Diabetes Mellitus: A Common Disease

Epidemiology In 2000, according to the World Health Organization, at least 171 million people worldwide suffer from diabetes, or 2.8% of the population. Its incidence is increasing rapidly, and it is estimated that by 2030, this number will almost double. Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the more developed countries. The greatest increase in prevalence is, however, expected to occur in Asia and Africa, where most patients will probably be found by 2030. The increase in incidence of diabetes in developing countries follows the trend of urbanization and lifestyle changes, perhaps most importantly a "Western-style" diet. This has suggested an environmental (i.e., dietary) effect, but there is little understanding of the mechanism(s) at present, though there is much speculation, some of it most compellingly presented. For at least 20 years, diabetes rates in North America have been increasing substantially. In 2010 nearly 26 million people have diabetes in the United States alone, from those 7 million people remain undiagnosed. Another 57 million people are estimated to have pre-diabetes. The Centers for Disease Control has termed the change an epidemic. The National Diabetes Information Clearinghouse estimates that diabetes costs $132 billion in the United States alone every year. About 5% 10% of diabetes cases in North America are type 1, with the rest being type 2. The fraction of type 1 in other parts of the world differs. Most of this difference is not currently understood. The American Diabetes Association cite the 2003 assessment of the National Center for Chronic Disease Prevention and Health Promotion (Centers for Disease Control and Prevention) that 1 in 3 Americans born after 2000 will develop diabetes in their lifetime. According to the American Diabetes Association, approximately 18.3% (8.6 million) of Americans age 60 and older have diabetes.[33] Diabetes mellitus prevalence increases with age, and the numbers of older persons with diabetes are expected to grow as the elderly population increases in number.

Philippines on Diabetes One out of every five adult Filipinos are diabetic, according to the latest national survey conducted on the prevalence of diabetes in the country. The survey, conducted in 2007 by the Philippine Cardiovascular Outcome Study on Diabetes Mellitus(PhilCOS-DM), further shows that as many as three out of five adults are already diabetic or on the verge of developing diabetes unless they change their lifestyle. (Philippine Daily Inquirer, By Dona Pazzibugan)

Diabetes Mellitus Rice and wheat products are the staple food of the Filipinos and even to other countries. It contains carbohydrates that is necessary in the production of energy in our body. The carbohydrates is converted into glucose (sugar) by metabolism. The glucose is the main source of the energy. However, in excess of sugar in our blood can affect our body system function and one of which is having Diabetes Mellitus. Diabetes is a group of metabolic diseases characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action, insulin receptors or any combination of conditions. Diabetes Mellitus (DM) is considered as one of the leading diseases in the world and even death, if left untreated. It is treatable and controllable if diagnosed at the early stage, however, treatment or medication is lifetime. Hundreds of years ago, a Greek physician named it diabetes, which means to flow through, because of the large amount of urine generated by the victims. Later, the Latin word mellitus, which means honeyed, was added because of the amount of glucose in the urine. Pancreas is an organ in our body that produces hormones to control or balanced the blood glucose level, is the amount of sugar in the blood. The hormones are found at the Islet of Langerhans and are produced by 3 different cells: ALPHA, BETA, and DELTA. The primary hormone in this work/ function is the INSULIN. Insulin is the hormone produced by the BETA Cells, which helps in the regulation or balance of sugar in the blood. The amount of glucose in the blood normally arises after a meal. The pancreas reacts by providing insulin. As the insulin circulates in the blood, it binds to surface receptors (plugs). This binding causes reduce amount of glucose in the blood. The symptoms experienced by a diabetic patient are Polyuria or excessive urine, Polydipsia or excessive thirst, Polyphagia or excessive appetite but at the same time loss of weight, weakness, and fatigue occur. Slow wound healing, visual changes, and recurrent skin and mucous membrane infections. Several diagnostic procedures are done to detect if a client is diabetic. These tests help the doctor to provide the proper care and to monitor the clients status. The most common test done is the Blood Glucose monitoring, there are 2 types: the FBS (Fasting Blood Sugar) and RBS (Random Blood Sugar). FBS needs 8- 12 hours not to eat something to be accurate. RBS in contrary needs no preparation unlike FBS. The Normal FBS Count is 3.3- 6.05 mmol/l (60-110 mg/dl), if there is a significant increase from the normal value, the client might have a diabetes. The Normal RBS Count is 3.58- 7.7 mmol/l (60- 140 mg/dl), same as to FBS, a significant increase imply a diabetic client. Classification of Diabetes

Diabetes Mellitus is a lifestyle and genetically acquired disease. It is considered lifestyle acquired because of the unbalanced and unhealthy habit of an individual. The cause of diabetes may vary to types. There are 2 types of diabetes: Type 1 Insulin Dependent Diabetes Mellitus (IDDM), and Type 2 NonInsulin Dependent Diabetes Mellitus (NIDDM). Type 1 Insulin Dependent Diabetes Mellitus (IDDM), is basically genetically acquired, meaning, it is acquired through familial history. For example, a mother/ father has a diabetes, the possibility of having a Type 1 diabetes is high. Type 1 is characterized by the destruction of beta cells, thus there is a decrease in the production of the insulin. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children. Type 2 Non- Insulin Dependent Diabetes Mellitus (NIDDM) is both acquired because of unhealthy lifestyle and genetics, however, the cause is still unknown. Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. Due to the impaired function of insulin there is less uptake of glucose, thus increases the blood sugar. Another type of Diabetes is the Gestational Diabetes Mellitus (GDM). Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2%5% of all pregnancies and may improve or disappear after delivery. Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. About 20%50% of affected women develop type 2 diabetes later in life. Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. A 2008 study completed in the U.S. found that the number of American women entering pregnancy with pre-existing diabetes is increasing. In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years. This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future. Diabetes mellitus is a chronic disease which cannot be cured except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal ("euglycemia") as possible, without causing hypoglycaemia (low blood sugar). This can usually be accomplished with diet, exercise, and use of appropriate medications (insulin in the case of type 1 diabetes, oral medications as well as possibly insulin in type 2 diabetes). Patient education, understanding, and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels. Complimentary therapy has also been discovered in the management and even prevention of diabetes. Ampalaya, also known as Bitter Melon, is a crawling vine that grows well in tropical countries, particularly in

the Philippines. Known for its bitter taste, the Ampalaya is at once a staple ingredient in Filipino and Asian cuisine and a reliable home remedy for various illnesses, particularly diabetes. Ampalaya has long been a popular part of many Asian vegetable dishes. Though notorious for its bitter taste, Ampalaya is rich in iron, potassium, beta-carotene and other nutrients. But aside from its role as a healthy food, Ampalaya is especially valued by diabetics for its known anti-diabetes properties. The traditional remedy is made by pounding the raw fruits of Ampalaya into a bitter liquid, or by boiling the leaves and fruits for a few minutes, the resulting water then drank as a herbal tea. Ampalaya has the most documented scientific reports that cite its blood sugar-lowering benefit. Research worldwide since the 1960s cites the plants key compounds, notably polypeptide-P, a plant insulin known to lower blood sugar levels. The plants insulin-like benefits have long-been enjoyed by many diabetics, who include Ampalaya as part of their daily diet, either eaten as a vegetable or taken as a tea. With the traditional use supported by modern scientific validation of the plants benefits, the Ampalaya is the single most promising plant/herb for diabetes today. (http://www.charantia.com/about-ampalaya/)