Diabetes Mellitus

My original research proposal was to study the increasing cases of food allergies and intolerances in an attempt to establish what factors could be responsible for the rising number of sufferers. Whilst conducting my initial research I found resources such as scientific studies were very limited, which would have considerably impaired my investigation. I took the decision to change my research subject to diabetes mellitus as this subject is of personal interest to me and the resources and literature on diabetes is vast.

Firstly I will give a medical explanation as to why we get diabetes, what it exactly is, the symptoms it causes and how scientists discovered the treatment. I will be using two diabetes sufferers as case studies, conducting in-depth telephone interviews. Initially I distributed questionnaires to be completed by the general public in order to gather information, my findings were inept and I was unable to use my results to prove or disprove my hypothesis. I therefore have made the decision to conduct two in depth case studies. Although my case studies will provide me with detailed information, case studies are time consuming so I will only be able to perform two, which will reduce my comparison availability.

Case study one suffers from insulin-dependent diabetes and case study two suffers with non-insulin-dependent diabetes. I will interview both subjects extensively in order to establish their past and present medical history, lifestyle, social background and vital statistics. I will then present my data and analyse the significance of my findings and conclude if my hypothesis was proved or disproved. I hypothesise that my case study one and two’s diabetes related health complaints i.e. excess thirst and urinating would be reduced if they were to make nutritional alterations to their current diet.

What is Diabetes? (1.2)

One of the pancreases functions is to monitor the level of blood glucose. If blood glucose levels become too high � cells in the islets of langerhans discharge insulin. Insulin then travels around the body in the blood, but exerts an effect mainly on cells in muscles, liver and adipose tissue. This hormone acts in the body by lowering blood glucose and making the cell surface membranes more permeable to glucose. It activates transport proteins in the membranes, allowing glucose to pass into cells, as well as this insulin also activates enzymes in the cells.

A proportion of these enzymes convert glucose into glycogen whilst other enzymes increase protein and fat synthesis. If the levels of blood glucose get to low ? cells in the islets of langerhans secrete glucagon. This hormone fits into the receptor sites on cell surface membranes and activates the enzymes inside the cells that convert glucogen into glucose. The glucose then passes out of the cells and into the blood, raising blood glucose levels.

Suffers of the disease diabetes mellitus are unable to control the level of glucose in their blood. Diabetes suffers produce little or no insulin, this makes their blood glucose levels too high. When the body does not produce enough insulin, glucose is unable to pass into the cells and stays in the blood. The solute concentration of the blood increases, inhibiting the effective circulation and causing the sufferer to be excessively thirsty. Weight loss occurs and eventually starvation occurs as the cells become starved of their main fuel, forcing them to respire lipids and proteins. The urine of a person with diabetes contains glucose as the kidneys are unable to reabsorb all the glucose making the blood sugar level high. Individual cases of diabetes are caused by a variety of factors and varied degree of severity.

Symptoms and type of diabetes (2.0)

There are two main types of diabetes: insulin-dependant diabetes (type 1) and non-insulin-dependant diabetes (type 2.) Type 1 diabetes occurs when the body is unable to produce insulin. This is often caused by an auto-immune which attacks and destroys cells in the islets of Langerhans. This form of the disease usually occurs before the age 20. The onset of this type of diabetes is sudden and the condition is permanent but it can be treated with regular injections of insulin matched to their glucose intake in the diet and expenditure in exercise and physical activity.

Prior to diabetes being understood, for people with untreated diabetes it was usually fatal, opposed to today where sufferers of the condition can lead normal lives. Non-insulin-dependant diabetes (type 2) is the most common form of diabetes, accounting for approximately 72 per cent of the cases in the United Kingdom. The onset appears usually in adults of middle age and is more common in people who are overweight or obese. Type 2 diabetes is due to a decline in the efficiency of islet cells, or to a failure of the cell surface membranes to respond to insulin. In a large proportion of cases this type of diabetes can be managed by dietary changes.

Glucose is imperative to our bodily functions. The majority of our energy is obtained by respiring glucose, therefore our cells need a regular supply of this simple sugar. Some of our vital organs including the brain cannot do without glucose even for a short period and an insufficient supply of glucose could even lead to brain damage. If glucose is unavailable Some cells and tissues such as muscles can respire lipids and proteins for a limited time. Blood glucose comes from the digestion of carbohydrates in the diet. There are a number of ways in which we can obtain blood glucose:

* Through the digestion of carbohydrates

* Through the breakdown of glycogen. This storage polysacharride is made from excess glucose in a process called glycogenesis. Glycogen is particularly plentiful in the liver and muscle cells. When necessary, glycogen can be broken down quickly to release glucose in the process of glycogenolysis

* Conversion of a non-carbohydrate compounds following deamination, this conversion process is called gluconeogenesis

How the treatment for diabetes was discovered (3.0)

In early science, the way scientists studied an organs function in the body was to remove the organ and observe any effects of this loss. They would then inject a ground up extract of the gland, if symptoms were cured. The organ was then identified as an endocrine gland. By the beginning of the 20th century, this technique had clarified the role of numerous organs. Researchers had the idea that the pancreas was an endocrine gland, they encountered obstacles when trying to use this method to show that the pancreas produced the hormone responsible for controlling glucose metabolism.

After researchers removed the pancreas of a dog it presented signs of diabetes but when they injected the dog with the extract of ground up pancreas it did not irradiate any of the symptoms presented. A Canadian doctor hypothesised that digestive enzymes produced by the pancreas could be responsible for destroying any other active substances that were being made there. The Canadian doctors along with his assistant preformed experiments on the dogs, the animals were split into two groups A and B. The pancreatic ducts of group A dogs were tied so the dogs were unable to produce pancreatic juice. Over several weeks the cells of the acini degenerated leaving the islets of langerhans still functioning.

Group A dogs did not become diabetic. The group B dogs had their pancreases removed and all became diabetic. The researchers then produced a pancreatic extract from the group A dogs and injected it into the group B dogs. The results were astounding, the researchers found an immediate reduction in blood sugar. The researchers proceeded with their research and began injecting humans with the same extract as the group B dogs. This proved disappointing as the humans became feverish. The help of biochemist James Collip was enlisted, he went on to produce a purer extract which could be used on humans.

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