We live in times that will be inscribed on the historical book pages. COVID-19 pandemics have many consequences. It has changed our living habits and shopping style making our lives just different, while the dark face affects our health. However, the fact that the media talks about it the whole time does not mean that it is the only pandemic.
Based on the metabolic disorders, a different one is not called pandemics, but annually, it silently affects many people worldwide. Diabetes is one of the most common disorders that ruin health. A sooner diagnosis makes it possible to avoid serious health complications. Still, it has to be treated seriously and put much effort into understanding the body in need while having it. Let us take a look closer at diabetes. Not only COVID-19 is a pandemic, but also diabetes is it.
Image credit: Pixabay, free licence
Diabetes – what is it?
Each of us has heard about diabetes, but not everyone knows it. Diabetes is one of the most common civilizational diseases affecting the metabolic path in the body. What does it mean in practice? It affects the way we get energy.
Everyone needs energy for functioning. Our body gets it from the food and transforms it into energy. Its decomposition products are released into the bloodstream. Most of the food we eat is converted into sugars; in particular, all carbohydrate foods are broken down into the simple sugar called glucose in the blood.
The hormone that helps us process sugars is glucagon. It works with the second hormone called insulin to control blood glucose levels. As blood sugar levels rise, the pancreas begins to produce insulin, responsible for further sugar processing by our body's cells for energy. However, this process does not always occur correctly; any disorders in that hormone production are severe health disorders, including heart diseases. In these cases, glucose remains in the blood and does not reach the cells.
When the body does not produce insulin or does not use it efficiently, diabetes occurs. What does it mean? Diabetes is a medical condition in which our body has a disturbing way of processing sugars from food. When people with diabetes eat foods that contain glucose, such as bread, cereals, starchy fruits and vegetables, legumes, milk, yogurt, and sweets, their bodies cannot turn it into energy. It can affect our entire body. If uncontrolled and neglected, it can significantly shorten the life of a person suffering from it. Abnormal blood glucose levels can trigger a series of short-term and long-term health complications.
Diabetes variability
When we suffer from diabetes, our pancreas may not produce enough insulin (it may produce excess insulin or too little insulin). Each of these disorders in insulin production leads to serious health problems over time. We can split the most common types of metabolic disease into diabetes type 1, diabetes type 2, and gestational diabetes. The rare diabetes types include monogenic diabetes and cystic fibrosis-related diabetes.
When we are dealing with dramatically too high blood sugar levels, it is a sign that we are affected by diabetes type 1. Most people with this condition have a malfunctioning immune system. Instead of defending our body against infection, it attacks the pancreas and its insulin-producing cells. This results in the cessation of insulin production and thus the remaining sugars in the blood instead of converting them into energy. At the same time, glucose can get to the cells. And the sugar level in your bloodstream increases and reaches a level well above the norm. Such people must take exogenous insulin to survive.
This type of diabetes mainly affects children and adolescents, although it can also develop later in life. If we have someone in our immediate family who suffers from type 1 diabetes (parents or siblings), the probability of developing the disease increases.
Diabetes type 2 is connected with high blood sugar levels; our body does not produce enough insulin or does not use it properly. As a result, too much glucose stays in the blood, and too little gets into the body's cells. It can take years to develop; during the development of the disease, the so-called insulin resistance begins, i.e., a state in which insulin is increasingly ineffective in controlling blood glucose levels.
As a result of insulin resistance, the pancreas produces more and more of this hormone to control blood sugar levels. When this process takes place over a long period, the cells that produce insulin are worn off. This process can be weakened by proper diet and physical activity. This type of diabetes is the most common one, likely it touches adults, but it is also possible to get sick as a child. This type of diabetes is fostered by health disorders such as high blood pressure, overweight/obesity, insufficient physical activity, poor diet, and an apple-like body shape. This condition is quite common in African Americans, Hispanics, American Indians, Asian Americans, or Pacific Islanders.
Gestational diabetes occurs during pregnancy. It manifests itself in the fact that the body cannot produce enough insulin. The demand for which is increasing during pregnancy due to various hormonal changes taking place in the woman's body. This type of diabetes harms the health of the mother and child and interferes with the course of pregnancy and its termination. Usually, after giving birth, a woman's blood sugar levels return to normal. However, the emergence of diabetes during pregnancy may indicate a greater tendency to develop type 2 diabetes.
