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How to Create a Structured Research Paper Outline | Example

Published on August 7, 2022 by Courtney Gahan . Revised on August 15, 2023.

How to Create a Structured Research Paper Outline

A research paper outline is a useful tool to aid in the writing process , providing a structure to follow with all information to be included in the paper clearly organized.

A quality outline can make writing your research paper more efficient by helping to:

  • Organize your thoughts
  • Understand the flow of information and how ideas are related
  • Ensure nothing is forgotten

A research paper outline can also give your teacher an early idea of the final product.

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Table of contents

Research paper outline example, how to write a research paper outline, formatting your research paper outline, language in research paper outlines.

  • Definition of measles
  • Rise in cases in recent years in places the disease was previously eliminated or had very low rates of infection
  • Figures: Number of cases per year on average, number in recent years. Relate to immunization
  • Symptoms and timeframes of disease
  • Risk of fatality, including statistics
  • How measles is spread
  • Immunization procedures in different regions
  • Different regions, focusing on the arguments from those against immunization
  • Immunization figures in affected regions
  • High number of cases in non-immunizing regions
  • Illnesses that can result from measles virus
  • Fatal cases of other illnesses after patient contracted measles
  • Summary of arguments of different groups
  • Summary of figures and relationship with recent immunization debate
  • Which side of the argument appears to be correct?

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Follow these steps to start your research paper outline:

  • Decide on the subject of the paper
  • Write down all the ideas you want to include or discuss
  • Organize related ideas into sub-groups
  • Arrange your ideas into a hierarchy: What should the reader learn first? What is most important? Which idea will help end your paper most effectively?
  • Create headings and subheadings that are effective
  • Format the outline in either alphanumeric, full-sentence or decimal format

There are three different kinds of research paper outline: alphanumeric, full-sentence and decimal outlines. The differences relate to formatting and style of writing.

  • Alphanumeric
  • Full-sentence

An alphanumeric outline is most commonly used. It uses Roman numerals, capitalized letters, arabic numerals, lowercase letters to organize the flow of information. Text is written with short notes rather than full sentences.

  • Sub-point of sub-point 1

Essentially the same as the alphanumeric outline, but with the text written in full sentences rather than short points.

  • Additional sub-point to conclude discussion of point of evidence introduced in point A

A decimal outline is similar in format to the alphanumeric outline, but with a different numbering system: 1, 1.1, 1.2, etc. Text is written as short notes rather than full sentences.

  • 1.1.1 Sub-point of first point
  • 1.1.2 Sub-point of first point
  • 1.2 Second point

To write an effective research paper outline, it is important to pay attention to language. This is especially important if it is one you will show to your teacher or be assessed on.

There are four main considerations: parallelism, coordination, subordination and division.

Parallelism: Be consistent with grammatical form

Parallel structure or parallelism is the repetition of a particular grammatical form within a sentence, or in this case, between points and sub-points. This simply means that if the first point is a verb , the sub-point should also be a verb.

Example of parallelism:

  • Include different regions, focusing on the different arguments from those against immunization

Coordination: Be aware of each point’s weight

Your chosen subheadings should hold the same significance as each other, as should all first sub-points, secondary sub-points, and so on.

Example of coordination:

  • Include immunization figures in affected regions
  • Illnesses that can result from the measles virus

Subordination: Work from general to specific

Subordination refers to the separation of general points from specific. Your main headings should be quite general, and each level of sub-point should become more specific.

Example of subordination:

Division: break information into sub-points.

Your headings should be divided into two or more subsections. There is no limit to how many subsections you can include under each heading, but keep in mind that the information will be structured into a paragraph during the writing stage, so you should not go overboard with the number of sub-points.

Ready to start writing or looking for guidance on a different step in the process? Read our step-by-step guide on how to write a research paper .

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Gahan, C. (2023, August 15). How to Create a Structured Research Paper Outline | Example. Scribbr. Retrieved February 15, 2024, from https://www.scribbr.com/research-paper/outline/

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How to Write a Research Paper on Diabetes | Complete Guide

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FAQs about Diabetes Research Paper

Yes, this page is all about how to write a research paper on diabetes, from topic selection to the final paper ready for submission. We have sampled 200+ diabetes research topics that you can pick from or order custom diabetes topics for free. Additionally, we have a standard outline for a diabetes research paper that can guide you through. Chat is free – tell us what you need and get solutions fast.

There are different tricks that students use to write research papers on diabetes. Scroll down and find a complete guide on how to write a research paper on diabetes. But if you have a complex topic about diabetes and limited time to write a paper that scores A, then hiring an expert writer is your best option. We have expert writers ready to write for you diabetes research papers, essays, and proposals.

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Category: Diabetes

Updated: July 22, 2023

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Diabetes is a growing concern worldwide, and its prevalence continues to escalate. As researchers diligently seek effective ways to prevent and treat this chronic condition, the significance of writing a research paper on diabetes becomes increasingly evident. Such a paper can foster greater awareness, bridge knowledge gaps, and contribute to the advancement of diabetes management and care..

