Cultural and Disease paper
Amy D. Talbert
HCS245
February 14, 2011
Michelle Clemons

Diabetes is the most common endocrine disorder of the human body. There are three types of diabetes, type I (Juvenile Diabetes), type II, and gestational. Type I diabetes, also called juvenile diabetes, strikes children, and young adults (American Diabetes Association, 1995-2011). Type II diabetes is more common in certain ethnic groups, and in older people. Gestational diabetes is only present during pregnancy and usually goes away after pregnancy; however some women will develop type II diabetes in later years (American Diabetes Association, 1995-2011). Type II diabetes is considered the most common of all diabetes types. Because type II diabetes is the most common form of diabetes, this is the type that will be discussed in detail. What is type II diabetes? Type II diabetes is a disease of the endocrine (hormone) system. In a normal working endocrine system, blood sugar levels stay consistent. In the case of diabetes, blood sugar levels fluctuate causing the body’s cells to keep from function properly (Web M.D., 2005-2011). Type II diabetes occurs when the body either does not produce enough insulin, or the body cannot use the insulin properly. Insulin is a hormone regulated by the endocrine system. Insulin helps the body store and use the sugar from eaten food (Web M.D., 2005-2011). The body is made up of cells; these cells need energy that energy comes from food and drink. When food or drink is ingested that food is broken down into sugar called glucose. Glucose is then distributed through the bloodstream to the cells in which energy is used for daily use. Insulin is very important for the glucose levels found in the body. Insulin is produced and stored in the pancreas. Insulin is also stored in the liver. The pancreas constantly releases insulin in small amounts. This insulin pushes glucose into the body cells so there is always energy to feed the cells. When the body does not make enough insulin, or the body’s cells do not recognize insulin, diabetes is the culprit. Diabetes is recognized by low and high blood glucose (sugar) levels. Risk Factors of type II Diabetes Currently there are several identifying risk factors in the development of type II diabetes. Not everyone will develop type II diabetes if he or she has any of all of these risk factors, but medical discoveries show the chance increases with more risk factors (Web, M.D. 2005-2011). The primary risk factors are as follows: 1. Family History-if a family member has diabetes, one is at high risk 2. 45 or older-chance increases with age 3. Race or ethnic background-certain race or ethnic background has higher risk 4. Hypertension-high blood pressure increases risk 5. Cholesterol levels-abnormal high or low levels increases risk 6. History of gestational diabetes-acquiring diabetes during pregnancy increases risk 7. Obesity-increases risk, at any age 8. Inactivity-increases risk
Of these listed risk factors, half of them may be controlled to lessen the risk of acquiring diabetes.
Hypertension can be controlled through diet and medication. Cholesterol can be controlled through diet, exercise, and medication. Obesity can be controlled through diet and exercise. Inactivity can be controlled through exercise. The risk of developing diabetes if a parent or sibling has diabetes is a risk factor that cannot be controlled. That risk factor is in the genetic makeup and cannot be altered or fixed. As a person ages, the risk of developing type II diabetes increases. The aging process cannot be controlled. If a person has a race or ethnic background of African American, Latino, Native American, Asian American, Native Hawaiian, and other Pacific Islanders, then he or she is at risk of developing type II diabetes (American Diabetes Association, 1995-2010). These backgrounds have been proven to have higher instances of developing the disease.
The disease diabetes, does not kill, the complications from possessing diabetes kills. Diabetes over time causes damage to the nerves, most notably in the feet, and damage to the small blood vessels of the eyes, kidneys, and heart (Web M.D., 2005-2011). Type II diabetes is responsible for two-thirds of the deaths from heart disease and stroke (Web M.D., 2005-2011). The higher number of risk factors a person has, the higher the risk of heart disease or stoke.
History of Diabetes treatment
In the 1700’s physicians prescribed very low calorie diets for patients suffering from diabetes. These low calorie diets kept the patients alive longer than those not on the diet, but often to the point of near starvation (Sattley, 2008). It was not until 1921 when insulin was discovered that patients had a chance to live a longer life once diagnosed with diabetes. Up until 1935 only one type of diabetes was known. Oral medications were developed for people with type II diabetes in the 1950s. In the 1960s urine strips were developed for the testing of blood sugar. If the strip turned blue, there was no sugar in the blood, if orange there was sugar. The single use syringe was developed in 1961. Before that time syringes were glass, and the needles large. The glass syringes had to be sterilized through 20 minutes of boiling after each use, and needles needed to be sharpened with a pumice stone (Sattley, 2008).
