Cultural and Disease Essay

In the current essay I would like to consider Diabetes mellitus and explore the social and cultural of the decease on the example of Mongoloid race. To begin with, it should be noted that Diabetes mellitus – is a group of endocrine diseases developing as a result of absolute or relative (a violation of interaction with target cells) lack the hormone insulin, causing hyperglycemia develops – a persistent increase in blood glucose. The disease is characterized by chronicity and a violation of all types of metabolism: carbohydrate, fat, protein, mineral and water-salt.
As a rule, food contains different types of carbohydrates. Some, such as glucose, are composed with one six-membered heterocyclic ring and the carbohydrate are absorbed in the intestine unchanged. Others, such as sucrose (disaccharide) or starch (polysaccharide) consisting of two or more linked five-membered or six-membered heterocycles. It can be said that these substances are split under the action of various enzymes of the gastrointestinal tract to the molecules of glucose and other simple sugars and, ultimately, also soaked in blood. In addition, simple molecules like fructose interact with glucose in the blood and, as a result, convert into glucose. Thus, glucose is the main carbohydrate of blood and body, which belongs to an exclusive role in the metabolism of the human body: it is a basic and universal source of energy for the entire body. Many organs and tissues (e.g. brain) use only glucose as an energy source, according to Joseph Graves (2009).
It is essential to note that the major role in the regulation of carbohydrate metabolism of the body plays the hormone of the pancreas – insulin. It is a protein synthesized in the β-cells of islets of langerhans (accumulation of endocrine cells in pancreatic tissue) and is intended to stimulate processing of glucose by cells. Almost all tissues and organs (e.g. liver, muscle, and adipose tissue) are able to process glucose only with the presence of insulin and can be named as insulin dependent. In turn, other tissues and organs, such as brain, do not need insulin to process glucose, and therefore are called non-insulin dependent.
Also, it should be noted that unprocessed glucose is deposited (stored) in the liver and muscles as glycogen polysaccharide, which can later be converted back into glucose. But in order to turn glucose into glycogen, the body needs insulin. Normally, blood glucose fluctuates within fairly narrow limits: from 70 to 110 mg / dL (milligrams per deciliter) in the morning after sleep and from 120 to 140 mg / dl after meals. This occurs because the pancreas produces more insulin in order to raise the blood glucose level. In the case of insulin deficiency (diabetes mellitus type 1) or breach of the mechanism of interaction of insulin with cells of the body (diabetes mellitus type 2), glucose accumulates in the blood in large quantities (hyperglycemia), and cells of the body (except for non-insulin dependent organs) are deprived of primary source of energy. The prevalence of diabetes in human populations, on average, amounts to 1-8,6%; the incidence among children and adolescents about 0.1-0.3%. In view of undiagnosed form of this figure may in some countries up to 6%. Statistics shows that in 2006 the world’s diabetes hurt nearly 120 million people in the world. Moreover, according to statistical studies, every 10-15 years, the number of people with diabetes is doubled, so that diabetes becomes a medico-social problem. Also, it is extremely important to note that the proportion of people suffering from the 1st type of diabetes increases constantly, but it is associated with improved quality of medical care and longer life for people with diabetes type 1, according to Joseph Graves (2009).
However, statistical data show the heterogeneity of diabetes incidence depends on the race of human. As a fact, Diabetes mellitus type 2 is most common among Mongoloids. For example, in the United States among the Mongoloid race over 40 years, 20% suffer from diabetes type 2, the second place has Negroid race, among people older than 40 years, the proportion of diabetic patients is 17%. However, the frequency of complications caused by diabetes is heterogeneous. As a fact, among the Mongoloid race the risk of diabetic kidney disease and coronary heart disease is extremely high, in comparison with Europeoid race, but the risk of diabetic foot is very small. In turn, the representatives of Negroid race can be characterized by severe, difficult to treat hypertension and more frequent development of gestational diabetes mellitus. In other words, current medical studies show that Mongoloid race is more prone to diabetes of the first, as well as the second type. For example, according to statistical data, in 2010 the most patients with diabetes of the first and second type were in Hong Kong, they accounted for 12% of the population. In the U.S., the number of cases was on the level of 10%, in Venezuela – 4%. The lowest number of reported cases of diabetes was occurred in Chile, on the level of 1.8%, according to Arleen Marcia Tuchman (2010).
It should be noted that today, the genetic predisposition to diabetes is proven. For the first time such a hypothesis was proposed in 1896, and it only confirmed the results of statistical surveys. In 1974, American scientists Nerup, Gudworth, Woodrow found a link in the locus of leukocyte histocompatibility antigens and diabetes mellitus type 1 and their absence in those with diabetes type 2. Subsequently there were identified several genetic variations that occur more frequently in the genome of patients with diabetes than in the rest of the population. However, it should be noted that in diabetes type 1 there is observed genetic heterogeneity and the disease can be caused by different groups of genes. Laboratory and diagnostic feature, which allows to determine the type 1 diabetes, is the detection of antibodies to β-cells of the pancreas. The nature of inheritance in the present is not entirely clear, the complexity associated with predicting the inheritance of genetic heterogeneity of diabetes, the construction of an adequate model of inheritance require additional statistical and genetic research, according to Michael J. Montoya (2007). In other words, there is a genetic predisposition to diabetes. If one parent is ill, the chance of inheriting the first type of diabetes is 10%, and second type diabetes – 80%.
Nowadays, the treatment of diabetes in the majority of cases is symptomatic and aimed at removing existing symptoms without addressing the causes of the disease. The main tasks of the physician in the treatment of diabetes are:
Compensation of carbohydrate metabolism.
Prevention and treatment of complications.
Normalization of body weight.
Patient education.
Compensation of carbohydrate metabolism can be achieved in two ways: by providing the cells with insulin, in different ways depending on the type of diabetes, and by ensuring the uniform of the same income of carbohydrates, which is achieved by compliance with the diet. Extremely important role in compensation of diabetes plays education of the patient. The patient must be aware of what diabetes is, what is dangerous for him and what he should do in case of episodes of hypo-and hyperglycemia, how to avoid them, be able to independently control the blood glucose level and have a clear understanding of the nature of allowable food for him.