  • For students, writing research papers on diabetes requires using credible sources, format, originality, and submission on time.
  • To write a high-quality research paper on diabetes, it is vital to use a clear and organized outline and conduct thorough research.
  • However, writing diabetes research papers still challenges students who lack proper writing skills, mastery of diabetes concepts, and access to scholarly sources .
  • Many resources are available for those looking to write a research paper on diabetes type 1 or 2 and an essay about diabetes.
  • Daily we get visitors looking for tips on how to write a research paper on diabetes or help writing custom research paper topics on diabetes.

Therefore, we provide a complete guide on writing a research paper on diabetes. We also have expert tutors who help write essays on diabetes and diabetes research papers, proposals, and dissertations. Get all solutions here.

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What is Diabetes?

Diabetes is a chronic condition where the body cannot produce or respond to insulin. This leads to elevated levels of glucose in the blood, which can cause different health problems, including heart and kidney disease, stroke, nerve damage, and eye problems.

  • There are two main types of diabetes type 1 and type 2. Students can be assigned to write diabetes essays, research papers, and proposals.
  • Type 1 diabetes is an autoimmune disorder in which the body's immune system attacks and destroys the cells that produce insulin.
  • Type 2 diabetes occurs when the body becomes resistant to insulin and cannot effectively use it to regulate blood sugar levels.
  • A good research paper on diabetes can consider the different aspects of the disease, such as the causes, symptoms , and treatments for type 1 or type 2.
  • Sometimes we get customers looking for help writing a research paper childhood diabetes or an APA research paper on diabetes of 4 to 5 pages.
  • Additionally, a research paper on diabetes must have a clear thesis statement and significant contributions to understanding this important topic.

Students often get help from online tutors who can help them understand the topic, create good diabetes topics, and write diabetes research papers or essays about diabetes without plagiarism.

Why Students Need Help Writing Diabetes Papers

Daily we get many students looking for assistance with writing research papers on diabetes mellitus, type 1 or type 1. Some want samples of a research position paper on type 2 diabetes or college analytical research papers on diabetes type 1 or 2.

  • Most students struggle with balancing coursework and personal responsibilities, leaving them limited time to research and write nursing papers correctly.
  • Writing a diabetes research paper requires extensive time and attention to research and accurately convey information about the topic.
  • Additionally, a diabetes research paper must use credible sources that are scholarly and peer-reviewed; some students lack access to these sources.
  • Also, writing a research paper on diabetes 4 to 5 pages or more requires accurate grammar, paragraph structures, proofreading, and formatting.
  • Seeking help from experienced research paper writers provide students with original, high-quality papers that are free from plagiarism.
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Do not panic about writing essays or research papers on diabetes type 1 or type 2. Use our professional writers to solve these complex papers on time and deliver the Grade-A quality you deserve.

Can I Pay Someone to Write My Research Paper on Diabetes Mellitus?

Yes, we have professional writers you can pay to write a research paper on diabetes mellitus for you. Many students pay us to write a research paper on type 1 diabetes or a research paper on type 2 diabetes for varied reasons.

  • This approach ensures you get a quality research paper on diabetes mellitus written accurately by conducting research, analyzing data, and writing a well-structured paper.
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  • Instructors expect every student to craft relevant and thoughtful research paper topics on diabetes type 1.
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We have professional online tutors who can do your diabetes research papers fast and meet any deadline. Submit your instructions to us, select an expert to work with, and get the paper ready on time.

  • Writing a research paper on the effect of sugary drinks and diabetes requires factual data and details of the condition.
  • But how do students overcome the challenge of writing a research paper on diabetes? Here we provide all the tips and cheap paper writing services.
  • We have extensive experience writing diabetes essays, diabetes informative speeches, diabetes mellitus type 2 research papers, and research papers on childhood diabetes.
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How to Write a Research Paper on Diabetes: A Complete Guide

The fastest way to write a diabetes research paper or essay accurately is by hiring expert writers to do it for you. Our writers have vast experience writing these papers, and we will get it done quickly.

Using a diabetes research paper outline can help you get started, but it does not guarantee you will meet all quality requirements. Here is a sample of a standard outline for a diabetes research paper that is a complete guide to writing a research paper.

  • Pick a specific research topic:  diabetes is broad, and you must focus on a particular research paper topic on diabetes type 1, type 2, insulin pumps, or any issues you select.
  • Conduct background research:  Gather information from credible sources such as medical journals, government websites, and academic libraries to familiarize yourself with the current knowledge about the diabetes topic selected.
  • Develop a thesis statement for a research paper on diabetes:  A thesis statement is a sentence that summarizes the central argument of your paper. It should be clear, concise, and specific.
  • Outline your paper:  Organize your information into a logical structure, including an introduction, body, and conclusion sections. The research paper outline on diabetes must include sources you selected and key bullet points.
  • Write the introduction for diabetes research paper : Start by writing a clear and concise introduction that sets the stage for your research and provides background information on diabetes. The diabetes research paper introduction should end with a thesis statement.
  • Write the body paragraphs:  Write your arguments to support the thesis statement with accurate structure, opening statement, main arguments , counterarguments, and citations.
  • Write the conclusion for diabetes research paper : Restate the thesis statement, summarize your findings, and provide insights on their implications for future research.
  • Cite your sources:  Ensure that you properly cite all sources in your paper using the appropriate citation style, such as APA or MLA.
  • Proofread and edit your paper : Review your paper for grammar , clarity, and coherence, and make revisions as needed.

