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Diabetes is a condition that affects a large number of the worlds population. Worryingly cases are on the rise; given there is no cure, diabetes presents a major problem. Statistics have shown diabetes is the ninth major cause of death in the world, however medication is available to help control diabetes (which is very successful), therefore you would expect to see a decline in the number of deaths due to diabetes; however the number of deaths is actually increasing.
Deaths in millions
% of deaths
Ischaemic heart disease
Stroke and other cerebrovascular disease
Lower respiratory infections
Chronic obstructive pulmonary disease
Trachea, bronchus, lung cancers
Road traffic accidents
http://www.who.int/mediacentre/factsheets/fs310/en/index.html (source 1)
What is diabetes?
There are two types of diabetes, type 1 and type 2. What they both have in common is that the body cannot use glucose properly in the same way as a healthy person can. Glucose is a form of sugar, and is the by-product of foods we eat which contain starch or sugar e.g. potatoes.
What separates these conditions is the way in which the production of insulin begins to cease. I will mention each case below.
Type 1 diabetes http://media.sharecare.com/mediaItems/4/c/8/4c8e41b6b34cf/adam_pancreas_and_surrounds_8909.jpg.jpg
This molecule is known as propan-2-one or acetoneType1 diabetes usually occurs before the age of 30 and most commonly develops in children and teenagers. The pancreas (an organ that is positioned behind the stomach) is responsible for the production of insulin. Beta cells in the pancreas produce insulin and release it on the signal of glucose levels in the blood. However in a person with type1 diabetes the immune system destroys these cells and over time there is little or none of these specialised cells left and the production of insulin ceases. The human body contains specialised cells known as white blood cells, these cells recognise foreign bodies such as bacteria, in type1 diabetics the white blood cells attack the beta cells mistaking them for foreign bodies, it is unknown why this happens. In a healthy person the hormone (hormones regulate cells in the body) insulin would be secreted in response to the glucose levels in the blood, the insulin would then transport the glucose into cells, where it is converted into ATP, 'ATP triggers cellular metabolism and without its presence, cells have no energy to repair, reproduce, or function'. (3) (The energy is either used or stored). In people with diabetes this process does not function correctly and instead glucose accumulates in the blood. This becomes a real problem as the glucose starts to bind to the red blood cells. In turn the red blood cells mobility becomes reduced and they start to stiffen. This can cause numerous problems with the blood circulation, and can actually cause cholesterol to accumulate inside artery walls which could lead to much further complications such as atherosclerosis. An even greater risk is a condition called ketosis, because glucose is not used appropriately energy sources are scarce, therefore the body begins to break down fats, when too much fat is broken down at a given time ketones are formed. If there is not enough insulin to use the glucose correctly, more ketones are released due to the breakdown of fat. Ketones are acidic and too much of these make the blood PH very low (acidosis). If left untreated acidosis can cause shock and even death.Ketone production by the liver during fasting conditionsimage:acetone.png
Type 2 diabetes
Functional groupType2 diabetes is the most common form of diabetes it differs from type 1 diabetes as the sufferer is still able to produce insulin, however it may be the pancreas does not produce enough insulin or the body does not respond correctly to the insulin being produced. Therefore the cells do not use glucose correctly in the same process mentioned above.
This is the simplest ketone. A ketone is an organic molecule with a double bonded oxygen attached to the carbon. What distinguishes it from similar compounds is the carbon attached to the oxygen is attached to two other carbon atoms.
What causes diabetes?
It is not fully understood why diabetes develops, but there are several suggestions to explain why insulin production is reduced.
The risk of developing diabetes is increased if direct family members are diagnosed with the condition.
Type 1 diabetes and genetics - average risks
Mother with diabetes increases risk of diabetes by 2%
Father with diabetes increases risk of diabetes by 8%
Both parents with diabetes increases risk by 30%
Brother or sister with diabetes increases risk by 10%
Non-identical twin with diabetes increases risk by 15%
Identical twin with diabetes increases risk by 40%
Type 2 diabetes and genetics - average risks
If either mother of father has diabetes increases risk of diabetes by 15%
If both mother and father have diabetes increases risk by 75%
If non-identical twin has diabetes increases risk by 10%
If identical twin has diabetes increases risk by 90%
However by looking at these results it can be said that genetics are not a sole cause for diabetes as the concordance rates are not 100%, it may be genetics are just a trigger. The data suggests that genetics play a bigger role in the development of type 2 diabetes.
