Diabetes Mellitus Case Analysis

According to the new recommendation by the American Diabetes Association and the World Health Organization (WHO), diabetes mellitus (DM) is broadly classified as Type I DM or Insulin Dependent Diabetes Mellitus (IDDM) and Type II DM or Non-Insulin Dependent Diabetes Mellitus (NIDDM). In general, diabetes mellitus involves metabolic disorders leading to hyperglycemia. Sensitive parts of the body such as kidneys and eyes are affected as a result of chronic hyperglycemia in most patients. However, the causes of chronic hyperglycemia differ from one person to the other and therefore the screening and treatment methods of this disorder depend specifically on the individual. At present, only one-half of the DM patients have been diagnosed (Pugliese and Eisenbarth 134).

Type I DM is a result of beta-cell destruction caused by an autoimmune process that leads to insulin deficiency. According to statistics, 95 percent of individuals with type I diabetes mellitus get the disease between the age of 10 to 14, with an equal occurrence between males and females though an increased prevalence in the white population (Pugliese and Eisenbarth 146). The etiology of type I DM is genetically related and is usually triggered by various environmental factors. Other causes include; cow’s milk which has high bovine insulin antibodies compared to breast milk, viral infection, coxsackie B virus, rubella virus, cytomegalovirus, and environmental factors such as high levels of zinc and magnesium in the diet.

Symptoms related to this disorder are excessive thirst, frequent urination, sweating, and being severely underweight. In addition, patients are more vulnerable to ketoacidosis (diabetic coma). Most common diseases related to type I DM are celiac disease (gluten enteropathy) or other endocrine diseases. Most patients are characterized with “immune-mediated form” with islet cell antibodies and resulting to autoimmune disorders such as Hashimoto’s thyroiditis, pernicious anemia or Addison’s disease. A few patients, in particular those of Asian or African origin lacks the antibodies and such a condition is referred to as idiopathic form of type I DM.

On the other hand, the etiology of type II DM is less clearly understood to those of type I DM. The onset of this disorder is usually adult life with fewer cases involving the juvenile stage. There are two major causes of this disorder involving insulin impairment or resistance. The failure of the insulin may lead to abnormality of glucose metabolism in the body. Patients with type II diabetes have impaired glucose tolerance and hypeglycemania as a result of defective beta cells.

This condition is treated by supplying the body with insulin secretion drugs such as sulfonylureas. This disorder has been associated by genetic factor and inheritance of a defective pattern of insulin secretion. Mostly it affects the adults with a history of diabetes present of first degree relatives (Harris, et al. 528). The second major factor that causes type II DM is when insulin becomes resistant. This condition is caused by the failure of insulin receptors on the target cells to function properly.

In most cases, insulin resistance occurs in obese, overweight and pregnant persons. In normal persons who become obese, the beta cells secrete increased levels of insulin to counteract glucose metabolism. However, obese persons with genetic history of diabetes are vulnerable and likely contract the type II DM as their beta cells cannot compensate. Other causes of type II DM include; older age, lack of exercise, diet and lifestyle.

However, in most cases it affects women especially those with a history of gestational diabetes, blacks, Hispanics and Native Americans. People with certain risk factors such as hypertension, overweight, obesity and history of relatives with diabetes mellitus are prone to this disease and screening should therefore be conducted more often. Earlier detection of the disease may lead to easier management and treatment. Persons with type II DM manage the disorder with diet, physical exercises and reduce drug intake (Harris, et al. 528). To attain and maintain blood glucose level and healthy height, a healthy lifestyle should be followed (Grodner, Sara, and Bonnie 17).Moreover, patients need to be aware of appropriate intake of carbohydrates, vitamins, minerals, protein and fat each day.

In the above case study, the person has high risk of becoming obese unless the diet and exercise recommended is changed. A wide variety of food has been recommended for each day which include; high fiber such as whole grain, fruits and vegetables. Deserts which are fat-free, sugar-free and low calorie are more encouraged for this patient. For instance, the amount of cheese taken within 24 hours is likely to increase the risk of type II DM due to presence of saturated fats and cholesterol. The person should instead low-fat cheddar cheese. In addition, the amount of meat taken should be reduced to half and fiber or vegetable intake increased at every meal.

Types of vegetable include; cucumbers, onions, red pepper, carrots, zucchini, steamed spinach etc. (Grodner, Sara, and Bonnie 330). On the other hand, the patient is encouraged to undergo vigorous physical activity daily of about 30 to 60 minutes. Active aerobics are highly recommended as they help in the muscle flexibility. This may also help in maintaining the blood sugar level and healthy body weight.

Work cited

Grodner, M., Sara L., and Bonnie C. Foundations and Clinical Applications of Nutrition: A Nursing Approach, 4th ed. Mosby Elsevier Health Science, 2007.

Harris, M., Hadden W., Knowler W., and Bennett P. “Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20-74 year.” Diabetes 36 (1987): 523-34.

Pugliese, A., Eisenbarth, G. Human Type 1 Diabetes Mellitus: Genetic Susceptibility and Resistance. In Type 1Diabetes: Molecular, Cellular, and Clinical Immunology. Ed. Eisenbarth, G., Lafferty, K. New York: Oxford University Press. 1996.

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