This standard research paper outline on diabetes is best for high school and college students. You can hire our professional writers to do your diabetes papers fast and efficiently. Just Place your order and get the paper done.

How to Write a Diabetes Research Paper Proposal

A diabetes research proposal differs from a simple essay or research assignment based on a specific prompt. A proposal requires a unique topic, background analysis, study objectives, research questions, literature review, data collection, and analysis, among others.

  • Here is the complete guide on how to write a diabetes research proposal that gets approved fast and easy.
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Good Diabetes Research Topics to Write About

Copying diabetes research topics online reduces the students' chances of writing original papers that are unique and impactful. Students should get custom diabetes topics, diabetes presentation ideas, or diabetes project ideas that have not been studied before.

Here are 50+ free diabetes research topics that you can use for brainstorming or refine into a unique topic:

  • Advancements in insulin therapy and impact on glycemic control
  • Aging and glucose metabolism
  • Diabetes statistics research paper
  • Diet and insulin sensitivity
  • Different types of exercise and diabetes management.
  • Effects of alcohol consumption on diabetes.
  • Effects of mindfulness-based therapies on diabetes.
  • Effects of sleep apnea on glucose metabolism.
  • Effects of stress on diabetes.
  • Environmental factors and diabetes development.
  • Epigenetics and diabetes.
  • Exercise and insulin sensitivity.
  • Genetics in type 1 and type 2 diabetes development.
  • Gestational diabetes research paper
  • Gut bacteria and glucose metabolism.
  • Gut hormones and glucose metabolism.
  • Gut-brain axis and glucose metabolism.
  • High-carbohydrate diet and glucose metabolism.
  • High-fat diet and glucose metabolism.
  • High-protein diet and glucose metabolism.
  • Impact of air pollution on diabetes.
  • Impact of environmental toxins on diabetes.
  • Impact of psychosocial stress on diabetes.
  • Impact of social support on diabetes management.
  • Inflammation and diabetes development and progression.
  • Informative speech on diabetes
  • Juvenile diabetes research paper
  • Liver role in glucose metabolism and diabetes development.
  • Low-carbohydrate diet and glucose metabolism.
  • Low-fat diet and glucose metabolism.
  • Macrovascular complications in diabetes.
  • Mediterranean diet and glucose metabolism.
  • Mental health and diabetes.
  • Microvascular complications in diabetes.
  • New therapies for diabetic neuropathy.
  • Non-alcoholic fatty liver disease and diabetes.
  • Obesity and insulin sensitivity.
  • Oral health and glucose metabolism.
  • Periodontal disease and diabetes.
  • Physical inactivity and glucose metabolism.
  • Phytochemicals and glucose metabolism.
  • Progression of diabetes research paper
  • Relationship between diabetes and cardiovascular disease.
  • Relationship between diabetes and kidney disease.
  • Role of bariatric surgery in diabetes management.
  • Role of nutrition education in diabetes management.
  • Role of physical therapy in diabetes management.
  • Role of technology in diabetes management.
  • Socioeconomic factors and diabetes incidence and management.
  • Telemedicine in diabetes care.
  • Use of artificial intelligence in diabetes diagnosis and management.
  • Use of machine learning in diabetic complication prediction.
  • Use of mobile health apps in diabetes management.
  • Use of natural compounds in diabetes management.
  • Use of wearable devices in diabetes management.
  • Vitamin d deficiency and diabetes.

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45 of the Best Diabetes Dissertation Topics

Published by Owen Ingram at January 2nd, 2023 , Revised On August 16, 2023

The prevalence of diabetes among the world’s population has been increasing steadily over the last few decades, thanks to the growing consumption of fast food and an increasingly comfortable lifestyle. With the field of diabetes evolving rapidly, it is essential to base your dissertation on a trending diabetes dissertation topic that fills a gap in research. 

Finding a perfect research topic is one of the most challenging aspects of dissertation writing in any discipline . Several resources are available to students on the internet to help them conduct research and brainstorm to develop their topic selection, but this can take a significant amount of time. So, we decided to provide a list of well-researched, unique and intriguing diabetes research topics and ideas to help you get started. 

