In the United States, about 16 million people suffer from diabetes mellitus, although only half of these individuals are diagnosed. Every year, about 650,000 people learn they have the disease. Diabetes mellitus is the seventh leading cause of all deaths and the sixth leading cause of all deaths caused by disease. Diabetes is the most common in adults over 45 years of age; in people who are overweight or physically inactive; in individuals who have an immediate family member with diabetes; and in minority populations including African Americans, Hispanics, and Native Americans. The highest rate of diabetes in the world occurs in Native Americans.
More women than men have been diagnosed with the disease. Diabetes can develop gradually, often without symptoms, over many years. It may reveal itself too late to prevent damage. In fact, you may first learn you have diabetes when you develop one of its common complications – cardiovascular disease, kidney disease, or vision problems. Diabetes is a condition that occurs because of a lack of insulin or because of the presence of factors opposing the actions of insulin.
The result of insufficient action of insulin is an increase in blood glucose concentration (hyperglycemia). Hyperglycemia is the unused glucose that builds up in your blood. Many other metabolic abnormalities occur, notably an increase in ketone bodies in the blood when there is a severe lack of insulin. The condition may also develop if muscle and fat cells responds poorly to insulin. In people with diabetes, glucose levels build up in the blood and urine, causing excessive urination, thirst, hunger, and problems with fat and protein metabolism.
Diabetes mellitus differs from the less common diabetes insipidus, which is cause by the lack of the hormone vasopressin that controls the amount of urine secreted. The earliest known record of diabetes on third dynasty Egyptian papyrus by physician Hesy-ra; mentions polyuria (frequent urination) as a symptom in 1552 B. C. In the 16th century, Paracelsus identifies diabetes as a serious general disorder.
In the Early 19th century, the first chemical tests developed to indicate and measure the presence of sugar in the urine. In 1919-20, Allen establishes the first treatment clinic in the USA, the Physiatric Institute in New Jersey, to treat patients with diabetes, high blood pressure, and Bright’s disease; wealthy and desperate patients flock to it. On January 23,1922, one of Dr. Collip’s insulin extracts are first tested on a human being, a 14-year-old boy named Leonard Thompson, in Toronto; the treatment was considered a success by the end of the following February. In 1955, oral drugs are introduced to help lower blood glucose levels, and in 1960, the purity of insulin is improved.
Home testing for sugar levels in the urine increases level of control for people with diabetes. The 75th anniversary of the discovery of insulin was celebrated worldwide in 1996. Diabetes is classified into two types. In Type I, or insulin-dependent diabetes mellitus (IDDM), formerly called juvenile-onset diabetes, the body does not produce insulin or produces it only in very small quantities. Symptoms usually appear suddenly and in individuals under 20 years of age. Most cases occur before or around puberty.
In the United States, about 5 to 10 percent of all diagnosed cases of diabetes, up to 800,000 persons, suffer from Type I diabetes. About 30,000 new cases are diagnosed every year. Type I diabetes is considered an autoimmune disease because the immune system (system of organs, tissues, and cells that rid the body of disease-causing organisms or substances) attacks and destroys cells in the pancreas, known as beta cells, that produce insulin. Scientists believe that genetic and environmental factors, such as viruses or food proteins, may somehow trigger the immune system to destroy these cells. Untreated Type I diabetes affects the metabolism of fat. Because the body cannot convert glucose into energy, it begins to break down stored fat for fuel.
This produces increasing amounts of acidic compounds called ketone bodies in the blood, which interfere with respiration. In Type II, or non-insulin-dependent diabetes mellitus (NIDDM), formerly called adult-onset diabetes, the body either makes insufficient amounts of insulin or is unable to use it. Symptoms characteristic of Type II diabetes include repeated infections or skin sores .
