Diabetes 2019 will focus on metabolic disorder having multiple aetiology. In case of Diabetes mellitus there are high blood sugar levels over a prolonged period of time and is characterized by chronic hyperglycaemia resulting from either insulin secretion, insulin action, or both. The effects of diabetes mellitus with disturbances of carbohydrate, fat and protein metabolism include long-term damage, dysfunction and failure of various organs .When it became most severe , ketoacidosis or a non-ketotic hyperosmolar state may develop and lead to hypnosis, coma and in the absence of adequate treatment, death will occur.
According to National Diabetes Statistics Report which provides updated statistics about diabetes in the United States for a scientific audience stated that about 30.3 million people have diabetes (9.4% of the US population), out of which 23.1 million people are diagnosed and 7.2 million people are undiagnosed. In case of pre-diabetes, 84.1 million adults aged 18 years or older are suffering (33.9% of the adult US population) and 23.1 million adults aged 65 years or older have pre-diabetes.
With mild symptoms, it is very difficult to say if someone have diabetes. Patient could not even notice these sypmtoms. Therefore awareness in this area need to be explore. Here are some of the symptoms which can gave you some idea about your health.
Peolple with different age groups suffering from different types of diabetes. Diabetes 2019 will talk about these types and new researches trending in particular types. Diabetes can be classified as given below:
1. Type 1 diabetes occurs due to autoimmune β-cell destruction, usually leading to absolute insulin deficiency and will results from the pancreas’s failure to produce enough insulin previously referred as “Insulin dependent diabetes mellitus” or “Juvenile diabetes”. It is of two type’s further i.e. Autoimmune and Idiopathic. The cause of type 1 diabetes is unknown.
2. Type 2 diabetes may range from predominantly insulin resistance due to a progressive loss of β-cell insulin secretion in which cells fail to respond to insulin properly. Type 2 diabetes previously referred as “Non-insulin dependent diabetes mellitus” or “adult onset diabetes”. The main primary cause of type 2 diabetes is excessive weight and not enough exercise.
3. Specific types of diabetes include diseases of the exocrine pancreas (such as cystic fibrosis), and drug or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation).
Pre-diabetes is a condition in which person blood sugar level doesn’t meet the diabetes criteria but the blood sugar level is higher than the normal level. People who have diabetes suffer from pre-diabetes for many years in most of the cases.
Gestational Diabetes Mellitus (GDM) occurs in pregnant women having no diabetic history develop high blood sugar level (diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation). It resembles type 2 diabetes mellitus in many aspects and may occur in 2-10% of all pregnancies but disappear after delivery.
Diabetic Ketoacidosis is a life threatening problem and needs awareness about its prevention. It occurs when body doesn’t produce enough insulin and body cells can’t use sugar in blood for energy then body start using fat as fuel for energy. When the body continue to burn fat, it makes acids called ketones. If this process remains continue for a period of time, it will build up in body and can change the chemical balance of body and will affect the whole body functions. It is seen more in young ones having type 1 diabetes.
Food is absorbed from intestinal tract into bloodstream and this food is used as a fuel for the proper working of the body system. We consume more food than our need at every feeding. Not the all food is digested and absorbed at once, some is stored for later use and some is used immediately especially in the case of carbohydrates and fat. Fat is stored in fat cells and carbohydrates stored in the body as glycogen in liver and muscle cells and especially for brain whose complete functioning is dependent on glucose. For glucose transport into the cells, insulin plays a very crucial role. Insulin is produced by the beta cells found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin also facilitates the uptake of fat, amino acid by all cells .So the insulin deficiency will result into reversal of all these functions. One more function associated with insulin is that it not only facilitates the uptake of food components but also their storage. The enzyme which make glycogen and fat is stimulated by insulin and suppresses the enzymes which breakdown them. Glucose produced by liver play important role in hyperglycemia of diabetes either by insulin resistance or by its deficiency.
Hyperglycaemia or high glucose is a condition in which an exorbitant amount of glucose circulates in the blood plasma. This is basically a glucose level higher than 11.1 mmol/l (200 mg/dl), yet side effects may not begin to wind up perceptible until considerably higher qualities, such as 15– 20 mmol/l (~250– 300 mg/dl). A person is considered hyperglycemic if the blood sugar level fall in the range of ~5.6 and ~7 mmol/l (100–126 mg/dl)(American Diabetes Association guidelines), while above 7 mmol/l (126 mg/dl) is generally considered to have diabetes.
Each form of diabetes has very serious effects on health. Type 1diabetes and type 2 diabetes, both are caused by a combination of genetic and environmental risk factors. There are very rare forms of diabetes which are directly inherited. These forms include maturity onset diabetes in the young (MODY), and the one which occurs due to mutations in mitochondrial DNA.
- The risk of developing Type 1 diabetes is higher in first degree relatives. It is significantly higher in Individuals with two high risk DRB1-DQA1-DQB1 haplotypes than individuals with no high risk haplotype.
- Type 2 diabetes is inherited and has been known from a long time and studies on Type 2 diabetes revealed that first degree relative are about 3 times more likely to suffer from diabetes than individuals without a positive family history of the disease.
About less than 5% of all type 2 diabetes cases generally occurs before 25 years of age is MODY and is characterized by no evidence of beta cell autoimmunity, absence of obesity and slow onset of other symptoms. MODY extending across three generations is an autosomal dominant pattern inheritance and due to advances in molecular genetics ,it has been found that there are at least six forms of MODY, each caused by mutation in a different gene.
There is no permanent way to prevent Type 1 diabetes at present. Only the lifelong insulin injections are available for this disease. A cure for type 1 diabetes is currently unavailable. Genetics currently play no major role in the treatment or management of diabetes whereas type 2 diabetes can be prevented by maintaining age appropriate body weight and by following physical activities.
Now-a-days there are many new techinques which is currently used for the treatment of diabetes. Diabetes 2019 will surely focus on them.
Reprogramming skin cells: In a laboratory, Skin cells were grown in a culture medium to develop into specialized beta cells, which produces insulin. This process will lead to new treatments for patients with diabetes using their own skin cells.
Islet cell transplants: This study focuses on islet transplant in which clusters of insulin producing beta cells that live in islets are taken from a donor pancreas and implanted in the recepient’s liver to make insulin.
Gut hormones: Gut hormones such as Incretins which are involved in controlling the rise of blood glucose after eating.
Diabetes 2019 will discuss about the new drugs in clinical trials for the treatment of diabetes. There are medicines given below in the treatment of diabetes besides the fact that some of them has many side-effects.
- Type 1 diabetes mellitus
- Short acting insulin
- Rapid acting insulins
- Intermediate acting insulins
- Long acting insulins
- Combination insulins
- Amylinomimetic drugs
- Type 2 diabetes mellitus
- Alpha-glucosidase inhibitors
- Dopamine agonist
- DPP-4 inhibitors
- Glucagon-like peptides
- Sodium glucose transporter 2 inhibitor