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List of Diabetes Dissertation Topics

  • Why do people recently diagnosed with diabetes have such difficulty accepting reality and controlling their health?
  • What are the reactions of children who have recently been diagnosed with diabetes? What can be done to improve their grasp of how to treat the disease?
  • In long-term research, people getting intensive therapy for the condition had a worse quality of life. What role should health professionals have in mitigating this effect?
  • Why do so many individuals experience severe depression the months after their diagnosis despite displaying no other signs of deteriorating health?
  • Discuss some of the advantages of a low-carbohydrate, high-fat diet for people with diabetes
  • Discuss the notion of diabetes in paediatrics and why it is necessary to do this research regularly.
  • Explain the current threat and difficulty of childhood obesity and diabetes, stressing some areas where parents are failing in their position as guardians to avoid the situation
  • Explain some of the difficulties that persons with diabetes have, particularly when obtaining the necessary information and medical treatment
  • Explain some of the most frequent problems that people with diabetes face, as well as how they affect the prevalence of the disease. Put out steps that can be implemented to help the problem.
  • Discuss the diabetes problem among Asian American teens
  • Even though it is a worldwide disease, particular ethnic groups are more likely to be diagnosed as a function of nutrition and culture. What can be done to improve their health literacy?
  • Explain how self-management may be beneficial in coping with diabetes, particularly for people unable to get prompt treatment for their illness
  • Discuss the possibility of better management for those with diabetes who are hospitalized
  • What current therapies have had the most influence on reducing the number of short-term problems in patients’ bodies?
  • How have various types of steroids altered the way the body responds in people with hypoglycemia more frequently than usual?
  • What effects do type 1, and type 2 diabetes have on the kidneys? How do the most widely used monitoring approaches influence this?
  • Is it true that people from specific ethnic groups are more likely to acquire heart disease or eye illness due to their diabetes diagnosis?
  • How has the new a1c test helped to reduce the detrimental consequences of diabetes on the body by detecting the condition early?
  • Explain the difficulty of uncontrolled diabetes and how it can eventually harm the kidneys and the heart
  • Discuss how the diabetic genetic strain may be handed down from generation to generation
  • What difficulties do diabetic people have while attempting to check their glucose levels and keep a balanced food plan?
  • How have some individuals with type 1 or type 2 diabetes managed to live better lives than others with the disease?
  • Is it true that eating too much sugar causes diabetes, cavities, acne, hyperactivity, and weight gain?
  • What effect does insulin treatment have on type 2 diabetes?
  • How does diabetes contribute to depression?
  • What impact does snap participation have on diabetes rates?
  • Why has the number of persons who perform blood glucose self-tests decreased? Could other variables, such as social or environmental, have contributed to this decrease?
  • Why do patients in the United States struggle to obtain the treatment they require to monitor and maintain appropriate glucose levels? Is this due to increased healthcare costs?
  • Nutrition is critical to a healthy lifestyle, yet many diabetic patients are unaware of what they should consume. Discuss
  • Why have injuries and diabetes been designated as national health priorities?
  • What factors contribute to the growing prevalence of type ii diabetes in adolescents?
  • Does socioeconomic status influence the prevalence of diabetes?
  • Alzheimer’s disease and type 2 diabetes: a critical assessment of the shared pathological traits
  • What are the effects and consequences of diabetes on peripheral blood vessels?
  • What is the link between genetic predisposition, obesity, and type 2 diabetes development?
  • Diabetes modifies the activation and repression of pro- and anti-inflammatory signalling pathways in the vascular system.
  • Understanding autoimmune diabetes through the tri-molecular complex prism
  • Does economic status influence the regional variation of diabetes caused by malnutrition?
  • What evidence is there for using traditional Chinese medicine and natural products to treat depression in people who also have diabetes?
  • Why was the qualitative method used to evaluate diabetes programs?
  • Investigate the most common symptoms of undiagnosed diabetes
  • How can artificial intelligence help diabetes patients?
  • What effect does the palaeolithic diet have on type 2 diabetes?
  • What are the most common diabetes causes and treatments?
  • What causes diabetes mellitus, and how does it affect the United Kingdom?

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You can contact our 24/7 customer service for a bespoke list of customized diabetes dissertation topics , proposals, or essays written by our experienced writers . Each of our professionals is accredited and well-trained to provide excellent content on a wide range of topics. Getting a good grade on your dissertation course is our priority, and we make sure that happens. Find out more here . 

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How to find diabetes dissertation topics.

To find diabetes dissertation topics:

  • Study recent research in diabetes.
  • Focus on emerging trends.
  • Explore prevention, treatment, tech, etc.
  • Consider cultural or demographic aspects.
  • Consult experts or professors.
  • Select a niche that resonates with you.

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Essays on Diabetes

As you work on a diabetes essay or obesity essay, you get a chance to educate yourself about this dangerous disorder. Diabetes is a metabolic disorder characterized by high blood sugar (glucose) levels due to certain defects in insulin secretion. Most essays on diabetes mention only two types of diabetes: 1 and 2. Type 1 diabetes is insulin-dependent diabetes or juvenile diabetes. Type 2 diabetes is non-insulin-dependent. In essays, people refer to it as an adult form of diabetes. Explore more types of diabetes in samples of diabetes essays. Among the consequences of diabetes are heart diseases; stroke; amputation; loss of vision; hearing impairment; bladder and kidney infections; erectile dysfunction and impotence. Check diabetes essay samples below for extra info on the issue.

