Exercise in Health and Disease

Section 1

Chronic disease-Diabetes Mellitus

Diabetes mellitus DM is a prolongedmetabolic disorder that is identified by increased abnormal sugar levels in the body due to defects in insulin action or secretion of insulin. Insulin is a vital hormone in the body whose role is to regulate carbohydrate metabolism. Impaired secretion of insulin can result from tumors of the pancreas which affects the islet cells of Langerhans. Moreover, decreased number of insulin receptors can also result in hyperglycemia. There are two categories of diabetes mellitus namely type 1 and type 2. Type 1 DM accounts for 5-10% of diagnosed diabetic patients (Kharroubi, 2015). This type of diabetes constitutes 80-90% of diabetes in adolescents and children. As per the International Diabetic Federation IDF, there were 78,900 newly diagnosed cases of type 1 diabetes mellitus in 2013 among the youth. In the united states, it was estimated that 3million teenagers had type 1 diabetes (Kharroubi, 2015). The frequency and predominance of type 2 diabetes mellitus occur in the elderly of approximate age 20-79years. According to IDF, 382 million people had diabetes mellitus type 2 by the year 2013 (Kharroubi, 2015). The prevalence is more in men than women. The same statistics predicted that by 2035, there would be 592million cases of diabetes throughout the world.

The causes of diabetes are dependent on the classification. Type 1 results from immune-mediated destruction of insulin-producing cells of the pancreas, which are cells responsible for insulin secretion. The damage is mediated by activated T-cells. Therefore, diagnosis of type 1 diabetes mellitus depends on the identification of autoantibodies directed at pancreatic islet cells. These autoantibodies are namely protein tyrosine phosphatase(IA2), glutamic acid decarboxylase (GAD65), Insulin Auto-Antibodies (IAA), and zinc transporter protein(ZnT8A) (Kharroubi, 2015). Type 2 DM is caused by insulin resistance in the target tissues. Patients who have type 2 DM are not dependent on insulin. The resistance may result from a decreased number of insulin receptors in the tissues. The predisposing factors include obesity, lack of exercise, poor diet, dyslipidemia, and hypertension. Increasing age also predisposes to type 2 DM. Genetic predisposition is the primary risk factor for type 1 DM. A family history of DM is likely to increase the chances of the children to have the same condition. Young age has also been implicated as a risk factor for type 1 DM. A particular type of diabetes occurs during pregnancy, and it is known as gestational diabetes. This type of DM results from increased body demands and excessive release of gestational hormones.

Treatment of type 1 DM requires patient education on self-glucose monitoring practices and attending regular diabetic clinics. Insulin therapy is also indicated for type 1 DM patients. Patients can administer self-therapy by injecting insulin on a daily basis. Treatment of type 2 DM requires diet modifications, regular exercises, blood sugar monitoring, and insulin therapy may be indicated for severe cases. Metformin has been used widely to treat type 2 DM. Heart diseases are the major complication of DM; and these results from blockage of heart vessels by atheromatous plaques. Diabetic retinopathy is an ophthalmic complication of DM. Increasingly, diabetic foot ulcers result from poorly controlled diabetes. Severe complications of diabetesmay include nephropathy, which, unfortunately, results in kidney failure.

Section 2

Individual/intrapersonal-

Age of an individual-diabetes type 1 occurs in young individuals of less than 14years of age while type 2 diabetes occurs in persons of approximat

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