Curated Paper, Diabetes

I have seen the effects of diabetes in my family and with a friend or two. Both my uncle and grandfather-in-law have/had diabetes. My uncle has currently type 1 diabetes as so far it is uncurable and my grandpa-in-law has had type 2 diabetes and has had better and worse times of it. Something I have thought about is how type 2 diabetes is preventable and people can oftentimes cure it on their own but choose not to do so. It makes me wonder what types of things and factors cause people to choose to not take good care of themselves. Type 2 diabetes is shown to be directly correlated to obesity which in most cases is preventable. We often make mistakes as people and that is not preventable but I think it would be worthwhile to research the various mental/emotional causes of diabetes (I am sure there are some) and teach people how to take care of themselves and why it's so important.

I did some more research about factors causing obesity (which can cause diabetes) and I was surprised at some of the things I learned. I read an article by the Mayo Clinic and it mentions how our diet can affect our microbiome which can then affect obesity in people. It's amazing to see just how complex our bodies are and we need to take care of every part. It also mentioned lack of sleep or too much sleep can affect our hormones and make us more or less hungry and crave more carbohydrates. I think the basic physical health needs are diet, exercise, and rest and I think it's astounding how three simple things change our health so much.

I believe one factor that leads to people not taking care of themselves is outdated information or lack of knowledge. My grandfather-in-law used to be in medical school a long time ago but his health choices and reasoning behind them have seemed to lack knowledge and may attribute to his varying levels of diabetes. I believe many people today do not seek good knowledge and learning and especially when it comes to their health. And many people often hold beliefs about health that they have learned that are wrong or outdated. This may be why some people drink large amounts of soda or other unhealthy food not knowing how bad it is for their body. Or why some people do diets that aren’t effective and may cause more problems with health. I’m sure type 2 diabetes levels would increase with greater health education.

 From learning in my anatomy course type 2 diabetes is caused when there is too much sustained glucose intake that cells can’t produce enough glucose receptors to keep up with the sugar intake. If this is sustained for large periods of time the cells lose the receptors completely because they normally break down over time and need to be constantly produced. This causes the resistance to insulin and then unbalanced glucose levels. Then people start to get the symptoms and negative effects of diabetes. I am amazed how our knowledge and understanding of the body and its metabolism has grown over time allowing for more opportunity to help improve life.

 It is amazing to see how the body checks itself and is all intertwined. Learning more about sugar metabolism and the various steps and countermeasures of the body to maintain balanced levels of blood sugar shows how incredible it is and astounds me. Especially as this is a fairly simple example of how interconnected our body is. A more complex example could be when the eye sees something that signals the brain to then send hormones to create various effects in our body from stopping digestion or increasing blood flow. I remember learning in physiology about various body systems like RAAS and how it can affect every part of our body and is stimulated by various things like hydration, blood pressure, ion concentrations, and others. I would love to learn more about our bodies and I am sure there are many things that we have not yet discovered that influence insulin, glucose uptake, and diabetes in general.

 I am currently a pre-optometry student and I love to learn about the eye. I currently work in an optometrist’s office as an optician and mainly take eye scans, schedule appointments, and dispense and sell glasses/contacts. In my training, I was told to always schedule a longer 30-minute appointment for anyone with diabetes. I knew diabetes had various effects on the body but was not sure what the purpose of the longer appointment was until reading through the diabetes power point. It's cool to know now that diabetes can cause cataracts, glaucoma, and retinopathy and that these are given special attention to be treated and prevented as much as possible. Its interesting to see how a problem with one part of the body can cause problems in so many others. I wonder what other effects other diseases have and how they effect the various systems in our body. For example, does skin cancer have an effect on blood pressure and then other things? Or does Lyme disease have effects on our gaining weight for some reason? These would be interesting to research and learn more about.

 I have a dear friend as well who is a type 1 diabetic and has many impacts/costs to his life. We were roommates for a while in Argentina while on a mission for the Church of Jesus Christ of latter-day saints. Even with his disease, he had become a bodybuilder which helped with symptoms because he was in great physical condition. He told us at home he would work out for many hours a day and with us he would exercise for a time longer than most missionaries to stay in good shape. I am impressed at how a disease can affect a person beyond metabolism and shape even who they become/are and their behaviors.

 I have seen in my life how diabetes can affect/cost the people around a diabetic and how it changes their lives as well. I remember how much we all needed to be aware of my friend’s condition and his assigned companion received special instruction/training to be able to help our friend when he needed it. There were a few times when his blood sugar would drop too low and he would go a little crazy and because he was so physically fit it would take all of us and be even slightly dangerous to help him get Metabolism Journaling back to normal and get medication/sugar. I wonder what it was like for his family growing up when it wasn’t something he could be aware of and help manage.

