There are hundreds of different kinds of birth defects, and diabetes mellitus is one of the most common birth defects that exists. Not all birth defects are apparent at birth but diabetes can be detected at a very young age and sometimes even in utero. In the past, little could be done to improve the chances of having a healthy baby. Today, organizations continually fund research into the cause, prevention, and treatment of all types of birth defects. Diabetes affects more than 100 million people worldwide, and it is among the most common causes of death and disability in North America and Europe. It is such a common disease that is taken lightly by many people, but ultimately leads to serious complications over time. Diabetes mellitus is a disease where the body’s cells cannot use glucose properly for lack of or resistance to the hormone insulin, produced by the pancreas (The Complete Canadian Health Guide, p459). The three distinct types of diabetes are Type I, Type II, and gestational diabetes in which all acquire similar diagnosis and treatment, symptoms, causes, and complications.
What is Type I diabetes? Type I, or insulin-dependent diabetes is an autoimmune disease where the immune system attacks and destroys cells in the pancreas that produce insulin. In type I the person has either completely stopped making insulin or only makes a very small amount of the hormone.
Without insulin the body’s cells cannot utilize glucose and remains in a state of starvation, regardless of how much the person eats. This is why people with this disease must take insulin on a daily basis. The insulin is injected beneath the skin into the body’s subcutaneous tissue (Diabetes, p16).
Untreated type I affects the metabolism of fat. Since the body cannot convert glucose into energy, it begins to break down stored fat for fuel (Encarta Encyclopedia 99, p2). Ten percent of those with diabetes have type I, formerly called “juvenile” diabetes. It affects one in 600 North Americans, mostly children, often showing up in adolescence. Even though this illness affects a small percentage of people with diabetes, its effects on the body is often the most severe (Diabetes, p16). The causes of diabetes are heredity and environmental factors. Some of these environmental factors include: any diseases or infections that strike the mother during pregnancy, alcohol, tobacco smoke, drugs, and radiation (The Developing Child, p71). Symptoms of type I often seem to come on suddenly. The key signs or symptoms of type I are: frequent urination, blurred vision, unusual thirst, extreme hunger, easy tiring, irritability and nausea. Those with type I are frequently lean. Besides taking insulin shots as needed, people with type I must learn to be consistent in their food intake and exercise regularly (The Canadian Health Guide, p460).
Type II or non-insulin-dependent diabetes tends to develop gradually in later life. It is also known as “maturity” or “adult-onset” diabetes. Type II accounts for 90 percent of all people with diabetes; Caucasians, African-North Americans, Hispanics, and aboriginal North Americans are especially prone to it. By the age 65, it affects 10 percent of the North American population. Currently, 1.5 million Canadians have been diagnosed, an additional 750 000 Canadians have the disease but don’t know it. Many people with type II have none of the usual symptoms and therefore remain oblivious to the problem for years, until complications begin to appear. Type II diabetes means that your pancreas is functioning and making plenty of insulin. Insulin resistance occurs and the pancreas can become overworked and eventually may not make enough, or any, insulin (Managing Your Diabetes, p1,2,3,4). Type II is not “mild” diabetes just because routine insulin injections aren’t needed to sustain life. The strongest factors or causes of type II diabetes are family history of diabetes and obesity. In North America, 80 percent of those diagnosed are overweight (TCCHG, p462). Although at times the symptoms are so mild they go undetected, the most common signs of the illness include: increased thirst and urination, exhaustion, nausea, blurred vision, dry flaky skin, skin wounds that are slow to heal, tingling or loss of sensation in the hands or feet (Diabetes, p21).
Gestational diabetes develops in some women during pregnancy and then disappears after they give birth. There’s a connection between gestational diabetes and the onset of type II in later life. Pregnancy rises a woman’s chances of developing diabetes by 16 percent after she turns 40. Thirty to forty percent of women who experience gestational diabetes develop type II diabetes within five to ten years (Diabetes, p22). Gestational diabetes affects 2 to 5 percent of pregnancies in Canada. In some pregnant women, it develops for the first time. Two things may trigger diabetes: weight gain and the production of certain hormones which alter the way insulin works. A baby born to a diabetic mother, although very large may have immature organs and suffer the complications of prematurity. If blood sugar levels cannot be normalized, complications may arise during pregnancy (TCCHG, p462). Gestational diabetes shows up in the last half of the pregnancy, from the 24th week onward. During pregnancy, the body must produce an increasing supply of insulin that enables glucose to move from the bloodstream into the cells. Some factors and causes include: family history, previous stillbirth, previous birth in which baby weighed more than 9 pounds, obesity, high blood pressure(hypertension), history of skin, genital, or urinary tract infections, a twin or triplet pregnancy, and age over 25 (Managing Your Gestational Diabetes, p4). Risks for the baby when the mother has gestational diabetes are: macrosomia, hypoglycemia, jaundice, and respiratory distress syndrome (p9).
When diabetes mellitus is left untreated many complications could arise. Type I diabetes can result in diabetic coma, a state of unconsciousness caused by extremely high levels of glucose in the blood, or death. In both type I and type II diabetes, blood sugar, blood pressure, and blood fats must be well controlled to prevent possible development of blindness, kidney failure, and heart disease. Tiny blood vessels in the body may become blocked, resulting in retinopathy and nephropathy. Blocked vessels may also lead to loss of feeling, particularly in the lower legs. Other complications include higher risk pregnancies in diabetic women and a greater occurrence of dental disease (Encarta Encyclopedia99, p3).
There are different kinds of tests that doctors use for the diagnosis of each of the three types of diabetes. The first test for diagnosis is done by measuring the amount of glucose in the blood after the individual has fasted for several hours. This is known as the glucose tolerance test. This test is used for the diagnosis for both type I and type II diabetes (Encarta Encyclopedia99, p4). The urine sugar test is used to screen for gestational diabetes. If tests show abnormally high amounts of glucose for at least 2 of the total 4 readings, the patient surely has gestational diabetes (Managing Your Gestational Diabetes, p8).
Diabetes mellitus is certainly one of the many birth defects to look out for when planning to start a family. It is a wise decision to seek genetic counseling in advance, in order to prevent any hereditary defects from happening. Genetic counseling may be provided by several different types of doctors, including family doctors. If necessary, special laboratory tests may be performed and the counselor may be able to tell the couple whether genetic problems are indeed present.
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