Depression In Latin American Adolescents By Diabetes Mellitus

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Depression in Latin American adolescents by Diabetes Mellitus

The term diabetes comes from the Greek Diabétes, which in turn derives from the Diabaíno verb "walk", formed from the prefix dia-, "through", and Báino, "walk, pass".Diabetes mellitus is a systemic disease of multiple causes;Chronic-degenerative, of heterogeneous nature, with variable degrees of hereditary predisposition and with the participation of various environmental factors characterized by chronic hyperglycemia, due to the production or action deficiency of insulin . It has been known for centuries and, nevertheless, over time, they continue South glanding new uncertainties and empty knowledge;So today, it is a pathology that still affects most of the population worldwide.

It is a disorder that is characterized by chronic hyperglycemia due to the lack of secretion of a protein (insulin);where this fails in its action or both alterations;Therefore, hyperglycemia in a person may be due to an alteration in the action of insulin, which is accompanied by diminished secretion, or only a failure in secretion. In its initial stage, it does not produce symptoms and when it is detected late and it is not properly treated it causes serious health complications. Where it is worrisome, since, according to López Stewart G “DM has reached epidemic proportions, affecting 5.1% of individuals 20 to 79 years old worldwide." 

When an exam is performed to see the status of glucose in the blood, it is considered within the normal range of glycemia (fasting) values between 70 and 100 mg/dl. There is an intermediate state between normal and diabetes: diabetes is considered to glymia values greater than 126 mg/ml and between 100 and 126 mg/dl. 

The hypothesis determines the genotype as an explanation of diabetes, where it excluded social, anthropological and lifestyles of adolescents from adolescents. 

Types of Diabetes Mellitus

Type 1 diabetes mellitus

Type 1 diabetes mellitus is an autoimmune disease that is characterized by the destruction of beta cells of the pancreas, the principle is lacking in insulin is low but as time passes the individual needs more and more, until the hormone stops occurring,What returns to the individual in insulin -dependent. The earlier the appearance of this pathology is the greater the intensity and speed with which the hormone stops. Where most cases, the origin of this destruction is autoimmune (DM1A). 

DM1 happens to be a challenge for diagnosed patients and not because of the same disease, but by the emptiness of knowledge about its effects and complications that can suffer throughout their lives, which are not completely related to this pathology. For example, the most frequent symptom in children and adolescents is the daily need for insulin. According to the Rev. Cuban of Public Health indicate that “genetic studies have identified more than 40 DNA segments, which determine the susceptibility of DM1 development. Also, it has been described that this type of DM shares routes in common with other autoimmune diseases, such as: celiac disease, thyroid, multiple sclerosis and rheumatoid arthritis, among others. And in recent years, epidemiological studies have been carried out that show an increase in the incidence rate (IT) between 1 to 3 % per year ”. 

The phenotype in people with DM covers from diabetic ketoacidosis to diabetes that can be controlled with only diet. Where the three criteria must be known: age to the diagnosis, positivity of autoantibodies and the need for insulin treatment.  Some of the symptoms related to the DMT1 are polyphia, polyphia, polyuria along with hyperglycemia. 

Pathophysiology of Diabetes Mellitus Type 1

At the beginning of this pathology, antibodies are presented that attack cytoplasmic antigens of these cells. “As the decarboxylase of glutamic acid 65 and 67 (GAD65 and 67), the thermal shock protein 65 (HSP-65), and against insulin. However, the greatest susceptibility to develop DM1 is found in the genes of the human leukocyte antigen (HLA class II) of chromosome 6, which contribute 50% of the risk." 

Other histocompatibility antigens are DR3, DR4, DQ BETA and DQ ALFA. On this genetic basis, environmental factors act that favor the expression of the disease and that can be endogenous or exogenous. Among these factors are: viral autoantibodies, which explains the relationship between viral epidemics and the appearance of new cases of DM1;eating habits, such as artificial breastfeeding that can act as a trigger for the appearance of DM1;stress;the accelerated growth that occurs in puberty;And in some cases, pollution, which has been associated as a possible cause of the increase in the number of new cases in recent times.