Type 2 diabetes is a critical characteristic prolonged ailment caused by a complicated inheritance-environment interaction alongside other risk factors including obesity, and inactive lifestyles. This kind of diabetes together with its complications constitutes a fundamental worldwide problem facing public health. It affects nearly all population in both developing and developed...

Words: 2263

Discussion Board Prompt: In the readings, students will learn about the causes of obesity and know how to differentiate between obesity and being overweight. It is expected that everyone will be aware of BMI calculation where the square of their height divides a person's weight, and the result is expressed...

Special thanks to Jonas Gray of Cambridge University for his contribution to the development of the content of this paper. Thus, it meets the requirement of the current assignment. Type 2 Diabetes and the Cardiovascular System Etiology As a polygenic disease, type 2 diabetes is associated with blood sugars which are seemingly too...

Words: 1934

Type 2 diabetes is a metabolic health disorder caused by the limited production of insulin by the pancreas. The disorder is characterized by high levels of glucose in the bloodstream caused by the failure of the body to maintain normal blood sugar levels. The body requires insulin to regulate the...

Words: 1917

Type 2 Diabetes and its Complications Type 2 diabetes is a medical condition that occurs when the process of sugar metabolism is altered. The body’s main source of energy is sugar, and once the way the body metabolizes it is affected, almost all body processes are altered as well. Insulin is...

Health literacy is an extent to which one has the ability to acquire, to process and acknowledges information regarding health and the required services in order to make decisions appropriately. However, diabetes is one of the issues that the people need to beware and know how to control or manage....

Words: 1060

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Diabetes as an overall term of diseases that affect the body's ability to produce or respond positively to the insulin hormone results in high levels of blood glucose as the agency cannot conduct efficient carbohydrate metabolism. There are two main kinds of diabetes, i.e., Type 1 and Type 2, and...

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Knee bilateral amputation causes major alterations in the patient's overall body structure as well as bodily functioning. It obviously results in the loss of a body component, but it also has an impact on the underlying disease, in this case diabetes. As a result, it has an impact on comorbidities...

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Amit Sapra ; Priyanka Bhandari .

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Last Update: June 21, 2023 .

  • Continuing Education Activity

Diabetes mellitus (DM) is a disease of inadequate control of blood levels of glucose. It has many subclassifications, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. Type 1 and 2 DM are the main subtypes, each with different pathophysiology, presentation, and management, but both have a potential for hyperglycemia. This activity outlines the pathophysiology, evaluation, and management of DM and highlights the role of the interprofessional team in managing patients with this condition.

  • Describe the pathophysiology of diabetes mellitus.
  • Outline the epidemiology and risk factors of diabetes mellitus.
  • Review the treatment considerations and common complications of diabetes mellitus.
  • Identify the importance of improving collaboration and care coordination amongst the interprofessional team to enhance the delivery of care for patients affected by diabetes mellitus.
  • Introduction

Diabetes mellitus is taken from the Greek word diabetes , meaning siphon - to pass through and the Latin word  mellitus  meaning sweet. A review of the history shows that the term "diabetes" was first used by Apollonius of Memphis around 250 to 300 BC. Ancient Greek, Indian, and Egyptian civilizations discovered the sweet nature of urine in this condition, and hence the propagation of the word Diabetes Mellitus came into being. Mering and Minkowski, in 1889, discovered the role of the pancreas in the pathogenesis of diabetes. In 1922 Banting, Best, and Collip purified the hormone insulin from the pancreas of cows at the University of Toronto, leading to the availability of an effective treatment for diabetes in 1922. Over the years, exceptional work has taken place, and multiple discoveries, as well as management strategies, have been created to tackle this growing problem. Unfortunately, even today, diabetes is one of the most common chronic diseases in the country and worldwide. In the US, it remains as the seventh leading cause of death.

Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels. DM has several categories, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and secondary causes due to endocrinopathies, steroid use, etc. The main subtypes of DM are Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM), which classically result from defective insulin secretion (T1DM) and/or action (T2DM). T1DM presents in children or adolescents, while T2DM is thought to affect middle-aged and older adults who have prolonged hyperglycemia due to poor lifestyle and dietary choices. The pathogenesis for T1DM and T2DM is drastically different, and therefore each type has various etiologies, presentations, and treatments.

In the islets of Langerhans in the pancreas, there are two main subclasses of endocrine cells: insulin-producing beta cells and glucagon secreting alpha cells. Beta and alpha cells are continually changing their levels of hormone secretions based on the glucose environment. Without the balance between insulin and glucagon, the glucose levels become inappropriately skewed. In the case of DM, insulin is either absent and/or has impaired action (insulin resistance), and thus leads to hyperglycemia.

T1DM is characterized by the destruction of beta cells in the pancreas, typically secondary to an autoimmune process. The result is the absolute destruction of beta cells, and consequentially, insulin is absent or extremely low.

T2DM involves a more insidious onset where an imbalance between insulin levels and insulin sensitivity causes a functional deficit of insulin. Insulin resistance is multifactorial but commonly develops from obesity and aging.

