. Diabetes is a global health concern. The American Diabetes Association (ADA) states that about 30.3 million American have been diagnosed with diabetes (Inzucchi et al. 2015). The risk of developing diabetes increases with age with many cases being reported in individuals aged 65 years and above. About 1.5 million new cases are diagnosed with diabetes every year. Diabetes was the 7th leading cause of death in the USA in 2015 (Inzucchi et al. 2015). This paper seeks to discuss the differences between types of diabetes, medications used to treat type 2 diabetes, and impacts of diabetes.

Differences between the Types of Diabetes

Type 1 Diabetes

Type 1 diabetes is the most chronic form of diabetes. It is also called insulin-dependent diabetes. Although diabetes type 1 can develop at any age, it is more prevalent at childhood and teenage thus sometimes known as “juvenile” diabetes. This condition occurs when the body’s immune system attacks the pancreas. In patients with type 1 diabetes body mistakenly recognizes the islets which secrete insulin as foreign and destroys them. This form of attack is known as autoimmune disease. The islets recognize the presence of glucose in the blood and secrete the required amount of insulin to normalize blood glucose (Hayashino et al. 2017).

Type 2 diabetes

Type 2 diabetes also known as non-insulin dependent diabetes and is the most common form of diabetes.  Type 2 diabetes develops when the body does not secrete enough insulin or cannot use insulin properly when it is released. This condition results in a buildup of glucose instead of it being used as energy. Hayashino et al. 2017 argue that type 2 diabetes is the most prevalent form of diabetes and about 90% of individuals with diabetes have this condition. Although type 2 diabetes can affect any individual of any age, it is more common in adults above 35 years hence known as onset diabetes. Type 2 diabetes can be managed through medications, diet and physical activity depending on the severity of the condition. These interventions help to control blood sugar effectively.

Gestational diabetes

It a temporary condition which occur during pregnancy. It is estimated that 3-20% of pregnant women are at risk of developing gestational diabetes depending on their risk factors (Hayashino et al. 2017). Gestational diabetes predisposes the mother and the child for developing type 2 diabetes in future.

Common differences between type 1 and type 2 diabetes

  1. Type 1 diabetes usually develops during childhood while type 2 diabetes is often diagnosed in individuals aged 30 years and above.
  2. Type 2 diabetes is associated with obesity and excess body weight which is not the case for type 1 diabetes.
  • Type 1 diabetes is managed with an insulin pump or insulin shots while type 2 diabetes is initially treated without medication or tablets.
  1. Type 1 diabetes cannot be controlled without insulin injection while in type 2 diabetes is possible to come off diabetes medication.

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Treatment of Type 2 Diabetes

Although some people can achieve their targets for blood sugar levels with exercise and diet alone, many diabetes patients may also need diabetes medication or insulin therapy. However, the decision on the administration of drugs depends on many factors such as blood glucose levels as well as other health problems which the patient may be having. An example of a possible medication which prescribed to manage type 2 diabetes is metformin (Bowling, Rashid & Boulton, 2015). Metformin works through enhancing the sensitivity of the body tissues on insulin. Once this sensitivity is improved, the body can use insulin more effectively. Metformin tablets are administered orally. It should be taken with meals to help minimize bowel or stomach side effects which are likely to occur during the first weeks of treatment.  The dietary considerations during treatment of diabetes type 2 include carbohydrates from whole grains, vegetables, fruits, and low-fat milk.

Short-term and Long-term Effects of Type 2 Diabetes

The short-term effects occur if levels of blood sugar go too high or too low for the body to function appropriately in the current state. These short-term complications manifest immediately and can pose an immediate danger and thus need to be addressed immediately to avoid adverse effects (Bowling, Rashid & Boulton, 2015). The short-term impacts of diabetes include hypoglycemia, ketoacidosis and hyperosmolar hyperglycemic state (HHS).  Hypoglycemia is a condition characterized by low levels of glucose while ketoacidosis occurs when the body takes a long time with too little insulin to energize the body cells. HHs is a condition in diabetes type 2 individuals characterized by high blood sugar levels and can lead to dehydration, fever confusion, and even coma (Cusi et al. 2016).

The common long-term effects of diabetes include damage of large blood veins of the brain, the heart, and the legs. Other complications include damage to the small blood vessels resulting in complications in the nerves, feet, kidneys, and in the eyes. Damage to these blood vessels causes retinopathy, neuropathy, and nephropathy (Cusi et al. 2016). Other long-term complications include compromised immune system, erectile dysfunction in men, skin and digestive system complications. Drugs used to manage diabetes can also have complications. For instance, Metformin can is associated with tiredness, stomach upset, mental taste, dizziness and kidney complications (Bowling, Rashid & Boulto, 2015).

References

Bowling, F. L., Rashid, S. T., & Boulton, A. J. (2015). Preventing and treating complications associated with diabetes mellitus. Nature Reviews Endocrinology, 11(10), 606.

Cusi, K., Orsak, B., Bril, F., Lomonaco, R., Hecht, J., Ortiz-Lopez, C.,   & Webb, A. (2016). Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial. Annals of internal medicine, 165(5), 305-315

Hayashino, Y., Izumi, K., Okamura, S., Nishimura, R., Origasa, H., Tajima, N., & JDCP study group. (2017). Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: The Japan Diabetes Complication and its Prevention prospective study 3 (JDCP study 3). Journal of diabetes investigation, 8(2), 243-249.

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.

Read PDF : Diabetes and Drug Treatments

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