1. Diabetes Mellitus.
By Samantha Dalton.

2. What is diabetes mellitus??
A chronic condition in which the male/female is unable to utilise the blood glucose correctly.
It is the basic unit of fuel for energy, and is therefore the body’s cells to maintain normal function.
When the blood glucose isn’t being taken into the cells, the blood glucose levels become high and the cells cannot function properly.
Insulin is a hormone that is hidden by the pancreas, it’s job is to keep the uptake of the glucose from the blood into the cells.

3. Different types of diabetes mellitus.
Type 1: mostly diagnosed within children and youths, but can also occur in any other stage of life.
Mostly characterised by the pancreas not producing enough (or if any) insulin to allow the glucose from the blood into the cells.
The cause of type 1 diabetes is unknown, but there is a strong genetic link, also exposure to certain viruses such as influenza is also thought to be a cause.
As little or no insulin is produced the individual must do it themselves, was once administered by a needle and syringe, but now its done by a pump.
Those with type 1 must constantly monitor their blood glucose levels to stay within a certain range. If they get to high (hyperglycaemia) or to low (hypoglycaemia), a range of side effects such as: tiredness, confusion & headaches. Its then they must pay special attention to their diet, exercise and body weight.

4. Different types of diabetes mellitus cont.
Type 2: usually occurs in older or overweight people, but there has been more cases when a younger person is diagnosed with it, and is unable to be cured but managed effectively.
In type 2 the pancreas doesn’t produce enough insulin, OR the body cannot use the insulin effectively (known as insulin resistance).
Being overweight is the greatest risk factor for getting type 2 diabetes, the exact reason is unknown, but there is a number of possibilities for example:
Fat cells maybe more resistant
Overweight people have put a strain on their pancreas as it has tried to produce the insulin to the body
High levels of fat in the body may destroy the insulin being distributed by the pancreas
Type 2 is associated with other conditions such as cardiovascular, obesity, hypertension & high cholesterol

5. Different types of diabetes mellitus cont.
Gestational diabetes: occurs during pregnancy in 3 to 8 per cent of pregnant women, as the baby develops, hormones are released to assist its growth and development.
The hormones are essential for the growth and development of the baby but also reduce the impact that insulin has on blood glucose levels of the mother.
As the energy requirements for the duration of the pregnancy increases so does the insulin levels, but if the mother cannot produce enough insulin to maintain the glucose, this may result in diabetes.
Gestational diabetes may mean that more glucose is passed onto the baby, which can increase gestational growth, meaning that the baby has a high birth weight, and can cause low glucose levels in a newborn.
GD usually disappears after the baby is born, and the mothers weight and energy levels return to normal. Those who experience this are at high risk of developing type 2.

6. Why is it a NHPA??
Diabetes mellitus is a NHPA because of the following reasons:
Is the leading contributor to the burden of disease. In 2010, diabetes was estimated to be ranked sixth with regards to the burden of disease, contributing to 6.2 per cent of DALYs.
Australians (4 per cent) reported having diabetes as a long-term condition.
In 2010 diabetes mellitus was the underlying cause of death in 2.7 per cent of all registered. In a further 7 per cent of deaths in 2010, diabetes was listed as an associated (or contributing) cause of death. Diabetes was considered to play an associated role in approximately 10 per cent of all deaths.

7. Costs associated with diabetes mellitus?
DIRECT: in , approximately $900 million was spent on diabetes. Most of the money was put towards the management of the condition, (due to there is no cure), such as ‘doctors’ and ‘specialist’ consultations and pharmaceuticals benefits scheme, and private health insurance companies.
Direct costs to the individual include co-payments for health services and medication. Uncontrolled diabetes can lead to ‘diabetic coma’ and unconsciousness, which can require ambulance transport, another direct cost to the individual.

8. Costs associated with diabetes mellitus?
INDIRECT: according to the access economics (2008), the indirect costs almost amounted to almost $3 billion.
To the community it includes government security payments, lost productivity and payment for carers.
To the individual indirect cost associated to their condition, this includes paying for a dietician or personal trainer to assist with weight management, and loss of income if they are unable to work.

9. Costs associated with diabetes mellitus?
INTANGIBLE: involves making lifestyle changes to diet and activity levels to manage the condition, these changes may have to be made to both the individual and those living with them. Examples include:
Frustration over having to make changes to diet and exercise routines,
Loss of self-esteem after being diagnosed with diabetes,
Anxiety about the possibility that the condition could progress ( diabetes has a number of long term effects such as blindness & limb amputations).
Frustrations with family members having to make lifestyle changes.

10. Risk factors.
BIOLOGICAL: being over weight or obese are risk factors for type 2 diabetes.
High blood pressure and high cholesterol are more common with people who have type 2 diabetes, there is conflicting evidence as to whether these determinants contributes to the onset of diabetes or whether the higher rates of obesity in diabetes sufferers increase the likelihood of developing these conditions.
Impaired glucose regulation. (a precursor of type 2, and makes the risk factor even higher for developing type 2 and cannot be addressed by life style change).
Genetic predisposition. (family members who have had it make your chances of getting all types of diabetes it is even higher, than those who don’t).
Age. (the risk of type 2 increases with age, those over 55 are most susceptible, but younger people are also at high risk due to high obesity rates among these groups.

11. Risk factors. BEHAVOURAL:
Tobacco smoking (high blood glucose levels can lead to insulin resistance).
Excessive alcohol consumption (can lead to obesity, which is a risk factor for type 2 and gestational diabetes).
Dietary behaviour (eating an energy-dense or high fat foods can contribute to weight gain and lead to type 2 and gestational).
Physical inactivity (being inactive can lead to weight gain which increases the chances of being obese and therefore type 2 and gestational diabetes).

12. Risk factors.
Physical environment: as obesity is a risk factor for type 2 diabetes, aspects of the physical environment can increase the risk of obesity and also increase the chances of type 2 diabetes. Examples include:
Access to recreational facilities (if there are no ovals or walking paths, the individual might not get the required amount of exercise).
Work environment (not walking up stairs and being in a small office space can contribute to obesity and type 2 diabetes).
Transport systems (transport systems that foster passive methods of transport, such as car travel, can increase the risk of obesity and type 2 diabetes).

13. Risk factors.
Social:
Socioeconomic status (people with low socioeconomic status have higher rates of obesity and higher rates of type 2 and gestational diabetes).
Occupation (people with low physical job may be at risk of obesity and type 2).
Food security (those with a lack of food security are more likely to eat energy-dense food and increase the chances of obesity and type 2, as well as gestational diabetes).
Early life expectancy's (low birth weight increases the chances of type 2, the lack of malnutrition and damage to the insulin-producing cells in the pancreas).

14. Promotional programs. Swap it, don't stop it.
The shape up campaign ( promotes physical activity and healthy eating).
Prevention of type 2 diabetes program (aims to decrease or delay the development of diabetes in high risk individuals aged 40-9).
National diabetes week (an annual event coordinated by Diabetes Australia. Aims to raise awareness about type 2, and reduce the risk factors that contribute to it).
Life! (aims to reduce the incidence of type 2 diabetes among those at risk).

15. Bibliography.
Key concepts in VCE Health and Human Development textbook. P.G