In 1969 the first portable glucose meter was created. It weighed three pounds, and cost $650 (Sattley, 2008). The insulin pump was developed in the late 1970s. The pump delivered an insulin dosage through a small needle inserted into the skin. This pump weighed 17 ounces, had blinking red lights and had to be carried in a backpack (Sattley, 2008). The first needle-free insulin delivery named Derma-Ject was developed in 1979. Derma-Ject weight one and a half pounds and cost $925. The first models had no pressure adjustment feature and could be painful when administering a dose of insulin (Sattley, 2008).
In 1979 the hemoglobin A1c test was developed. The hemoglobin A1c gives an average of the past 90 days of blood glucose readings.
Current Treatment Methods
Diabetes has no cure, only treatment, and management. Testing used to diagnose diabetes is most often done through blood tests. If the fasting blood glucose is greater or equal to 126mg/dL, the diagnosis is diabetes (Web M.D., 2005-2011). If a patient has any risk factors associated with diabetes and normal fasting blood glucose, a glucose tolerance test may be given. In this test there is no patient fasting. The test is given at any time. If the glucose level is higher than 200 mg/dL, diabetes may be present. This test is also done a second time. The hemoglobin A1c test is another blood test that measures blood sugar over a six to 12 week period. This test is done every three months to measure several weeks of blood sugar levels (Web M.D., 2005-2011). Diabetes is a time -consuming disease. The disease takes daily commitment from the patient. The patient checks his or her blood sugar levels at least once a day using a blood glucose meter and test strips. The results are written down and used as a window to measure blood glucose levels. Some patients need to check blood glucose levels up to six times a day to receive a full reading of how his or her blood glucose levels are reacting throughout the day. Blood glucose levels rise and fall throughout the day, and rise after eating. How far the levels rise and how long they stay high are markers in blood glucose management. Most people diagnosed with type II diabetes control the disease through oral medication and diet. Diabetes oral medication is grouped in categories. Each category works differently. One category, sulfonylureas and meglitinides, stimulate the pancreas to release more insulin. Another category, biguanides, helps insulin move sugar into cells. This category also stops the liver from releasing stored sugar. Thiazolindinedions is a category that improves insulin’s effectiveness in muscle and fat tissue. Alpha-glucosidase inhibitors block enzymes that help digest starches. Several oral medications are combination medications that combine two medications into one (Web M.D., 2005-2011). Typically insulin treatment was linked only to type I diabetes; however many patients diagnosed with type II diabetes use a combination of oral medication and insulin treatment. The oral medication is taken once or twice daily with insulin shots given before meals or once daily, depending on the type of insulin. To receive the most benefits from any diabetes treatments, the patient also needs to combine regular health care, exercise, a healthy diet, and stress reduction. By following these proven steps, diabetes can be controlled; not cured. That is the best that can be done for this disease. What does the future bring for diabetes? As noted earlier in this paper, there is no cure for diabetes; however researches are diligently searching for ways to prevent, treat, and cure diabetes. In one ongoing study, some middle schools are trying to lower the risk factors for type II diabetes in children by offering healthy food choices in the cafeteria and vending machines, and through more physical education and behavioral change (American Diabetes Association, 1995-2010). Recently researchers found a link between nutrients and insulin, but results from follow-up studies are pending. Recent researchers developed a model in mice that can increase blood flow, which can restore blood flow and decrease tissue death caused by decreased blood flow. This research is a combination of gene and cell therapy that, so far, has not been tested on humans (American Diabetes Association, 1955-2010). These new research discoveries are promising but not conclusive.
In Dallas, Texas you can attend many different types of diabetic management classes at most of the larger hospitals (Baylor, Parkland, Methodist, Presbyterian), both designed for the patient and family members. The Juvenile Diabetes Research Foundation has junior ambassadors that will schedule a time to come meet with your office, school, or organization about what it’s like living with diabetes. Summary The National Diabetes Fact Sheet from 2007 states that 7.8% of the population in the United States has diabetes (American Diabetes Association, 1995-2010). There are approximately 80 people per day in the United Stated diagnosed with diabetes. This is a disease that is rising daily, not only in adults, but children as well. Currently treatment and management are the only ways to treat diabetes.

References
American Diabetes Association. (1995-2010). DiabetesBasics: type 2. Retrieved February 10, 2011, from http://www.diabetes.org/diabetes-basics/type-2/?utm_source=Homepage&utm_medium=ContentPage&utm_content=type2&utm_campaign=TDT

The History of Diabetes. Retrieved February 11, 2011, from http://www.diabeteshealth.com/read/2008/12/17/715/the-history-of-diabetes/

Web M.D. (2005-2011). Diabetes Guide. Retrieved February 10, 2011, from http://diabetes.webmd.com/guide/diabetes-overview-facts