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Alex Oliver

Anatomy & Physiology II

Professor Craner

April 16, 2014

Diabetes Mellitus Type I

There are many diseases that have infiltrated the human population throughout

its existence. Diseases can sneak up on people and infiltrate their bodies without

warning at any time. One disease that does not discriminate who it infects, no matter

someone’s age, sex or race is Diabetes Mellitus Type I; more commonly known as Type I

diabetes.

History and Definition

To understand Diabetes Mellitus Type I in its entirety, a person must first

become familiar with the origination and history of this infectious disease. (Guthrie D.

and Guthrie R., 1999) The word diabetes originates in Greece and is defined as to

siphon, and in the case of this disease, it means to get rid of sugar in the body. The

word mellitus is a Latin word that has been defined as sweet tasting, referring to

glucose. In ancient Egypt, people were diagnosed with diabetes depending on how

sweet of a taste their urine possessed (Guthrie and Guthrie, 1999). Contrary to popular

belief, diabetes is actually a group of diseases that work in unison due to sharing the

same trait of having high glucose, otherwise known as high blood sugar (Izenberg et al.,

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2003). Those who are unfamiliar with diabetes believe it to be a singular disease, which

is a common error.

Etiology

With Type I diabetes being around for this long, there has been an abundance of

information found to try and help explain the cause of it. (Izenberg et al., 2003) When

the pancreas is producing insufficient insulin or if it is not secreting any insulin

whatsoever, diabetes is developed over time. Type I diabetes can take anywhere from

months to years to be contracted. This is believed to develop because of genes encoded

in a person’s DNA, and or environmental triggers. The gene for Type I diabetes is

inherited through biological parents. As for environmental triggers, these are defined as

a virus which causes an individual’s immune system to destroy beta cells like an

autoimmune disease. Beta cells secrete insulin. Once destroyed, insulin is no longer able

to be produced from the beta cells in the pancreas. A person’s genetic make-up is what

can make them vulnerable to this scenario, thus environmental triggers go hand in hand

with genes in developing Type I diabetes (Izenberg et al., 2003).

Insulin is a very important hormone for proper body function. (Saudek et al.,

1997) Its function is to help the body use sugar as an energy source. Insulin makes cells

susceptible to absorb sugar from the blood stream, which originates in a person’s food.

For a person with Type I diabetes, their beta cells are completely destroyed, thus no

insulin is being secreted from the pancreas. This means that a person with Type I

diabetes has to inject insulin into their body to regulate their blood sugar and provide an

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energy source for their body. The disease can target anyone, but usually infects humans

at a young age. It can develop earliest as childhood and can even be contracted around

age thirty or even later in life (Saudek et al., 1997). Type I diabetes is a disease that

infiltrates a person’s body like a parasite without warning and has no cure except

regulation.

Signs and Symptoms

There are multiple symptoms and signals that help alert an individual that they

may have diabetes and need to see a physician for confirmation. (A.D.A.M., National

Library of Medicine, 2013) A great indication to possessing diabetes is high blood sugar.

A few symptoms of high blood sugar are: Excessive thirst, hunger, frequent drowsiness,

blurred vision, a numbing or tingling sensation in the feet, unintentional weight loss, and

frequent urination. There is also a list of more serious symptoms of Type I diabetes:

having dryness of the mouth or skin, color flushing the face, fruit smelling breath,

inability to keep down fluids causing nausea and/or vomiting, stomach pains, and fits of

deep rapid breaths (A.D.A.M., National Library of Medicine, 2013). Granted there is a

large list of symptoms associated with diabetes, but if someone is experiencing multiple

symptoms from these lists, they should be open to the possibility that they are living

with the disease.

One of the most potent symptoms of Type I diabetes is uncontrollable deep,

rapid breathing. One group of investigators (The et al., 2013) studied the correlation

between cardiovascular risks and medical nutrition therapies or MNTs. This research

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was also conducted by selecting subjects with different sociodemographic backgrounds.

The study rounded up 1,191 persons with Type I diabetes from Ohio, Colorado, South

Carolina, and Washington of different races/ethnicities, parental education, and physical

activity levels if the subject was older than 10. The MNTs that the researchers compared

to cardiovascular risks were tracking fat grams, calories, glycemic index and their diet.

