Diabetes: Common Genetic Disease in the Philippines

Abstract

The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge
social, health, and economic consequences. It is estimated that in 2010 there were globally 285
million people (approximately 6.4% of the adult population) suffering from this disease. This
number is estimated to increase to 430 million in the absence of better control or cure. An ageing
population and obesity are two main reasons for the increase. Furthermore, it has been shown
that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the
disease, hence the real prevalence of global diabetes must be astronomically high. This chapter
introduces the types of diabetes and diabetic complications such as impairment of immune
system, periodontal disease, retinopathy, nephropathy, somatic and autonomic neuropathy,
cardiovascular diseases and diabetic foot. Also included are the current management and
treatments, and emerging therapies.

Introduction
A hallmark of diabetes mellitus is unusually high blood sugar (glucose) levels. The hormone
insulin is released from the pancreas when the level of blood glucose rises, such as after eating.
Circulation sugar levels return to normal as a result of insulin's stimulation of the liver's
metabolization of glucose and the removal of glucose from the blood by muscle and fat cells.
Blood sugar levels in diabetics continue to be high. This could be as a result of insulin not being
created sufficiently, not being produced at all, or not being as effective as it should be. Type 1
diabetes (5%), an autoimmune condition, and type 2 diabetes (95%), a metabolic illness, are the
two most prevalent types of diabetes. Other types of diabetes are extremely uncommon and are
brought on by a single gene mutation, with the exception of gestational diabetes, which develops
during pregnancy.
Scientists have been looking for genetic hints that could explain why some people are more
likely to develop diabetes than others for a long time. Some of the genes that have been proposed
to be involved in the onset of diabetes are introduced in "The Genetic Landscape of Diabetes."

Definition
The condition known as diabetes impairs your body's capacity to make or use insulin. It is a
hormone, insulin. Insulin is released when your body converts food into energy (also known as
sugar or glucose) to assist in delivering this energy to the cells. Insulin serves as a "key,"
instructing the cell to open and accept glucose through its chemical message. Too much sugar
lingers in your blood if you have insufficient or no insulin production or if you are insulin
resistant. Diabetes patients have higher-than-normal blood glucose levels. Type 1 and Type 2
diabetes are the two primary subtypes. The condition known as diabetes impairs your body's
capacity to make or use insulin. It is a hormone, insulin. Insulin is released when your body
converts food into energy (also known as sugar or glucose) to assist in delivering this energy to
the cells. Insulin serves as a "key," instructing the cell to open and accept glucose through its
chemical message. Too much sugar lingers in your blood if you have insufficient or no insulin
production or if you are insulin resistant. Diabetes patients have higher-than-normal blood
glucose levels. Type 1 and Type 2 diabetes are the two primary subtypes.

Characteristics
Extreme hunger, unintentional weight loss, weakness and weariness, blurred eyesight, agitation,
and other mood swings. You should consult your doctor if any of these symptoms apply to you
or your kid. A blood test is the most reliable approach to find out if you have type 1 diabetes.

Case Presentation
Patient L is an Filipino citizen, 52 years of age, presenting to his primary care physician with
complaints of frequent urination and excessive thirst, particularly in the late afternoon and early
evening. He is a truck driver and works 12 hours each day. Patient L is 6 feet 1 inch tall and
weighs 215 pounds, with a calculated BMI of 28.4 kg/m2. He confirms a family history of
diabetes on both his father's and mother's sides. A random finger stick results in a blood glucose
level of 243 mg/dL. The information gained from Patient L's initial examination indicates
diabetes. Again, any random blood glucose greater than 200 mg/dL, accompanied by symptoms
(polyuria and excessive thirst for this patient), is considered diagnostic for diabetes.

Treatment Options
Doctors treat diabetes with a few different medications. Some are taken by mouth, while others
are available as injections.
Type 1 diabetes
Insulin is the main treatment for type 1 diabetes. It replaces the hormone your body isn’t able to
produce.
Various types of insulin are commonly used by people with type 1 diabetes. They differ in how
quickly they start to work and how long their effects last:

 Rapid-acting insulin: starts to work within 15 minutes and its effects last for 2 to 4
hours
 Short-acting insulin: starts to work within 30 minutes and lasts 3 to 6 hours
 Intermediate-acting insulin: starts to work within 2 to 4 hours and lasts 12 to 18 hours
 Long-acting insulin: starts to work 2 hours after injection and lasts up to 24 hours
 Ultra-long acting insulin: starts to work 6 hours after injection and lasts 36 hours or
more
 Premixed insulin: starts working within 5 to 60 minutes and lasts 10 to 16 hours
Type 2 diabetes
Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t
enough to lower your blood sugar, you’ll need to take medication.

