I believe that educators benefit from having a
deeper understanding of the conditions they teach about and work to
prevent. That includes pathophysiology
of diabetes. I love anatomy and physiology so I thought the image below was
interesting and helpful.
Diabetes is a very complex condition which affects
every single part of the body. There is much we don’t understand about diabetes
but we do know a lot. In type 2 diabetes, either
the body does not produce enough insulin or the cells are not using insulin properly (insulin
resistance). Insulin helps
the body use glucose for energy/fuel by taking the sugar from the blood and
delivering in into the cells. When there is insulin resistance or deficiency,
too much glucose builds up in the blood stream instead of entering the cells.
This is called hyperglycemia or high blood sugar, which lead to complications such
as blindness, kidney disease, amputations, nervous system disease, and oral
complications like gum disease and tooth loss (NDEP, 2007). Cardiovascular
disease is the major cause of death in people with diabetes (NDEP, 2007).
The diagram below shows how insulin resistance and
hyperglycemia (high blood sugar) lead to cardiovascular disease. Insulin
resistance leads to decreased glucose uptake by the muscles, an increased
breakdown of fat to supply the body’s energy needs which then also leads to an
even further increase of glucose production resulting in hyperglycemia, too
much sugar in the blood (Pitta, 2004). Insulin resistance & hyperglycemia increase
risk for CVD by increasing blood pressure, affecting blood lipid levels
(cholesterol & triglycerides) and increasing clotting.
There are many factors that affect an individual’s
risk for developing diabetes but the major factors are weight, activity level,
eating habits and genetics. Three out of
these four are modifiable and closely inter-related.
Obesity is a major problem in the U.S. and is largely affected by our poor dietary habits and sedentary lifestyles. There
is a clear association between obesity and insulin resistance. Increased fat
makes it harder for the body to use insulin, it increases insulin resistance.
Most people are overweight when they are diagnosed with diabetes (NDEP, 2007).
Figures 1
& 2 below show an increase in diabetes prevalence from 1990 – 2000s parallel
to the increase in obesity prevalence.
 |
 |
| Source: NDEP, 2007 |
The two
are so closely related they are often referred to as diabesity. We have to
address both obesity and diabetes to truly have an impact on our country’s
health status.
References
U.S. Centers for Disease Control and Prevention. (2012). Diabetes data and trends. Retrieved from http://www.cdc.gov/diabetes/statistics/
National Diabetes Education Program. (2007). Working together to manage diabetes: a guide for pharmacists, podiatrists, optometrists, and dental professionals, 2007. Retrieved from
National Diabetes Education Program. (2007). Working together to manage diabetes: a guide for pharmacists, podiatrists, optometrists, and dental professionals, 2007. Retrieved from
http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=26#page6
Pitta, A.
G. (2004). Diabetes Mellitus: Diagnosis and Pathophysiology. Retrieved from
Tufts University Open Courseware website:
http://ocw.tufts.edu/Content/14/lecturenotes/265878
Hello Alex,
ReplyDeleteOne of the nice things about this blogging assignment is learning about all the different health topics. I have started reading more about diabetes because of the connection to childhood obesity. The information you have provided has been very informative and great asset to my understanding the connection between diabetes and obesity. I agree with your statement that many of the factors that cause diabetes can be modified through exercise and diet. I was speaking with a friend about a month ago and he told me that at his last health checkup they told him he was pre-pre-diabetic and if he continued down the same road he would become diabetic. He chose not to become diabetic. He completely changed his diet and increased his exercise. Eight weeks after the doctor gave him the news he had completely changed his health status. The doctor told him that he had never seen such a drastic change in such a short period of time and that no combination of medicine could have helped him the way his diet and exercise regime has. It is amazing to me how something as simple as diet and exercise can help a person change their diagnosis. Thanks for the new term “diabeisty.” Diabeisty is very fitting because of the alarming trend of obesity in children and young adults.
Tracy
It really is amazing how our body adapts quickly, whether we engage in healthy or unhealthy habits. Research has shown that diet and exercise (lifestyle changes) has a greater impact on reducing the risk for developing diabetes and diabetes complications than medications. Medicaitons are important but we also need to do the basic things - put good food in our bodies and get moving! THanks for sharing. I love hearing inspirational stories like this.
DeleteHi Alex,
ReplyDeleteI agree with you that lifestyle factors such as diet and weight often contribute to the onset of type 2 diabetes. But also so many individuals increase their chances of getting these conditions because they have many of the genetic factors in diabetes. One of the strongest factors is a family history of the conditions. In general, if someone parents develop diabetes, he/she is more likely to suffer from it. Genes that increase the susceptibility of a person to type 2 diabetes either encode for proteins that influence the function of insulin-secreting cells or the function of cells targeted by insulin. In 2010, a team led by researchers at the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH), has captured the most comprehensive snapshot to date of DNA regions that regulate genes in human pancreatic islet cells, a subset of which produces insulin. The study highlights the importance of genome regulatory sequences in human health and disease, particularly type 2 diabetes, which affect more than 20 million people in the United States and 200 million people worldwide (National Human Genome Research Institute, 2010).
References:
National Human Genome Research Institute. (2010). NIH researchers identify genetic elements influencing the risk of type 2 diabetes. Retrieved from http://www.genome.gov/27542097
Alex, how I love your post! As an anatomy and physiology instructor, it encourages me to see health educators diving into the biology of health problems. Your comment about three out of four of the major factors for developing diabetes being modifiable is an excellent point. Last fall, I had the opportunity to listen to a Fort Worth pediatrician speak about what he called “diabesity” in children. Much of his discussion was about how a woman’s exercise and nutrition habits affect the health outcomes of their children not only because of the nutrition the child received in utero, but also because of the modeling the parent does after the child is born. Unfortunately, the doctor says he is seeing more and more children with obesity and diabetes. He mentioned a screening test for acanthosis nigricans, the black-brown marker on the back of the neck, which is an indicator of excess insulin in the blood. This year, for the first time, my son came home with a note stating that students in the 1st, 3rd, 5th and 7th grades will be tested because it is now a state law. How wonderful! Okay, now is the hard part, what happens next?
ReplyDeleteI love biology, I don't think I could ever tire of it. I just recently starting seeing more of the term acanthosis nigricans. It is a strong predictor of diabetes, as you mentioned, a sign of excess insulin (insulin resistance likely). It's great that they're testing for this. It should be a simple test, a great way to identify children at risk. You're very right, once done, then what?? It seems that we may be getting better and better at diagnosing conditions and identifying risk but still lacking in the prevention deparment.
DeleteInteresting fact about testing of school age children. This is the first I have heard of it, but then I don't have children that young. I have a couple of neighbor kids that just this week said they were "tested" and had some problems. I did not ask where, assumed it was at their doctor. From what I just read, could have been at school. This is a positive use of resources and a good opportunity to catch this condition early to help change lifestyles and potentially the outcome of developing diabetes.
ReplyDelete