DIABETES MELLITUS.
By Samantha Dalton.
What is diabetes mellitus??




A chronic condition in which the male/female is unable
to utilise the blood glucose correctly.
It is the basic unit of fuel for energy, and is therefore
the body’s cells to maintain normal function.
When the blood glucose isn’t being taken into the cells,
the blood glucose levels become high and the cells
cannot function properly.
Insulin is a hormone that is hidden by the pancreas, it’s
job is to keep the uptake of the glucose from the blood
into the cells.
Different types of diabetes mellitus.





Type 1: mostly diagnosed within children and youths, but can also occur
in any other stage of life.
Mostly characterised by the pancreas not producing enough (or
if any) insulin to allow the glucose from the blood into the cells.
The cause of type 1 diabetes is unknown, but there is a strong genetic
link, also exposure to certain viruses such as influenza is also thought to
be a cause.
As little or no insulin is produced the individual must do it themselves,
was once administered by a needle and syringe, but now its done by a
pump.
Those with type 1 must constantly monitor their blood glucose levels to
stay within a certain range. If they get to high (hyperglycaemia) or to
low (hypoglycaemia), a range of side effects such as: tiredness,
confusion & headaches. Its then they must pay special attention to their
diet, exercise and body weight.
Different types of diabetes mellitus cont.







Type 2: usually occurs in older or overweight people, but there has
been more cases when a younger person is diagnosed with it, and is
unable to be cured but managed effectively.
In type 2 the pancreas doesn’t produce enough insulin, OR the body
cannot use the insulin effectively (known as insulin resistance).
Being overweight is the greatest risk factor for getting type 2
diabetes, the exact reason is unknown, but there is a number of
possibilities for example:
Fat cells maybe more resistant
Overweight people have put a strain on their pancreas as it has
tried to produce the insulin to the body
High levels of fat in the body may destroy the insulin being
distributed by the pancreas
Type 2 is associated with other conditions such as cardiovascular,
obesity, hypertension & high cholesterol
Different types of diabetes mellitus cont.





Gestational diabetes: occurs during pregnancy in 3 to 8 per cent of
pregnant women, as the baby develops, hormones are released to assist its
growth and development.
The hormones are essential for the growth and development of the baby
but also reduce the impact that insulin has on blood glucose levels of the
mother.
As the energy requirements for the duration of the pregnancy increases so
does the insulin levels, but if the mother cannot produce enough insulin to
maintain the glucose, this may result in diabetes.
Gestational diabetes may mean that more glucose is passed onto the baby,
which can increase gestational growth, meaning that the baby has a high
birth weight, and can cause low glucose levels in a newborn.
GD usually disappears after the baby is born, and the mothers weight and
energy levels return to normal. Those who experience this are at high risk of
developing type 2.
Why is it a NHPA??




Diabetes mellitus is a NHPA because of the following
reasons:
Is the leading contributor to the burden of disease. In 2010,
diabetes was estimated to be ranked sixth with regards to
the burden of disease, contributing to 6.2 per cent of DALYs.
850 000 Australians (4 per cent) reported having diabetes
as a long-term condition.
In 2010 diabetes mellitus was the underlying cause of death
in 2.7 per cent of all registered. In a further 7 per cent of
deaths in 2010, diabetes was listed as an associated (or
contributing) cause of death. Diabetes was considered to
play an associated role in approximately 10 per cent of all
deaths.
Costs associated with diabetes mellitus?


DIRECT: in 2004-05, approximately $900 million was
spent on diabetes. Most of the money was put towards
the management of the condition, (due to there is no
cure), such as ‘doctors’ and ‘specialist’ consultations and
pharmaceuticals benefits scheme, and private health
insurance companies.
Direct costs to the individual include co-payments for
health services and medication. Uncontrolled diabetes
can lead to ‘diabetic coma’ and unconsciousness, which
can require ambulance transport, another direct cost to
the individual.
Costs associated with diabetes mellitus?



INDIRECT: according to the access economics
(2008), the indirect costs almost amounted to almost
$3 billion.
To the community it includes government security
payments, lost productivity and payment for carers.
To the individual indirect cost associated to their
condition, this includes paying for a dietician or
personal trainer to assist with weight management,
and loss of income if they are unable to work.
Costs associated with diabetes mellitus?





INTANGIBLE: involves making lifestyle changes to diet and
activity levels to manage the condition, these changes may
have to be made to both the individual and those living with
them. Examples include:
Frustration over having to make changes to diet and
exercise routines,
Loss of self-esteem after being diagnosed with diabetes,
Anxiety about the possibility that the condition could
progress ( diabetes has a number of long term effects such
as blindness & limb amputations).
Frustrations with family members having to make lifestyle
changes.
Risk factors.





BIOLOGICAL: being over weight or obese are risk factors for type 2
diabetes.
High blood pressure and high cholesterol are more common with people
who have type 2 diabetes, there is conflicting evidence as to whether
these determinants contributes to the onset of diabetes or whether the
higher rates of obesity in diabetes sufferers increase the likelihood of
developing these conditions.
Impaired glucose regulation. (a precursor of type 2, and makes the risk
factor even higher for developing type 2 and cannot be addressed by
life style change).
Genetic predisposition. (family members who have had it make your
chances of getting all types of diabetes it is even higher, than those
who don’t).
Age. (the risk of type 2 increases with age, those over 55 are most
susceptible, but younger people are also at high risk due to high
obesity rates among these groups.
Risk factors.





BEHAVOURAL:
Tobacco smoking (high blood glucose levels can lead to
insulin resistance).
Excessive alcohol consumption (can lead to obesity,
which is a risk factor for type 2 and gestational
diabetes).
Dietary behaviour (eating an energy-dense or high fat
foods can contribute to weight gain and lead to type 2
and gestational).
Physical inactivity (being inactive can lead to weight
gain which increases the chances of being obese and
therefore type 2 and gestational diabetes).
Risk factors.




Physical environment: as obesity is a risk factor for type 2
diabetes, aspects of the physical environment can increase
the risk of obesity and also increase the chances of type 2
diabetes. Examples include:
Access to recreational facilities (if there are no ovals or
walking paths, the individual might not get the required
amount of exercise).
Work environment (not walking up stairs and being in a
small office space can contribute to obesity and type 2
diabetes).
Transport systems (transport systems that foster passive
methods of transport, such as car travel, can increase the
risk of obesity and type 2 diabetes).
Risk factors.





Social:
Socioeconomic status (people with low socioeconomic status
have higher rates of obesity and higher rates of type 2 and
gestational diabetes).
Occupation (people with low physical job may be at risk of
obesity and type 2).
Food security (those with a lack of food security are more
likely to eat energy-dense food and increase the chances of
obesity and type 2, as well as gestational diabetes).
Early life expectancy's (low birth weight increases the
chances of type 2, the lack of malnutrition and damage to
the insulin-producing cells in the pancreas).
Promotional programs.







Swap it, don't stop it.
The shape up campaign ( promotes physical activity and healthy
eating). http://shapeup.gov.au/
Prevention of type 2 diabetes program (aims to decrease or
delay the development of diabetes in high risk individuals aged
40-9).
National diabetes week (an annual event coordinated by
Diabetes Australia. Aims to raise awareness about type 2, and
reduce the risk factors that contribute to it).
Life! (aims to reduce the incidence of type 2 diabetes among
those at risk). http://www.diabeteslife.org.au/links
http://www.diabetesaustralia.com.au/
http://www.healthdirect.gov.au/topic/diabetes
Bibliography.

Key concepts in VCE Health and Human
Development textbook. P.G. 181-85