Biology Reference
In-Depth Information
Diabetes is a wonderful affection, being a melting down of the flesh
and limbs. Life is short, disgusting and painful, death inevitable.
Aretaeus the Cappadocian, 2nd century
A
.
D
.
Diabetes is one of the most prevalent serious diseases in
modern society. In America, the high level of obesity
(a predisposing factor for diabetes) makes it likely that an
increasing number of people will contract the disease.
Diabetes mellitus occurs when the body is unable to use
glucose effectively. Insulin is a hormone that helps to get
glucose from the blood into the cells, where it is used to
provide energy for the body. There are three major types
of diabetes: Type 1 diabetes mellitus (T1DM), type
2 diabetes mellitus (T2DM), and gestational diabetes.
T1DM usually occurs in people under age 30. With
T1DM, the beta cells of the pancreas have been destroyed
or fail to function properly, and insulin is not produced.
T2DM usually occurs in people over the age of 40. Those
who are obese or have a family history of diabetes are at
increased risk. With T2DM, insulin is produced by the
pancreas, but the body is unable to use it properly, and
progressively the body loses the ability to produce
insulin. Gestational diabetes affects about 4% of all
pregnant women—about 135,000 cases in the United
States each year.
Chapter 5
RISK ANALYSIS OF
BLOOD GLUCOSE
DATA
Historical Overview
Clinical Blood Glucose Optimization
Problem of Diabetes
Quantifying Characteristics of Diabetes
Self-Monitoring of Blood Glucose
According to the American Diabetes Association, there
are 21 million people in the United States (6.3% of the
population) who have diabetes. Approximately 8% of
these have T1DM, whereas more than 90% have T2DM.
About one-third of the people with T2DM are unaware
they have the disease. In addition, at least 20.1 million
Americans are estimated to have pre-diabetes, a condition
where a person's blood glucose (BG) levels are higher
than normal but not high enough for a diagnosis of
T2DM. From 1990 to 1998, there was a one-third increase
in diabetes in U.S. adults.
Symmetrization of the Blood Glucose
Measurement Scale
The Blood Glucose Risk Function
The Low and High Blood Glucose
Risk Indices
Model Validation Strategies
Validation of the Blood Glucose
Risk Indices
More Complex Models
The economic costs of diabetes are enormous. A recent
study estimated that the direct medical and indirect
expenditures attributable to diabetes in 2002 were $132
billion (American Diabetes Association [2003]). The study
estimated that per capita medical expenditures totaled
$13,243 for people with diabetes and $2560 for people
without diabetes. Diabetes is the fifth-leading cause of
death by disease in the United States. Diabetes also
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