Monogenic diabetes is diabetes caused by a genetic mutation. We can inherit it from one or both parents. It can also appear spontaneously (neither parent is the carrier). It reduces our body's ability to produce insulin. We can split it into two main types: neonatal diabetes mellitus (NDM) and maturity-onset diabetes of the young (MODY). The first one attacks newborns and young infants, while the second appears in adolescence or early adulthood. MODY is very often misdiagnosed as type 2 diabetes. It requires, in most cases, genetic testing to confirm the diagnosis.
Cystic fibrosis-related diabetes combines the features of both type 1 and types 2 diabetes. People with cystic fibrosis secrete thick, sticky mucus that causes scars on the pancreas that prevent it from producing the right amount of insulin. As with type 1 diabetes, the body is deficient in insulin, so it is not sufficiently nourished.
Diabetes symptoms
How does diabetes manifest itself? It is not always easy to diagnose and is very often detected when it is already very advanced. Often the symptoms are confused with the aging process. And sometimes, before overt diabetes is diagnosed, complications already appear. Diabetes symptoms may include excessive thirst, frequent urination, feeling hungry, tired, and bored.
Often problems with the skin, its infection, slow healing of wounds can also be a symptom of diabetes. Blurred vision, gradual weight gain, mood swings, headaches, dizziness, and even leg cramps may also appear. Overall, diabetes produces a whole range of symptoms. In the case of cystic fibrosis-related diabetes, the signs may not be clearly visible, while they are similar to other symptoms of cystic fibrosis.
Pandemic, and it is not the COVID-19 pandemic at all
In 2020, the COVID-19 pandemic situation completely redesigned the approach to disease detection, especially chronic diseases. When the medical staff was focused on the fight with SARS-cov-2, other diseases were forced to take a back seat. In 2021 we are still struggling with COVID-19, as well as with diabetes.
According to the World Health Organization (WHO) data, the number of diabetes is constantly increasing, starting from 108 million in 1980, 422 million in 2014, to 463 million in 2019. It is predicted that the number of diabetes will increase to 700 million by 2045 [IDF Diabetes Atlas]. Diabetes caused 1.5 million deaths in 2012 and 1.6 million in 2016. Higher than optimal blood glucose levels caused an additional 2.2 million deaths by increasing the risk of cardiovascular and other diseases.
100th anniversary of the discovery of insulin
Before insulin was discovered, diabetes was a real reaper bringing lives to the grave. Luckily, due to human nature pursuing to discover or face challenges, this fantastic substance was found, becoming a breakthrough, saving many lives, and making life easier. The discovery of that hormone has many fathers starting. At the same time, in 1869, Paul Langerhans identified the cells that came to be known as the ‘islet of Langerhans’.
In 1889 von Mering and Minkowski proved that the removal of the pancreas leads to diabetes, and finally, in 1921, Banting, Best, and Collip confirmed that the lack of insulin caused diabetes. They have reported the insulins’ discovery to the American Society of Physiology. [Vecchio et al.]. On 11th January 1921, the first insulin injection to a human was conducted on a fourteen-year-old diabetic patient, Leonard Thompson, at the Toronto General Hospital [Rydosz et al.].
During these 100 years, insulin production was followed by several milestones such as changing the animal sources to recombinant human insulin with the utilization of genetics technology and adjusting the working time to restore the basal working in a similar way to how it is worked in the healthy human body. In addition, the researchers put efforts to develop a fully automated pancreas where the administration of the proper amount of insulin is controlled by real-time glucose monitoring with the utilization of two devices, i.e., continuous glucose monitor and insulin pump.
The novelty is related to another ground-breaking innovation: glucose-sensitive insulin that can auto-adjust its biological activity in response to fluctuating blood glucose levels. Such works are still ongoing, but the positive outcome may bring the revolution in diabetes treatment to insulin discovery in 1921.
Summary
Diabetes affects people globally. It can occur at any age and cause serious health consequences. Its symptoms cannot be ignored because it is easier to manage to live with this condition sooner it is detected. Luckily, we live in times when it is straightforward to deal with such a disease. Hopefully, it will be under control due to the progress in artificial pandemics research development.
This article is a joint work of Artur Rydosz (AGH University of Science and Technology, Biomarkers Analysis Lab, Institute of Electronics), Agnieszka Pregowska (Institute of Fundamental Technological Research, Polish Academy of Sciences), Magdalena Osial (Institute of Fundamental Technological Research, Polish Academy of Sciences; and Faculty of Chemistry, University of Warsaw) as a part of the Science Embassy project. Image Credit – Magdalena Osial.
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