Diabetes refers to two quite different diseases. Diabetes Mellitus which includes gestational diabetes (during pregnancy), type 1 (juvenile diabetes), type 2 (adult onset), and the less common Diabetes Insipidus. Type 2 is far and away the most common form, particularly in developed countries, and is identified by a decreased ability to metabolize glucose with normal amounts of insulin. The causes are complex in detail but are connected with lifestyle (eg, diet and obesity), and heredity.

Type 1 diabetes nearly always requires insulin injections, and is typically fatal without proper treatment. Type 2 diabetes can often be managed by exercise and weight loss diets alone. Frequently oral medication and/or insulin are at first required. The majority of type 2 diabetics are eventually treated with medication.

diabetes pancreasType 1 diabetes is an autoimmune condition, in which the body produces antibodies that attack the pancreas’ insulin-producing cells. The cause is varied and unclear, but may involve diet, genetics, viruses, and environmental elements such as chemicals. Type 1 diabetes was formerly called juvenile diabetes because it is frequently diagnosed in childhood or early adulthood. Those with type 1 diabetes must take insulin by pump, injection, or other methods. Practicable treatments, which are cures when effective, include transplant of a section of pancreas.

Until June, 1921 (when insulin was discovered and made globally accessible), a diagnosis of type 1 diabetes was more or less a quick death sentence. Today the primary risks are from its distinctive long-term complications. These include chronic renal failure (it is the main cause for dialysis in developed world adults), cardiovascular disease (doubled risk), retinal damage which is the most significant cause of blindness in the young in the developed world, gangrene and risk of amputation of toes, feet, and legs, and nerve damage which can result in erectile dysfunction (impotence).

Complications are less severe and less common and for those who control their blood sugars. In fact, the more successful the control, the less risk of complications. Patient participation and understanding is vital, as blood glucose levels fluctuate continuously throughout each day. Other habits and health problems that increase the damaging effects of diabetes include elevated cholesterol levels (control with diet, exercise or medication), smoking (abstain), obesity (even small losses can be very helpful), lack of regular exercise, and high blood pressure.

The disease has been recognized since antiquity. The word diabetes (Greek: diabainein), first recorded about 100B. C. Literally means “siphon” or “passing through” referring to one of the major symptoms – excessive urination. Thomas Willis, in 1675, added mellitus (Greek: mel (honey) when he observed that a diabetic’s urine and blood were sweet to the taste, not realizing the sweet taste was indeed due to an excess of sugar. Ancient Chinese tested for diabetes by noting whether ants were drawn to a person’s urine, and called it “sweet urine disease”.

In 1889 European researchers, Joseph von Mering and Oskar Minkowski discovered the role of the pancreas in diabetes. Completely removing the pancreas of dogs, they found that the dogs developed all the signs and symptoms of diabetes and died shortly afterward. In 1910, Sir Edward Albert Sharpey-Schafer in Scotland proposed that people with diabetes were lacking a single chemical that was produced by the pancreas – he called this substance insulin from the Latin insula (island) in reference to the small areas in the pancreas where insulin is produced.

The role of the pancreas and the existence of insulin, was not clearly define until 1921, when Charles Herbert Best and Sir Frederick Grant Banting, repeating the work of Von Mering and Minkowski, went a step further and showed that by giving dogs with induced diabetes an extract from the pancreatic islets of healthy dogs they could reverse the affects. They later isolated the hormone insulin from bovine pancreases which led to the first clinical treatment of a patient in 1922 with effective insulin injections. The two researchers did not attempt to control commercial production, but made the patent freely available. They received the Nobel Prize in Physiology and Medicine in 1923.

A new report by the University of Chicago forecasts that the number of Americans with diabetes will double in the next 20 years, and the medical costs of treating them will triple. The journal Diabetes Care estimates nearly twice the current number of 23.7 million will be living with diabetes by 2034. About 90% of those with the disease have type 2, a type that develops over time.

The direct medical cost, accounting for inflation, of treating them will increase from $113 billion to $336 billion annually, dwarfing present and potential resources. The study considers the predictions “very conservative” since they don’t count the swelling numbers of overweight children and teenagers who are at extreme risk for developing diabetes. The surge in diabetes may be far greater than the projections. The estimates also don’t consider immigration, or the surging population of minorities. African-Americans and Latinos suffer at higher rates from diabetes than the U.S. population in general.

As Baby Boomers assault the health care system in full force the diabetes caseload is anticipated to rise from 8.2 to 14.6 million people. Three fourths of adults with diabetes take oral drugs to control the disease. One in four uses insulin.

The American Diabetes Association Diabetes states that the leading cause of kidney failure, damaged blood vessels, and nerve damage is diabetes. Roughly 15 percent of diabetics need amputation of a lower extremity at some stage in their life.

Lawmakers are considering the merits of permitting insurers to charge higher premiums to individuals who don’t meet certain health standards, such as lowering weight if they’re obese. Diabetes, is one of the most preventable of major illnesses, and diabetic diets are the usual prescription.

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