Diabetes is a metabolic disease characterized by elevated blood glucose leading to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. It is a result of a mismatch between the production and utilization of insulin and the uptake of glucose from the bloodstream into the skeletal muscle.
In type I diabetes the pancreas has difficulty producing insulin to stimulate the uptake of glucose at the muscle, while in type II diabetes (or diabetes mellitus) there is resistance to the influence of insulin at the muscle, resulting in an increase in insulin production and an eventual inability of the pancreas to produce insulin. Type II diabetes has become increasingly common with decreases in physical activity and caloric-rich diets in western populations.
Complications from diabetes are responsible for a large percentage of health issues including cardiovascular disease, kidney disease, blindness, and amputations.
Diabetes is a slow onset disease with a progression of signs and symptoms that typically include:
- Increased thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Presence of ketones in the urine
- Blurred vision
- Slow-healing sores
- Frequent infections, such as gums or skin infections and vaginal infections
However, clinical diagnosis includes:
Fasting plasma glucose ≥ 7.0 mmol/L, or A1c ≥ 6.5% (in adults), or 2h plasma glucose in a 75 g, or an oral glucose tolerance test ≥ 11.1 mmol/L, or random plasma glucose ≥ 11.1 mmol/L
The prevalence of diabetes worldwide is expected to increase from 451 million people in 2017 to 693 million people in 2045 and this trend is expected in all regions of the globe with a current economic burden of $450 billion dollars spent on diabetes care in North America alone in 2017.
Thus, the impact of an AHHPS in the management of diabetes can have a profound quality-of-life impact combined with a reduced economic burden on the healthcare system.