Data from their study showed that individuals who grow up in an environment with less

educated parents with a lower income (dominantly minorities) learn multiple MNTs, but

have a tougher time regulating glycemic index which puts them at a higher risk for

cardiovascular struggles. Carbohydrate counting was deemed as the most used MNT

and is believed to be the most helpful in preventing cardiovascular risks. The

investigators believe that using only one MNT to regulate Type I diabetes is the best

strategy, but say more information is needed to solidify their theory. Physical activity

levels ended up not playing a large factor in the researcher’s collection of data, rather

the various MNTs were what was used to compare the risks of cardiovascular problems

in individuals (The et al., 2013).

Diagnosis

After an individual realizes that they have multiple symptoms of Type I diabetes,

the next best plan of action is heading to a physician so that they can diagnose whether

or not they have developed the disease. To find out whether or not an individual’s

suspicions of having Type I diabetes are correct, the physician will conduct a series of

tests on them. (A.D.A.M., National Library of Medicine, 2013) the first test someone can

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be put through is having their fasting blood glucose levels checked. In other words, not

eat and see what level their blood sugar is at from a blood sample. If blood glucose

levels are higher than 126 mg/dL at least twice throughout the test, the individual will

be diagnosed with the disease. The second test that can be conducted is done by taking

an individual’s blood glucose at a random time, with them carrying about their regular

dieting routine. In this test, if blood glucose levels are past 200 mg/dL along with signs

of thirst, excessive urination, and fatigue the subject may have diabetes and the fasting

blood glucose test will be done for confirmation. The third test is an oral glucose

tolerance test. Type I diabetes will be diagnosed if the patient’s glucose levels are higher

than 200 mg/dL two hours after they have been asked to ingest a sugary beverage. The

fourth test can be done by testing an individual’s hemoglobin A1C. A person shall be

diagnosed with the disease if these levels are at 6.5% or higher. In drastic measures a

ketone test can also be conducted to be positive whether or not the disease is present

by testing a urine sample (A.D.A.M., National Library of Medicine, 2013).

Once a person is diagnosed with diabetes they have to decide how they are

going to cope with this major change in their health and life. It is said that when going

into hearing the news on whether or not someone has a life altering disease that they

bring someone else with them in case they zone out into their thoughts once the news

is unveiled. (Saudek et al., 1997) Patients will be overcome with emotions such as fear,

anger, vulnerability or loss of control in their life. Tears may be shed once hearing the

news or the person may take their diagnosis in stride and realize that they still have a

life to live, no matter if Type I diabetes shall be with them throughout it like a monkey

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on their back until they take their last breath. Depression may befall someone once they

are trying to decide how to deal with contracting this disease, which means support

from friends and family is imperative. People generally aren’t thrown loads of

information as to how to regulate the disease right away so that they have a chance to

cope. But once they are ready, learning how to treat and regulate Type I Diabetes is the

next step (Saudek et al., 1997).

Treatment

There are ways to treat and regulate Type 1 diabetes. Just because a person is

diagnosed with the disease does not mean that they are going to drop dead on the spot.

(Izenberg et al., 2003) Regulating one’s diet is a way to make sure that glucose levels

stay stable throughout the day. Counting the carbohydrates taken in is key because this

is where glucose is stripped from food. Meals are more so planned out, and if someone

feels that their blood sugar is low they will consume something sugary to raise their

levels (Izenberg et al., 2003).

For someone with Type I Diabetes, getting insulin their body is the main goal,

due to the fact that their pancreas is not secreting it. This is where the innovation of

injecting insulin comes in handy. (Saudek et al., 1997) Insulin is injected into the body

through a syringe to help lower blood glucose levels. When someone is feeling the

symptoms of their diabetes kicking in and know that they are in dire need of insulin, this

would be when they inject themselves. In addition to lowering blood glucose, insulin

slows down glucose production in the liver. This is why many people inject insulin at

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night, in an attempt to shut down the production of glucose from the liver as they sleep.

Insulin is also a large factor in building muscle and allows the body to store calories in

the form of glycogen and fat that the body can use when in need of an energy source.

Insulin is involved in many chemical reactions in the body, so for someone with Type I

diabetes to be able to live life as normal as possible they need to inject it into their body

(Saudek et al., 1997).

Another way that an individual can treat Type I diabetes is by exercising.

