Diabetes is a disease that occurs when the body’s ability to produce insulin is impaired. The disease causes the immune system to attack the beta cells, resulting in the lack of production of insulin by the pancreas. Insulin is a hormone, which regulates the glucose level. According to a 2017 CDC report, more than 100 million adults living in the United States have a form of diabetes. As the seventh leading cause of death in the United States, researchers in the medical field developed lab-made insulin for patients to use to balance their glucose levels. Although there has been a significant amount of research to help diabetic patients live a better life, the scientific background of how diabetes affects the human body is complicated.
There are four types of diabetes with distinct differences: type 1 diabetes, type 2 diabetes, gestational diabetes, and pre-diabetes. Type 1 diabetes occurs in about fifteen percent of young children when their pancreas stops producing insulin. Type 2 diabetes appears in adults forty years of age or older when the body is not able to use the insulin produced by the body. The glucose builds up instead of being distributed to the cells, harming the body. The body’s cells are always in need of energy. An unhealthy lifestyle typically causes this form of diabetes but it may be reversed for a short period by staying active and eating healthy. However, if the patient is unable to control their condition, their kidneys, nerves, and heart will be harmed over time due to high levels of glucose. Gestational diabetes only develops in pregnant women if she had a history of type 2 diabetes. Although the condition usually subsides after the baby is delivered, extremely high glucose levels during pregnancy could affect the mother and baby’s health. Pre-diabetes is a condition where a person’s blood sugar is higher than average, but not high enough to be diagnosed as type 2 diabetes.
Overall, a similarity between the four forms of diabetes is their classification as an autoimmune disease.
There are two main ways to diagnose diabetes: fasting glucose test and oral glucose tolerance test. For the fasting glucose test, the patient must fast for eight hours overnight and have a sample of blood drawn the next day. A laboratory analyzes the sample of blood to see whether the glucose level is normal. The average fasting glucose level should be below 100 mg/dL. However, if it is above 125 mg/dL, it indicates that the patient may have diabetes. The oral glucose tolerance test is used to diagnose pre-diabetes and gestational diabetes. Just like the fasting glucose test, the oral glucose test requires patients to fast overnight for about eight hours. The physician first tests the fasting glucose level then gives the patient a sweet liquid to drink to test how well their insulin functions. In a non-diabetic patient, the blood sugar level rises and falls rapidly after drinking the sweet liquid. However, due to the lack of insulin in diabetic patients, they take much longer to absorb sugar and drop back down to the normal glucose range. Unlike non-diabetic patients, their sugar level spikes abnormally high, which requires much more insulin to stabilize it.
Since diabetic patients create little to no insulin, they must maintain their glucose level by injecting insulin into their bodies through a syringe or insulin pump. An insulin pump is a small digital machine that is attached to the body through a needle. The needle can be connected to various parts of the body, such as arms, abdomens, thighs, or buttocks. The clip on the back of the device is then attached to the waistline of the pants. An insulin pump is used as an alternative to syringe injections every few hours since it is more convenient and only needs to be changed every two to three days. When replacing the needle, patients also must refill the device with more insulin. Before eating any food, the number of carbohydrates consumed needs to be programmed into the pump so that it will know how much insulin to put into the patient’s body. There is also a basal range of fast-acting insulin set to automatically administer to the patient every hour to stabilize their glucose level.
There are several leading causes of insulin production problems in diabetic patients. The most common is pancreatic issues. The pancreas is an about six-inch organ located behind the stomach. Its main functions are to produce enzymes to break down food and hormones to regulate glucose levels. Within the pancreas, there are three types of endocrine cells: alpha cells, beta cells, and delta cells. The alpha cells secrete glucagon, beta cells secrete insulin, and delta cells inhibit the secretion of insulin and glucagon. In a diabetic patient’s body, their immune system attacks the beta cells, resulting in the lack of insulin secretion or production entirely. Endocrine cells play a significant role in how blood sugar increases and decreases throughout the day. After eating or drinking, the carbohydrates in the food cause the body’s glucose level to rise. The beta cells secrete insulin to lower the glucose level to a normal range of around 70-100mg/dL. The alpha cells of the pancreas release glucagon into the bloodstream to increase glucose levels when they are too low. Glucagon helps to breakdown glycogen to glucose in the liver. The stored sugar in liver cells is released.
The pancreatic beta cells in Type 1 diabetic patient’s body becomes inflamed over time. Chronic inflammation is the cause of beta cells’ losing their ability to secrete insulin. Cytosines, large groups of proteins secreted by cells in the immune system, cause inflammation to occur by controlling adaptive and innate immune responses. The results of these responses are tissue damage, internal defense, repair, and remodeling. Innate immune cells are white blood cells given by the phagocytes to defend against abnormal cells. Adaptive cells (B cell, T cell, natural killer cell) protect the body when the innate immune cells fail.
Currently, researchers are trying to find ways to prevent people from getting diabetes. Meanwhile, people may lower their chances of developing diabetes by leading a healthy lifestyle. Diabetes should not be taken lightly since improper care of the patient’s health may lead to their death.
Works Cited:
Grunnet, Lars Groth, and Thomas Mandrup-Poulsen. “Cytokines and Type 1 Diabetes: a Numbers Game.” Diabetes, American Diabetes Association, Mar. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3046829/.
“How Does the Pancreas Work?” InformedHealth.org [Internet]., U.S. National Library of Medicine, 6 Sept. 2018, www.ncbi.nlm.nih.gov/books/NBK279306/.
Kawasaki, Eiji. “Type 1 Diabetes and Autoimmunity.” Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology, The Japanese Society for Pediatric Endocrinology, Oct. 2014,www.ncbi.nlm.nih.gov/pmc/articles/PMC4219937/.
“New CDC Report: More than 100 Million Americans Have Diabetes or Prediabetes.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 18 July 2017, www.cdc.gov/media/releases/2017/p0718-diabetes-report.html.
Nordmann, Thierry M, et al. “The Role of Inflammation in β-Cell Dedifferentiation.” Scientific Reports, Nature Publishing Group UK, 24 July 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5524956/.
Rachel Nall, RN. “Diabetes: Symptoms, Treatment, and Early Diagnosis.” Medical News Today, MediLexicon International, 9 Jan. 2020, www.medicalnewstoday.com/articles/323627#how-insulin-problems-develop.
Written by Editor Updated on 15th January 2019, and Editor. “The Immune System Keeps Us Free from Infection. However, as with Other Organ Systems, Long Term Conditions Can Occur, Including Type 1 and Type 2 Diabetes.” Diabetes, 14 Feb. 2020, www.diabetes.co.uk/body/immune-system.html.
Image Credit: https://www.hopkinsmedicine.org/sebin/f/f/8-27-2018%20Marin%20Immune_2_pyramid.jpg
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