Researchers suggest that obesity is directly linked with obesity. It is thought that the more fat tissue someone has the more insensitive the body becomes to insulin, and so more insulin is needed to be produced in order for bodily functions to be carried out efficiently. This happens because fat cells release proteins, these proteins are thought to cause the body to become insensitive to insulin, because the pancreas has to produce more insulin it soon becomes exhausted and insulin production may fall or sometimes even stop completely.
Main solution- stem cell research
Stem cells are unique; they are undifferentiated cells that have the potential to grow into many specialised cells such as nerve cells, muscle cells and blood cells.
Stem cell research involves growing these unique cells and seeing how they behave in different conditions, for example growing beta cells (cells that produce insulin) and injecting them into diabetic suffers.
Totipotent: these are created when the human egg and sperm fuse they can develop into an embryo, these cells can give rise to all cells
Pluripotent: these cells can give rise to most specialised cells but not an embryo
Multipotent: these stem cells can give rise to some specialised cells.
Stem cells come from a variety of sources for example the embryo and bone marrow; however there is difficulty obtaining donors for stem cells especially since these cells would be required on such large scale and there is a risk of rejection.
Pluripotent cells can be taken from a blastocyst (a hollow ball of cells) it is the earliest stage of the development of the embryo. A blastocyst is thought to contain 50 or so pluripotent cells. The cells may come from fertility clinics from women who are undergoing in vitro fertilisation remaining embryos that are not used in the process can be used as a source of pluripotent cells.
The embryos being used are allowed to be grown into a blastocyst, then the embryos are cultured for a further period to see if stem cells form. If successful the stem cells are isolated from the embryo (which is discarded). If the process is successful these stem cells will be used in research and possibly used for treatment.
It is thought by researchers that stem cells may be able to:
'Be coaxed to produce insulin-producing cells that could be used in islet transplantation through cloning.
Be used to prevent diabetes and its complications (including complications during pregnancy).
Be able to repair the tissue damage that diabetes causes over time.'
Advantages of stem cell research
Stem cell research provides hope for a cure of many diseases such as: diabetes, cancer and Alzheimer's.
If a stem cells could cure diabetes
Disadvantages of stem cell research
The use of embryonic stem cells raises the issue of ethics; these cells are taken from a blastocyst which is the earliest form of the embryo, for those who believe life begins at contraception it is thought to be immorally wrong since the embryo has a right to life.
The stem cells used for treatment are not likely to be the patients therefore there is a risk of rejection as the body's immune system may destroy these cells, additionally treatment is very expensive and donors are hard find.
Like any other treatment/medication there are side effects, it is unknown what the risks are however researchers may have established a link between stem cells and tumour growth, on-going research is underway as a causation has yet to be established.
Type1 and Type2 diabetes can be kept under control by a balanced diet; it doesn't need to be restrictive but healthy. Type1 diabetics would still need to take insulin injections but still a healthy diet can improve the state of the condition.
It is important for diabetics to eat regular meals as glucose levels can be controlled more easily. If the sufferer is taking insulin the injections must coincide with meal times.
A basic eating plan:
Skimmed or semi-skimmed milk
Artificial sweetener instead of sugar
High fibre cereal e.g. porridge, bran flakes, weetabix
Wholemeal or wholegrain bread
Poly- or monounsaturated low-fat spread
Reduced-sugar jam or marmalade
Include some starchy food- leavened bread, potatoes, pasta, rice
At least two portions vegetables and try to include peas and beans as often as possible
Small portions of lean meat or fish cut of fat (avoid frying).
Sugar-free jelly or custard
Homemade or low fat soup.
Pasta, flat breads or jacket potatoes- low-fat fillings such as lean meat low-fat cheese or tinned fish
Fresh or tinned fruit
Vegetables or salad
Sandwiches- low fat fillings
Carbohydrates are broken down in the human body to produce glucose there are two types: sugar and starch:
Starch: foods such as rice bread and potatoes contain starch, diabetics should include these types of foods in their regular diet as they release glucose slowly into the body over a duration (they are good sources of energy).
Sugar: These include foods such as chocolate and sweets, diabetics should avoid these types of food because the glucose is released very quickly into the blood which can cause a sudden rise in blood sugar and may lead to further complications.
Insulin- insulin is the most common medication used for type 1 diabetics, without insulin blood sugars would not be controllable and death would be a likely outcome.
Insulin is a hormone; hormones are composed of amino acids which are represented as circles in the diagram.