(Izenberg et al., 2003) Regular exercise is shown to help insulin control blood glucose

more efficiently. Exercise also helps regulate and maintain a healthy weight, which in

turn helps keep a healthy cardiovascular system. People with the disease must plan

ahead for blood glucose levels to drop throughout exercise by either eating more prior

to exercise or keep insulin nearby. Exercise is also an activity that helps an individual feel

better about his/herself in general due to the fact that they are up moving around and

helping to improve their body image, fitness level and overall health (Izenberg et al.,

2003).

Personal hygiene is also a great way to regulate diabetes. (Guthrie D. and

Guthrie R., 1999) Infections can lead to an increase in blood glucose. Taking care of

one’s teeth is a way to prevent this. Teeth should be brushed at least twice a day to help

get rid of plaque, usually done in the morning and at night before bed. Also the dentist

recommends that an individual come in to have their teeth cleaned one every six

months. Skin care, such as bathing regularly is recommended. Foot care is important in

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the aspect of making sure feet are not dry and susceptible to cracks and cuts. Eye care is

also a hygienic act. Keeping hands clean and out of the eyes is important with how easy

it is to pick up germs. A person with Type I diabetes should visit an eye professional at

least once a year (Guthrie D. and Guthrie R., 1999).

Just like any other disease, treatment costs money. In a study (Cobas et al.,

2013) conducted in Brazil a group of investigators wanted to find the cost of treating

Type I diabetes. They found that the overall total treatment cost on average was

US$1216.33. Insulin used by the patients rounded out to be US$696.78 of the total cost.

Medical procedures had an average cost of US$75.64 and consultations rounded out to

be US$25.62. This data was found through evaluating 3180 patients with an average age

of twenty-two years old with being diagnosed with the disease on an average of 10.3

years (Cobas, et al., 2013). The fact that this data was obtained in the year 2013 shows

that these costs for treatment of Type I diabetes are still relevant.

Prognosis

Type I diabetes is a life-long disease once contracted. It is something that no one

asks for, but instead just happens to befall them like a plague. (Daneman, 2006)

Strangely enough Type I diabetes only makes up for 5-10% of cases of diabetes

throughout the world. Though genes are the main cause for developing the disease,

more research is needed to find the specific cause of it. Since the origination of Type I

diabetes, the medical community has made strides in treating it more efficiently. From

regulating blood glucose, to planning out meals, and most importantly using injections

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of insulin. When this disease first appeared, people diagnosed with it had their lives

shortened immensely. Now they have a chance to live a much longer and fulfilling life

due to advancements in treatment with insulin (Daneman, 2006). Just like with any

other disease there is always room for improvement in treatment until there is a day

when a cure is found.

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Literature Cited

A.D.A.M., National Library of Medicine. 2013. “Type 1 Diabetes.”

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001350/ (February 21,

2014).

Cobas, R.A., Ferraz, M.B., Saldanha de Mattos Matheus, A., Righeti Monteiro Tannus, L.,

Antonio Negrato, C., Antonio de Araujo, L., Atala Dib, S., Brito Gomes, M. 2013.

The cost of type 1 diabetes: a nationwide multicentre study in Brazil. Bulletin of

the World Health Organization 91(6): 434-440.

Daneman, D. 2006. Type 1 diabetes. The Lancet 367(9513): 847-858.

Guthrie, D.W., Guthrie, R.A. 1999. The Diabetes Sourcebook: Today's Methods and Ways

to Give Yourself the Best Care. Lowell House, Los Angeles, CA, pp. 2-7, 95-102.

Izenberg, N., Dowshen, S.A., Eppes, S.C., Masci, J. 2003. Human Diseases and Conditions,

Vol. 2. Scribner, NY, pp. 511-519.

Saudek, C.D., Rubin, R.R., Shump, C.S. 1997. The Johns Hopkins Guide to Diabetes: For

Today and Tomorrow. Johns Hopkins UP. Baltimore, MD, pp. 6-34, 159-161.

The, N.S., Crandell, J.L., Thomas, J., Couch, S.C., Shah, A.S., Maahs, D.M., Dabelea, D.,

Marcovina, S.M., D’Agostino Jr., R.B., Mayer-Davis, E.J. 2013. Correlates of

medical nutrition therapy and cardiovascular outcomes in youth with type 1

diabetes. Journal of Nutrition Education & Behavior 45(6): 661-668.