These drugs lower your blood sugar in a variety of ways:

Drug How it works Examples
slow your body’s breakdown acarbose (Precose) and
alpha-glucosidase inhibitors
of sugars and starchy foods miglitol
reduce the amount of glucose metformin (Glucophage,
biguanides
your liver makes Riomet)
alogliptin (Nesina),
improve your blood sugar
linagliptin (Tradjenta),
DPP-4 inhibitors without making it drop too
saxagliptin (Onglyza), and
low
sitagliptin (Januvia)
semaglutide (Ozempic),
stimulate your pancreas to
dulaglutide (Trulicity),
glucagon-like peptides produce more insulin; slow
exenatide (Byetta), and
stomach emptying
liraglutide (Victoza)
stimulate your pancreas to
meglitinides nateglinide and repaglinide
release more insulin
canagliflozin (Invokana),
release more glucose into the
SGLT2 inhibitors dapagliflozin (Farxiga), and
urine
empagliflozin (Jardiance)
glyburide (Glynase), glipizide
stimulate your pancreas to
sulfonylureas (Glucotrol), and glimepiride
release more insulin
(Amaryl)
pioglitazone (Actos) and
thiazolidinediones help insulin work better
rosiglitazone
You may need to take more than one of these medications. Some people with type 2 diabetes
also take insulin.
Gestational diabetes
If you receive a diagnosis of gestational diabetes, you’ll need to monitor your blood sugar level
several times per day during pregnancy. If it’s high, dietary changes and exercise may be enough
to bring it down.

Research has found that about 15% to 30%Trusted Source of women who develop gestational
diabetes will need insulin to lower their blood sugar. Insulin is safe for the developing baby.
The bottom line
The treatment regimen your doctor recommends will depend on the type of diabetes you have
and its cause.

Check out this list of the various medications that are available to treat diabetes.
Diabetes and diet
Healthy eating is a central part of managing diabetes. In some cases, changing your diet may be
enough to manage the disease.
Type 1 diabetes
Your blood sugar level rises or falls based on the types of foods you eat. Starchy or sugary foods
make blood sugar levels rise rapidly. Protein and fat cause more gradual increases.

Your medical team may recommend that you limit the amount of carbohydrates you eat each
day. You’ll also need to balance your carb intake with your insulin doses.

Check out this guide to starting a type 1 diabetes diet.

Type 2 diabetes
Eating the right types of foods can both manage your blood sugar and help you lose any excess
weight.

Carb counting is an important part of eating for type 2 diabetes. A dietitian can help you figure
out how many grams of carbohydrates to eat at each meal.

In order to keep your blood sugar levels steady, try to eat small meals throughout the day.
Emphasize healthy foods such as:

 fruits
  vegetables
 whole grains
 lean protein such as poultry and fish
 healthy fats such as olive oil and nuts

Certain other foods can hurt efforts to manage your blood sugar.

Discover the foods you should avoid if you have diabetes.

Gestational diabetes
Eating a well-balanced diet is important for both you and your baby during these 9 months.
Making the right food choices can also help you avoid diabetes medications.

Watch your portion sizes, and limit sugary or salty foods. Although you need some sugar to feed
your growing baby, you should avoid eating too much. Check out other do’s and don’ts for
healthy eating with gestational diabetes.
The bottom line
Work with a registered dietitian, if you have access to one. They can help you design an
individualized diabetes meal plan. Getting the right balance of protein, fat, and carbs can help
you manage your blood sugar.
Diabetes and exercise
Along with diet and treatment, exercise plays an essential role in diabetes management. This is
true for all types of diabetes.

Staying active helps your cells react to insulin more effectively and lower your blood sugar
levels. Exercising regularly can also help you:

 reach and maintain a healthy weight

 reduce your risk of diabetes-related health complications
 boost mood
 get better sleep
 improve memory

If you have type 1 or type 2 diabetes, general guidance is to aim for at least 150 minutes of
moderate-intensity exercise each week. There are currently no separate exercise guidelines for
people who have gestational diabetes. But if you’re pregnant, start out slowly and gradually
increase your activity level over time to avoid overdoing it.
Diabetes-friendly exercises include:

 walking
 swimming
 dancing
 cycling

Talk with your doctor about safe ways to incorporate activity into your diabetes management
plan. You may need to follow special precautions, like checking your blood sugar before and
after working out and making sure to stay hydrated.

Consider working with a personal trainer or exercise physiologist who has experience working
with people who have diabetes. They can help you develop a personalized workout plan tailored
to your needs.

Prevention
Type 1 diabetes is not preventable because it’s caused by an issue with the immune system.
Some causes of type 2 diabetes, such as your genes or age, aren’t under your control either.

Yet many other diabetes risk factors are manageable. Most diabetes prevention strategies involve
making simple adjustments to your diet and fitness routine.

If you’ve received a diagnosis of prediabetes, here are a few things you can do to delay or
prevent type 2 diabetes:

 Get at least 150 minutes per week of aerobic exercise, such as walking or cycling.
 Cut saturated and trans fats, along with refined carbohydrates, out of your diet.
 Eat more fruits, vegetables, and whole grains.
 Eat smaller portions.
 Try to lose 5% to 7%Trusted Source of your body weight if you have overweight or
obesity.

These aren’t the only ways to prevent diabetes. Discover more strategies that may help you avoid
this chronic health condition.
Conclusion
Diabetes is a serious, perhaps fatal condition that needs to be closely monitored in order to be
adequately controlled with medicine and lifestyle changes. We can observe a healthy and long
life by leading a healthy lifestyle, getting frequent checkups, and using the right medications.

Note
All content is intended only for educational purposes. No intent exists to plagiarize.

References
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2. https://www.ncbi.nlm.nih.gov/books/NBK1671/
3. https://www.mayoclinic.org/diseases-conditions/
diabetes/symptoms-causes/syc-20371444
4. https://www.netce.com/casestudies.php?courseid=1893
5. https://www.healthline.com/health/diabetes#exercise
6. https://www.toppr.com/guides/essays/essay-on-
diabetes/#:~:text=to%20absorb
%20glucose.-,Conclusion,a%20healthy%20and
%20long%20life.