Patients who present this disease may have symptoms such as excessive urine excretion (polyuria), thirst (polydipsia), constant hunger (polyphia), weight loss, visual disorders and tiredness, among others. These symptoms may appear suddenly. In the DM1, the disease can also manifest itself by a sudden comatous state of the patient. 

The speed of destruction of beta cells determines the intensity of the clinical picture;If the picture begins at earlier age, the intensity will be greater. In about 30% of the cases, it follows a stage of remission in which the patient remains stable and does not need insulin or requires very low doses thanks to an improvement in the functioning of the scarce beta cells that still survive, which decreases glycotoxicity. Subsequently a gradual intensification of the disorder. Most patients with DM1 have metabolic instability, that is, they present hyperglycemia very easily, although this is variable and insulin sensitivity is normal.

Some patients with DM1 are obese before starting treatment or after starting it;On the other hand, there may be a genetic tendency that predisposes the person to present resistance to insulin or obesity.

Historical history of type 1 diabetes mellitus

Originally the word diabetes meant in Greek "compass", and it was a metaphor based on the similarity of the compass open with a person walking, which has the legs placed in the position of taking a step. In pathology, it begins to be used in the 1st century. of c. By mappadocia areteo, which uses diabetes in the etymological sense of "transit, step", referring to excessive expulsion of urine, which was the first known symptom of the disease. The ailment was named with a word that refer to the passage of liquid from ingestion to urination.

Often it is the most diagnosed disease in children and adolescents. “The prevalence of the DM1 in 2015 in the world, was estimated of 542,000 cases and the incidence in 86,000 cases, respectively (no fees were calculated since they are preliminary data).  The epidemiology of the DM, is a young discipline that has made important contributions, in addition to the analysis of the frequency and distribution of the condition ”.  The cause of the DM1 is still unknown, although it points to an autoimmune, genetic and environmental origin and cannot be prevented with current knowledge.

Morbidity of Latin American teenagers by type 1 diabetes mellitus

The previous diagnosis of diabetes was reported for 0.68% (CI95% 0.48%-0.88%) of adolescents, being 0.59% (CI95% 0.30%-0.88%) among men, and 0.77% (CI95% 0.50%-1.05%) Among women. This represents around 155,000 individuals in this age range who have already been diagnosed with diabetes. 

Mortality in Latin American adolescents by type 1 diabetes mellitus

DM can be associated with various complications, which can be acute (metabolic or infectious) or chronic and these in turn can be micro or macrovascular. These complications are an important cause of morbidity, disability and death. According to a study in Mexico, the average age of people who died from diabetes in 2010 was 66.7 years, which suggests a 10 -year reduction . Where, these patients had presented the disease between puberty, but when acquiring a treatment, life time was extended even having pathology, but it was until the stage of adulthood, when it caused them unfavorable effects, until reaching thedeath.

Diabetes mellitus type 2

The DMT2 is a pathology that is characterized by the opposition to insulin in the beta cells of the pancreas, which produce an expressive change in the secretion of this hormone, in the liver and adipose tissue. Another effect of DMT2 is the decrease in incredin, together with the increase in glucagon secretion. Then the synthesis of ATP and insulin resistance in the liver is reduced, where glucose production increases hyperglycemia. Insulin secretion is altered, beta cells do not regenerate, which generates insulin resistance. And where we can add environmental factors such as overweight, obesity, stress, sedentary lifestyle. Genetic factors influence in such a way, that increase the possibility of suffering this pathology more frequently. 

This type of diabetes is more frequent than type 1 diabetes, and occurs mostly in adults, there are currently cases of adolescents with this disease, and this is due to childhood obesity, environmental and genetic factors. Annual incidence of the DMT2 is 8 out of 10 people suffer from this pathology, in these cases the body mass index was not the main factor that caused it, a history of ancestry are the main causes. 

Conclusions

Type diabetes mellitus, also called insulin -dependent;It is a chronic pathology that is characterized by poor insulin production, where this is a hormone that regulates blood sugar and is due to the destruction of beta cells of the pancreas, therefore, the daily administration of this hormone requires. This disease has become one of the biggest health problems worldwide, due to high mortality and morbidity rates, as well as high glucose concentrations by long periods of time induce important metabolic changes.

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