The genetic background for both types is critical as a risk factor. As the human genome gets further explored, there are different loci found that confer risk for DM. Polymorphisms have been known to influence the risk for T1DM, including major histocompatibility complex (MHC) and human leukocyte antigen (HLA). [1]

T2DM involves a more complex interplay between genetics and lifestyle. There is clear evidence suggesting that T2DM is has a stronger hereditary profile as compared to T1DM. The majority of patients with the disease have at least one parent with T2DM. [2]

Monozygotic twins with one affected twin have a 90% likelihood of the other twin developing T2DM in his/her lifetime. [3]  Approximately 50 polymorphisms to date have been described to contribute to the risk or protection for T2DM. These genes encode for proteins involved in various pathways leading to DM, including pancreatic development, insulin synthesis, secretion, and development, amyloid deposition in beta cells, insulin resistance, and impaired gluconeogenesis regulation. A genome-wide association study (GWAS) found genetic loci for transcription factor 7-like 2 gene (TCF7L2), which increases the risk for T2DM. [4] [5]  Other loci that have implications in the development of T2DM include NOTCH2, JAZF1, KCNQ1, and WFS1. [6] [7]

MODY is a heterogeneous disorder identified by non-insulin-dependent diabetes diagnosed at a young age (usually under 25 years). It carries an autosomal dominant transmission and does not involve autoantibodies as in T1DM. Several genes have implications in this disease, including mutations to hepatocyte nuclear factor-1-alpha (HNF1A) and the glucokinase (GCK) gene, which occurs in 52 to 65 and 15 to 32 percent of MODY cases, respectively. [8] [9]  The genetics of this disease are still unclear as some patients have mutations but never develop the disease, and others will develop clinical symptoms of MODY but have no identifiable mutation.

Gestational diabetes is essentially diabetes that manifests during pregnancy. It is still unknown why it develops; however, some speculate that HLA antigens may play a role, specifically HLA DR2, 3, and 4. Excessive proinsulin is also thought to play a role in gestational diabetes, and some suggest that proinsulin may induce beta-cell stress. Others believe that high concentrations of hormones such as progesterone, cortisol, prolactin, human placental lactogen, and estrogen may affect beta-cell function and peripheral insulin sensitivity. [10]

Several endocrinopathies, including acromegaly, Cushing syndrome, glucagonoma, hyperthyroidism, hyperaldosteronism, and somatostatinomas, have been associated with glucose intolerance and diabetes mellitus, due to the inherent glucogenic action of the endogenous hormones excessively secreted in these conditions. Conditions like idiopathic hemochromatosis are associated with diabetes mellitus due to excessive iron deposition in the pancreas and the destruction of the beta cells.

  • Epidemiology

Globally, 1 in 11 adults has DM (90% having T2DM). The onset of T1DM gradually increases from birth and peaks at ages 4 to 6 years and then again from 10 to 14 years. [11]  Approximately 45% of children present before age ten years. [12]  The prevalence in people under age 20 is about 2.3 per 1000. While most autoimmune diseases are more common in females, there are no apparent gender differences in the incidence of childhood T1DM. In some populations, such as in older males of European origin (over 13 years), they may be more likely to develop T1DM compared to females (3:2 male to female ratio). [13]  The incidence of T1DM has been increasing worldwide. In Europe, Australia, and the Middle East, rates are rising by 2% to 5% annually. [14] [15] [16]  In the United States, T1DM rates rose in most age and ethnic groups by about 2% yearly, and rates are higher in Hispanic youth. [17]  The exact reason for this pattern remains unknown. However, some metrics, such as the United States Military Health System data repository, found plateauing over 2007 to 2012 with a prevalence of 1.5 per 1000 and incidence of 20.7 to 21.3 per 1000. [18]

The onset of T2DM is usually later in life, though obesity in adolescents has led to an increase in T2DM in younger populations. T2DM has a prevalence of about 9% in the total population of the United States, but approximately 25% in those over 65 years. The International Diabetes Federation estimates that 1 in 11 adults between 20 and 79 years had DM globally in 2015. Experts expect the prevalence of DM to increase from 415 to 642 million by 2040, with the most significant increase in populations transitioning from low to middle-income levels. [19]  T2DM varies among ethnic groups and is 2 to 6 times more prevalent in Blacks, Native Americans, Pima Indians, and Hispanic Americans compared to Whites in the United States. [20] [21]  While ethnicity alone plays a vital role in T2DM, environmental factors also greatly confer risk for the disease. For example, Pima Indians in Mexico are less likely to develop T2DM compared to Pima Indians in the United States (6.9% vs. 38%). [22]

  • Pathophysiology

A patient with DM has the potential for hyperglycemia. The pathology of DM can be unclear since several factors can often contribute to the disease. Hyperglycemia alone can impair pancreatic beta-cell function and contributes to impaired insulin secretion. Consequentially, there is a vicious cycle of hyperglycemia leading to an impaired metabolic state. Blood glucose levels above 180 mg/dL are often considered hyperglycemic in this context, though because of the variety of mechanisms, there is no clear cutoff point. Patients experience osmotic diuresis due to saturation of the glucose transporters in the nephron at higher blood glucose levels. Although the effect is variable, serum glucose levels above 250 mg/dL are likely to cause symptoms of polyuria and polydipsia.

