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In addition, about 38% of youngsters aged between 12 and 18 were classified as overweight. The major causes of morbidity and mortality in the diabetic patient are heart disease and stroke (Tzagournis & Falko, 1982). 2. 0 Definitions Diabetes Mellitus is a chronic and progressive disorder that can have an impact upon lmost every aspect of life. It can affect children, young people and adults of all ages, and is becoming more common. Diabetes is a disease which causes the body to either not produce insulin or to not properly make use of the insulin that it does make (American Diabetes Association, 2002).

When carbohydrates are consumed, the body must convert glucose into energy that can be used to do everyday tasks. Insulin is a hormone which facilitates this process and is therefore an important part of the body’s normal functioning that helps to maintain an appropriate level of glucose in the blood. In the case of diabetic patient who do not produce or properly use insulin, blood glucose levels must be manually regulated or the patient may sufferer undesired consequences (Stratton et al. , 2000) contributes to a high prevalence of complications and thus to the high cost of their management (Eliasson et al. 2005). Complications from diabetes can be reduced by better and more adapted follow-up such as blood glucose control, regular eye and kidney function examinations, lipid and blood pressure management. 2. 1 Classification of Diabetes Mellitus Type-I insulin dependence diabetes mellitus was formerly called Juvenile-onset iabetes, because it mostly attacks young people. This type of diabetes mellitus is characterized by the destruction of pancreatic beta cells. The destruction of BETA cells will decreased insulin production and caused uncontrolled glucose production by the liver.

It symptoms include increased thirst and urination, constant hunger, weight loss, blurring of vision and extreme tiredness (Mayo Clinic, 2010). In type-2 diabetes, the body cells are resistant to the action of insulin and/or the pancreas produce decreasing amounts of insulin. As a result, the blood glucose level becomes rogressively higher over time and the body cells receive an inadequate supply of glucose – the bodys primary energy source. The symptoms of type-2 diabetes develop gradually and are not as noticeable as for type-I diabetes.

The symptoms include feeling tired or ill, frequent urination at night, unusual thirst, weight loss, blurring of vision, frequent infections and slow healing of sores (Mayo Clinic, 2010). Type 2 diabetes mellitus is a serious health problem affecting approximately 4. 0 percent of adults aged 20 years and over in the world in 1995 (Harris et al. , 1998) and this prevalence is projected to rise from 4. to 5. 4 percent (King et al. , 1998). The proportional increase in type 2 diabetes prevalence rates is greater in developing countries, especially those of Asia (King et al. , 1998; Cockram, 2000).

In both types of diabetes, the symptoms are quickly relieved once the diabetes is treated. Early treatment will also reduce the chances of developing serious health problems. third type of the diabetes is called gestational diabetes. It develops or is discovered during pregnancy. It usually disappears when the pregnancy is over and women who have had gestational diabetes have a greater risk of developing type 2 diabetes later Mayo Clinic, 2010). 2. 2 Cause and Risk factors for Diabetes Mellitus. There are many risk factors that predispose an individual or population to developing glucose intolerance and finally to have diabetes (Ram, 2000).

There is evidence that lifestyle related changes are the main factors influencing the explosion of diabetes in the modern times. Risk factors such as obesity, physical inactivity and high-fat diet are significant predictors of type 2 diabetes (Zimmet, 1992), which are the results of lifestyle choices determined by one’s culture. According to Mendosa (2001), the common risk factors are: . Person who has a family history of diabetes is in risk of type-2 diabetes if a parent risk to have type-2 diabetes as excessive fatty tissue will make the cells to be insulin resistant.

Past studies indicate that a person’s race or ethnicity such as blacks, Hispanics, American Indians and Asian-American are more likely to develop type-2 diabetes. it. The risk of type-2 diabetes increases as a person gets older, especially after age 45 as people tend to exercise less, lose muscle mass and gain weight as they age. However, current studies indicate that type-2 diabetes is also increasing dramatically mong children, adolescents and younger adults. iii. Hypertension, or high blood pressure, has many serious consequences, especially for people with diabetes. Hypertension is twice as common in people with diabetes.

Older persons with diabetes have higher rates of death at a younger age, disability, hypertension, heart disease, and stroke. lv. Hyperlipidemia can be defined as a condition where there are too many fats, or lipids, in the circulating blood. Untreated or poorly treated diabetics do not metabolize fats properly, due to lack of enough insulin to do so. The increased risk of oronary artery disease in subjects with diabetes mellitus can be partially explained by the lipoprotein abnormalities associated with diabetes mellitus. Hypertriglyceridemia and low levels of high-density lipoprotein are the most common lipid abnormalities.

In type-I diabetes mellitus, these abnormalities can usually be reversed with glycemic control. In contrast, in type-2 diabetes mellitus, although lipid values improve, abnormalities commonly persist even after optimal glycemic control has been achieved. v. If a woman developed gestational diabetes when they were pregnant, she has a higher risk of developing type-2 diabetes later. If a woman gave birth to a baby weighing more than 9 pounds (4. 1 kilograms), she also has a higher risk of having type-2 diabetes. 2. 3 Managing Diabetes Mellitus Diabetes is a chronic disease with no cure.

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