What is Diabetes?
Diabetes is a deadly, worldwide disease that affects people of all
backgrounds and nationalities. This disease is structured into three different classifications:
Type 1
Type 1: The least common form, formerly known as juvenile diabetes, this selective autoimmune disease seeks and eliminates the pancreatic beta cells in the pancreas. This leads people with this disease to have very little insulin and must therefore receive artificial insulin.
Type 2
Accounts for 90-95 percent of people with diabetes. In this case, insulin is being produced by the body but the insulin is flawed, therefore not fulfilling the body’s needs. This leads to a condition called insulin resistance. 80 percent of the people diagnosed with this disease are overweight and the majority of the people diagnosed with this disease are over 40 years of age.
Gestational Diabetes
A much rarer form that occurs in women during pregnancy.This condition
often disappears after the child is born. Only 5-10 percent of women with gestational diabetes develop type 1 or 2 diabetes after pregnancy.
Thesis
In understanding the past, present, and future of this disease we can understand its cultural and economic impact on Eastern and Western civilizations.
Past
Diabetes was initially discovered by the early Egyptians around the year 1500 B.C.E. The initial symptoms were defined as someone that “urinated excessively and lost weight.” The official Latin name “diabetes mellitus” was formed by the Greek Physician Aretaeus. In the mid 1800’s Claude Bernard discovered that the liver plays an important role in the regulation of blood glucose levels. Previous to this discovery, scientists were unsure as to what bodily organ produced or reduced glucose. All further scientific discoveries were founded upon this initial breakthrough. Later in 1889 Joseph von Mering and Oskar Minkowski conducted an experiment which removed the pancreas from dogs with the diabetes disease and discovered that removing this organ resulted in fatal complications in all the test subjects. This discovery narrows down the pancreas as the main function in regulation of blood glucose levels. In 1910, Edward Albert Sharpey-Schafer made a major breakthrough in regards to scientific study regarding diabetes in which he discovered that this disease stemmed from the deficiency of a “single chemical produced by the pancreas” which he labeled insulin. (Directly from the source: “Insulin from the Latin word insula, meaning island and referring to the pancreatic islet cells of Langerhans”). Although this chemical compound had been discovered, extraction did not occur until 1921 when Frederick Banting, Charles Best, James Collip and John Macleod reversed diabetes in dogs using a process of inducing dogs with an extract of pancreatic islet cells from healthier counterparts. This led them to refine insulin and conduct their first human test which was successful. This led to the rapid production of insulin for diabetic causes throughout the world.
Production of Insulin
Early insulin was very short acting requiring patients to take multiple
injections per day. In 1936, zinc was added to the insulin formula, creating protamine zinc insulin which allowed for more time between injections because the zinc prolonged the insulin’s effects. In 1946 isophane insulin was created which was a huge breakthrough for the insulin industry because it allowed much more flexibility with insulin injections and combination therapy. In 1980, the largest breakthrough for the insulin industry came through the creation of synthetic insulin. Synthetic insulin was the first hormone to ever be cloned in a lab. Previously companies were using animal-based insulin which (due to the rise of diabetes) many estimated that future production could not be sustained. Synthetic insulin both decreases chance of an allergic reaction drastically and allows for more methods of combination therapy.
Goal of Paragraph
To illuminate advances in diabetes knowledge and the timeline of growth in medical knowledge in the field.
Present
According to the U.S Census Bureau and the Center for Disease Control and
prevention, in 2010, there are approximately 25.8 million people living with diabetes in America. That represents about 8.3 percent of the population. 11.3 percent of people ages 20 and older have diabetes compared to 26.9 percent of all people ages 65 and older have diabetes. When comparing sex, 13 million men have diabetes and 12.6 million women have this disease. 10.2 percent (15.7 million) of all non-hispanic whites have diabetes compared to 18.7 percent (4.9 million) of non-hispanic blacks. There is not sufficient information regarding other minorities. (CDC)
Worldwide- This disease initially began as a Western problem but has now spread across the world. “According to the International Diabetes Federation, diabetes affects at least 285 million people worldwide, and that number is expected to reach 438 million by the year 2030, with two-thirds of all diabetes cases occurring in low-to middle-income countries. The number of adults with impaired glucose tolerance will rise from 344 million in 2010 to an estimated 472 million 2030. Globally, it was estimated that diabetes accounted for 12% of health expenditures in 2010, or at least $376 billion- a figure expected to hit $490 billion in 2030.”
(What does that mean?) Initially diabetes was thought of as “rich man’s disease” because it only affected those in first world countries and of higher socio-economic status but now that this disease has a global impact there is more of a push to understand what factors cause this disease in order to formulate a cure.
Causes of Diabetes
Because of the high rate of new diagnosis in first world and developing
countries many efforts have been put towards understanding the causes of this disease in order to form preventative methods for upcoming generations.
Weight/Body Mass
Obesity is noted as the main factor in otherwise healthy people developing diabetes. While actual weight is not a direct catalyst of diabetes, studies show that the sedentary lifestyles that many people of obese nature exhibit are huge factors for pre-diagnosis of diabetes. It seems that high dietary glycemic load (GL) and trans fat are associated with increased risk of diabetes. The worldwide increase in consumption of sugar-sweetened beverages, fast food, and specifically use of high-fructose corn syrup have effects on the body that led to obesity. “Weight loss can reduce the risk of diabetes in predisposed persons by 58%”.
Genetics
Unlike many incurable diseases, there is no single genetic marker that causes diabetes., “Type 1 and Type 2 diabetes are polygenic disorders, and multiple genes and environmental factors contribute to the development of the disease. 1” In cases of Type 1 diabetes, certain predominant genetic factors have been discovered arguing that this disease is hereditary. No “predominant genetic susceptibility” for Type 2 diabetes has been discovered.
Additional Information
60 percent of the world’s diabetic population resides in Asia. Asia is a developing economy and is vastly more connected to world trade and worldly conviences and they have adopted many of the unhealthy habits of western culture, which include fast food, sedentary lifestyles, personal automobiles, etc. China leads new diagnosis and India trails in second. Studying or chronicling the rise of diabetes in Asian countries will flesh out the thesis. Light-to-moderate alcohol consumption is linked to decreased chance of diabetes.
Goal of Paragraph
Goal of this paragraph- To chart the present day state of the diabetes epidemic and to establish its presence on the world stage.
Future
As stated earlier, cases of diabetes are only increasing, therefore causing strain on various nations’ economies around the world. (See Figure 4) From 1980- 2010 the number of diagnosed cases of diabetes jumped from 5.6 million to 20.9 million. Diabetic care and treatment cost the U.S government 174 billion dollars in 2007. At this time preventative care is the most effective way to fight the diabetes epidemic. Preventative care includes exercise, healthy diet, absence of smoking, and some argue the advance of stem cell research will open up new doors in the fight against diabetes. Technology has also given those with diabetes new ways to be in control and fully aware of insulin injections. See figure 3.
Conclusion
Is the diabetes epidemic a reflection of our dependence on technology/laziness or is it a much deeper problem? Restate thesis and explore cultural impact. How can we fix this problem? If we don’t
establish a cure in the near future will diabetes be a disease the next generation will have to deal with? Will it be worse for them, if so, what does that mean? Apply this disease to a larger context (fight against obesity) or make personal anecdote if this has personally affected your life.