Insulin injections are the only way to deliver it effectively into the body. Insulin is normally produced by the pancreas in response to food, so to imitate the body's natural process insulin injections are taken several times a day just after meal times to keep the blood sugar levels stable.
http://www.who.int/mediacentre/factsheets/fs310/en/index.html - Table of causes of death (2008)
http://www.carbs-information.com/glucose-energy.htm - The use of glucose
http://www.shankara.com/what-atp-what-does-it-stand-and-what-mechanism-which-it-energizes-cells - ATP
http://ourohio.org/food-and-cooking/diet/healthy-you/what-s-so-bad-about-high-blood-sugar/ - problems due to accumulation of blood cells.
http://arizonatransplant.com/healthtopics/pancreas.html information on pancreas.
http://www.wisegeek.com/what-are-beta-cells.htm - info on beta cells
http://www.sharecare.com/question/what-is-the-pancreas - picture of pancreas
http://diabetes.webmd.com/guide/type-2-diabetes - info on type 2 diabetes
http://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/ketones/ - info on ketones and picture of ketosis.
http://www.diabetes.co.uk/diabetes-and-genetics.html - table of risk of diabetes (genetics)
salters-Nuffield advanced biology students book 7/03/2012
http://www.livestrong.com/article/17608-obesity-causes-diabetes/ - Lifestyle as a cause.
Health issues diabetes- Jo Whelan page 23/02/2012
http://www.shutterstock.com/pic-99098642/stock-vector-human-insulin-stylized-chemical-structure.html - image of structure of insulin
The British medical association family doctor guide to diabetes- Dr.Rudy W. Bilous page 23/02/2012
Evaluation of sources
Source 9 - is an A-level text book. Because the book is used for educational purposes must have been thoroughly checked for incorrect information, however because the book is aimed at teens the information may be simplified so the information is easier to understand this may therefore undermine its accuracy. This book was published in 2005 seven years ago so the information is not outdated, however new research goes on everyday so the information I used on stem cell research might be slightly out dated, for this reason I looked up on the internet how stem cells are harvested, ethical issues and risk of rejection, the information on the internet was the same as the information in the textbook therefore this source is likely to be very accurate.
Source 13 - the author is a science writer who specialises in medicine and healthcare. The series consultant is Dr Kirsten lamb who did her medical training at Cambridge University. Therefore the author and series consultant are reliable resources and are obviously experienced in the subject. It aims to provide support for people living with diabetes especially young people so it has been published for educational purposes. Therefore the book would have been examined and edited by professionals to gain the most accurate information as possible. However because this book is aimed at young people the information may have been simplified, this may mean the information may not be as accurate as it could be, and it may be misleading. I cross referenced this source and found facts and figures (so I removed the information) were slightly outdated however other information such as eating plans were correct
Source 14- this book is written by a consultant physician in diabetes, therefore the writer has a lot of experience in the subject, so avoiding secondary sources which may be inaccurate. The content of information must be very accurate due to the writer's profession. This book is again written for diabetic sufferers and therefore published for educational purposes, so professionals would have examined the book before publishing. It is very likely that the information presented is valid. I cross referenced this book with other websites and the information on why does diabetes occur, treatments and impacts of diabetes were the same or very similar to source.
Facts & Figures
· More than 55 million people in the Europe Region have diabetes; by 2030 this will rise to 64 million
· 8.4% of adults have diabetes in the Europe Region
· Diabetes can lead to serious and costly complications
· Diabetes caused 622,114 deaths in the Europe Region this year
· EUR 138.8 billion were spent on treating diabetes in the region
global figures 2012
Prevalence of diabetes in adults
Number of people with diabetes
Number of undiagnosed cases
Deaths due to diabetes
Total healthcare expenditures in USD
Things to do : Comment on reliability and accuracy of data in tables
In 2012 we aim to invest £5.8m in diabetes research
It is estimated that 10% of the NHS budget is spent on diabetes
The cost of diabetes to the NHS is over £1.5m an hour or 10% of the NHS budget for England and Wales. This equates to over £25,000 being spent on diabetes every minute.
In total, an estimated £14 billion pounds is spent a year on treating diabetes and its complications, with the cost of treating complications representing the much higher cost.
Costs of diabetes treatment in the UK
The following table represents the relative cost of diabetes treatment in the UK in 2010.
Cost of diabetes treatment in the UK in 2010
Area of expenditure
Percentage of costs
Source: Kanavos, van den Aardweg and Schurer: Diabetes expenditure, burden of disease and management in 5 EU countries, LSE (Jan 2012)
Outpatient (excluding drugs)
Other (including social service)