Insulin resistance is attributable to excess fatty acids and proinflammatory cytokines, which leads to impaired glucose transport and increases fat breakdown. Since there is an inadequate response or production of insulin, the body responds by inappropriately increasing glucagon, thus further contributing to hyperglycemia. While insulin resistance is a component of T2DM, the full extent of the disease results when the patient has inadequate production of insulin to compensate for their insulin resistance. 

Chronic hyperglycemia also causes nonenzymatic glycation of proteins and lipids. The extent of this is measurable via the glycation hemoglobin (HbA1c) test. Glycation leads to damage in small blood vessels in the retina, kidney, and peripheral nerves. Higher glucose levels hasten the process. This damage leads to the classic diabetic complications of diabetic retinopathy, nephropathy, and neuropathy and the preventable outcomes of blindness, dialysis, and amputation, respectively. [23]

  • History and Physical

During patient history, questions about family history, autoimmune diseases, and insulin-resistant are critical to making the diagnosis of DM. It often presents asymptomatically, but when symptoms develop, patients usually present with polyuria, polydipsia, and weight loss. On physical examination of someone with hyperglycemia, poor skin turgor (from dehydration) and a distinctive fruity odor of their breath (in patients with ketosis) may be present. In the setting of diabetic ketoacidosis (DKA), clinicians may note Kussmaul respirations, fatigue, nausea, and vomiting. Funduscopic examination in a patient with DM may show hemorrhages or exudates on the macula. In frank diabetic retinopathy, retinal venules may appear dilated or occluded. The proliferation of new blood vessels is also a concern for ophthalmologists and can hasten retinal hemorrhages and macular edema, ultimately resulting in blindness. While T1DM and T2DM can present similarly, they can be distinguished based on clinical history and examination. T2DM patients are typically overweight/obese and present with signs of insulin resistance, including acanthosis nigricans, which are hyperpigmented, velvety patches on the skin of the neck, axillary, or inguinal folds. Patients with a longer course of hyperglycemia may have blurry vision, frequent yeast infections, numbness, or neuropathic pain. The clinicians must ask the patient bout any recent skin changes in their feet during each visit. The diabetic foot exam, including the monofilament test, should be a part of the routine physical exam.

The diagnosis of T1DM is usually through a characteristic history supported by elevated serum glucose levels (fasting glucose greater than 126 mg/dL, random glucose over 200 mg/dL, or hemoglobin A1C (HbA1c exceeding 6.5%) with or without antibodies to glutamic acid decarboxylase (GAD) and insulin.

Fasting glucose levels and HbA1c testing are useful for the early identification of T2DM. If borderline, a glucose tolerance test is an option to evaluate both fasting glucose levels and serum response to an oral glucose tolerance test (OGTT). Prediabetes, which often precedes T2DM, presents with a fasting blood glucose level of 100 to 125 mg/dL or a 2-hour post-oral glucose tolerance test (post-OGTT) glucose level of 140 to 200 mg/dL. [24] [25]

According to the American Diabetes Association (ADA), a diagnosis of diabetes is through any of the following: An HbA1c level of 6.5% or higher; A fasting plasma glucose level of 126 mg/dL (7.0 mmol/L) or higher (no caloric intake for at least 8 hours); A two-hour plasma glucose level of 11.1 mmol/L or 200 mg/dL or higher during a 75-g OGTT; A random plasma glucose of 11.1 mmol/L or 200 mg/dL or higher in a patient with symptoms of hyperglycemia (polyuria, polydipsia, polyphagia, weight loss) or hyperglycemic crisis. [24] The ADA recommends screening adults aged 45 years and older regardless of risk, while the United States Preventative Service Task Force suggests screening individuals between 40 to 70 years who are overweight. [26] .

To test for gestational diabetes, all pregnant patients have screening between 24 to 28 weeks of gestation with a 1-hour fasting glucose challenge test. If blood glucose levels are over 140mg/dL, patients have a 3-hour fasting glucose challenge test to confirm a diagnosis. A positive 3-hours OGTT test is when there is at least one abnormal value (greater than or equal to 180, 155, and 140 mg/dL for fasting one-hour, two-hour, and 3-hour plasma glucose concentration, respectively). [27]

Several lab tests are useful in the management of chronic DM. Home glucose testing can show trends of hyper- and hypoglycemia. The HbA1c test indicates the extent of glycation due to hyperglycemia over three months (the life of the red blood cell). Urine albumin testing can identify the early stages of diabetic nephropathy. Since patients with diabetes are also prone to cardiovascular disease, serum lipid monitoring is advisable at the time of diagnosis. Similarly, some recommend monitoring thyroid status by obtaining a blood level of thyroid-stimulating hormone annually due to a higher incidence of hypothyroidism. [24] [25]

  • Treatment / Management

The physiology and treatment of diabetes are complex and require a multitude of interventions for successful disease management. Diabetic education and patient engagement are critical in management. Patients have better outcomes if they can manage their diet (carbohydrate and overall caloric restriction), exercise regularly (more than 150 minutes weekly), and independently monitor glucose. [28] Lifelong treatment is often necessary to prevent unwanted complications. Ideally, glucose levels should be maintained at 90 to 130 mg/dL and HbA1c at less than 7%. While glucose control is critical, excessively aggressive management may lead to hypoglycemia, which can have adverse or fatal outcomes.

