Etiology of Diabetes Mellitus
“Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.” (Association, National Center for Biotechnology Information , 2009, p. 1)
“The cause of type 1 and type 2 diabetes remains a mystery. Although genetic factors may play a role”. (Association, Diagnosis and Classification of Diabetes Mellitus, 2010, pp. 562-569) Diabetes mellitus generally results from an insulin deficiency or resistance. Insulin transports sugar into cells for use as energy and storage as glycogen which is a carbohydrate. Insulin also stimulates protein synthesis and free fatty acid storage. Insulin deficiency or resistance compromises the bodies access to essential nutrients for fuel and storage. Several processes called pathogens(capable of causing disease) are involved in the development of diabetes. The reasons of the abnormalities in carbohydrates, fats, and protein metabolism in diabetes is deficient action of insulin on certain tissues in the body. The term Deficient insulin action, results from not enough insulin secretion and/or diminished tissue response to insulin at one or more points in the complex pathways of hormone action (a chemical messenger that transports a signal from one cell to another). If insulin secretion is blocked or impaired, then defects in the insulin action occur in the same patient, and it is often unclear which abnormality, the cause of the hyperglycemia. (Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 1997, pp. 107-109) Type 1 Diabetes Mellitus is defined as an autoimmune disorder or simply put an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body actually attacks its own cells (What-is-Autoimmune-Disease). This form of diabetes is brought on by a viral infection in which certain cells are destroyed which leads to absolute (complete) insulin deficiency and is usually diagnosed in childhood. Many pediatric patients that have diabetes normally have Type 1 diabetes and therefore a lifetime dependency on insulin. “Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone.” (Diabetes-Mellitus---Definition-Causes-Symptoms-and-Treatment) In contrast Type 2 Diabetes Mellitus is a more progressive disorder in which the glandular organ in the digestive system and endocrine system known as the pancreas makes less insulin over time. Because the body’s cells have a reduced response to insulin, symptoms arise that include poor control of liver glucose (sugar) output, a decrease in cell function, and eventually cell failure. The true cause of Type 2 diabetes is unknown; however, it usually occurs in adulthood, from heredity, excessive obesity and sedentary lifestyle. These lifestyle choices may play a major role in its development. For both types of diabetes the main feature is chronic high blood glucose (sugar) levels (Ignatavicius, 2006). Risk factors for Diabetes Mellitus include obesity, physiologic or emotional stress, which can lead to an elevation of stress hormone levels. In women sometimes pregnancy, which causes weight gain and increases levels of estrogen and placental hormones, may aggravate insulin output. There is also something called the metabolic syndrome which is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. There are also some medications that can provoke the effects of insulin, including thiazide diuretics, adrenal corticosteroids, and hormonal contraceptives (Mackay, 2004).