 I really learned a lot from the paper “Economic Costs of Diabetes in the U.S. in 2012. In the paper, researchers studied the direct and indirect costs of diabetes in people's lives and in society. They estimated the total cost to society to be “$245 billion”. That is a very large number and a crazy amount of money. The researchers studied the direct costs to both individuals and society from many surveys and databases and determined that on average a diabetic person spends 2.3 times as much in medical expenses as someone without diabetes or an extra 7,000$ a year. They also found the indirect cost on society to be 68.6 billion due to reduced productivity. The researchers seem to have been very thorough and there are many more important facts and statistics in the report.

I found the costs of diabetes to be crazy. Diabetes is pretty common compared to most diseases and is currently the 7th leading cause of death in the United States. What I found very surprising was the jump in cost from 2012 to now. In 2012 the cost of diabetes was estimated as 245 billion and currently, the CDC estimates the cost to be 327 billion. In the 2012 study, the researchers stated that they underestimated by a fair amount their estimate due to lack of data and other reasons. They mentioned they didn’t include dental/optometry expenses and working in an optometrist's office I know there is quite a bit of those. This means likely both the 2012 and current estimates are likely far below true values. I wonder how much of this is preventable and how better management and teaching would reduce these costs which can then be put to use elsewhere.

 We have a very good country and government which I believe is why we are able to afford these large costs in healthcare related to diabetes. I mentioned living with my friend in Argentina who had diabetes and it was interesting to see how in a less developed country where this is not possible, how different life can be with diabetes. Financially I remember insulin was very expensive and hard to come by. Even in large cities insulin was hard to find and this made things difficult for my friend. Luckily where we lived there was a diabetic family that was able to help him in case of any emergency or if he ever ran out of insulin. This creates not only a large financial cost for diabetics in underdeveloped countries but also a large cost to quality or ease of life and a large worry/burden.

 Reading through the initial slides of the Diabetes beyond biology powerpoint show and make me think about how important it is to take care of oneself. And how many healthcare problems could be prevented with good health/diet habits like consistent exercise and eating good food. In the chart of 2009 top risk factors for death the 3rd, 4th, and 5th risk factors (physically inactive, high blood glucose, and obesity) are all preventable with good exercise and diet. Even the top 1, high blood pressure, would be significantly decreased with good health habits. There are sometimes these things are beyond our control but these are few and far between when compared to preventable cases.

 I read some of the article Chronic Illness and Mental Health: Recognizing and Treating Depression. By the NIH. The article talks about how chronic illnesses often lead to or are associated with depression either directly or indirectly. The article mentions that people can be negatively affected when they are diagnosed with chronic illness or as a side effect of medications. I think it is important to understand how mental health ties into disease and how both can cause the other and often come together. A depressed person is more likely to resort to poor eating or someone who eats poorly may become depressed and then obese which goes to show the interconnectedness of our bodies and minds. My wife and I have listened to videos by a neurologist who talks about brain health and by exercise and good diet our brains can be healthier and this fights depression or other mental diseases. I think our behaviors/stress play a large role in our physical health. And it would be interesting to see how much the practice of good mental health habits would effect someone’s physical health.

 I read the abstract of “Sweetened blood cools hot tempers: physiological self-control and aggression” because the rest of the article was not free. But in the abstract the paper reviews 4 studies where aggression and violence were linked to low blood sugar or diabetes. In one study people who drank a glucose drink behaved less aggressively than those who didn’t. In 2 of the other studies diabetes was linked to violent crime and aggressiveness with low self control. I wonder how much diet, which can cause type 2 diabetes and low blood sugar, is related to violent crime and aggression. It would stand to reason that eating poorly would cause unbalanced blood glucose levels and then in this study it says that self control uses a lot of glucose in the brain. I have seen firsthand how low blood sugar in a type 1 diabetic can make the person go crazy and that could definitely cause violent crime. I wonder if lower than normal blood sugar can have small effects that are generally unnoticeable or unchecked that cause people to execute less judgment before committing crimes or being aggressive.

 All of this study about diabetes and how it affects all of a diabetic person’s body and then all of their life has been eye-opening. As well as learning about the effects outside of the body on a person’s individual life, then friends and family relationships, then social dynamics and macroscale costs. I want to be able to help people with diabetes in my work as an optometrist as well as helping people live better lives in general. It has amazed me how much cost both to wallets and mental/emotional banks of diseases and type 2 diabetes can be prevented with good health and exercise and that makes me want to be better as well.