Since T1DM is a disease primarily due to the absence of insulin, insulin administration through daily injections, or an insulin pump, is the mainstay of treatment. In T2DM, diet and exercise may be adequate treatments, especially initially. Other therapies may target insulin sensitivity or increase insulin secretion by the pancreas. The specific subclasses for drugs include biguanides (metformin), sulfonylureas, meglitinides, alpha-glucosidase inhibitors, thiazolidinediones, glucagonlike-peptide-1 agonist, dipeptidyl peptidase IV inhibitors (DPP-4), selective, amylinomimetics, and sodium-glucose transporter-2 (SGLT-2) inhibitors. Metformin is the first line of the prescribed diabetic medications and works by lowering basal and postprandial plasma glucose. Insulin administration may also be necessary for T2DM patients, especially those with inadequate glucose management in the advanced stages of the disease. In morbidly obese patients, bariatric surgery is a possible means to normalize glucose levels. It is recommended for individuals who have been unresponsive to other treatments and who have significant comorbidities. [29]  The GLP-1 agonists liraglutide and semaglutide correlate with improved cardiovascular outcomes. The SGLT-2 inhibitors empagliflozin and canagliflozin have also shown to improve cardiovascular outcomes along with potential renoprotection as well as prevention for the development of heart failure.

Regular screenings are necessary since microvascular complications are a feared complication of diabetes. Regular diabetic retinal exams should be performed by qualified medical personnel to assess for diabetic retinopathy. Neurologic examination with monofilament testing can identify patients with neuropathy at risk for amputation. Clinicians can also recommend patients perform daily foot inspections to identify foot lesions that may go unnoticed due to neuropathy. Low-dose tricyclic antidepressants, duloxetine, anticonvulsants, topical capsaicin, and pain medications may be necessary to manage neuropathic pain in diabetes. Urine microalbumin testing can also assess for early renal changes from diabetes with albuminuria greater than 30mg/g creatinine along with the estimated GFR. The antiproteinuric effect of the angiotensin-converting enzyme (ACE) inhibitors and the angiotensin receptor blockers (ARBs) makes them the preferred agents to delay the progression from microalbuminuria to macroalbuminuria in patients with both Type 1 or Type 2 diabetes mellitus.

The FDA has approved pregabalin and duloxetine for the treatment of diabetic peripheral neuropathy. Tricyclic antidepressants and anticonvulsants have also seen use in the management of the pain of diabetic neuropathy with variable success. 

The ADA also recommends regular blood pressure screening for diabetics, with the goal being 130 mmHg systolic blood pressure and 85 mmHg diastolic blood pressure. [30]  Pharmacologic therapy for hypertensive diabetics typically involves angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics, beta-blockers, and/or calcium channel blockers. The ADA recommends lipid monitoring for diabetics with a goal of low-density lipoprotein cholesterol (LDL-C) being less than 100 mg/dL if no cardiovascular disease (CVD) and less than 70 mg/dl if atherosclerotic cardiovascular disease (ASCVD) is present. Statins are the first-line treatment for the management of dyslipidemia in diabetics. The ADA suggests that low dose aspirin may also be beneficial for diabetic patients who are at high risk for cardiovascular events; however, the role of aspirin in reducing cardiovascular events in patients with diabetes remains unclear. [31] [32] [33]

  • Differential Diagnosis

In addition to T1DM, T2DM, and MODY, any disorder that damages the pancreas can result in DM. There are several diseases of the exocrine pancreas, including: [34]  

  • Cystic fibrosis
  • Hereditary hemochromatosis
  • Pancreatic cancer
  • Chronic pancreatitis

Hormonal syndromes that can lead to impaired insulin secretion include:

  • Pheochromocytoma
  • Cushing syndrome

Drug-induced insulin resistance is also in the differential of classical diabetes. These drugs include:

  • Glucocorticoids

Other diseases in the differential of diabetes mellitus include:

  • Gestational diabetes [10]
  • Thyroid disorders
  • Pertinent Studies and Ongoing Trials

Various trials have been undertaken to understand the cardiovascular outcomes with antidiabetic medications. The LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results), was a double-blinded trial comparing the use of liraglutide, which is a GLP -1 agonist to placebo in around 10000 patients. After a follow-up period of about four years, liraglutide was shown to reduce mortality from cardiovascular causes as well as all-cause mortality. It also seemed to reduce the first occurrence of the first nonfatal myocardial infarction (MI) and stroke.

The EMPA-REG OUTCOME trial ([Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) have shown considerable reductions in mortality and heart failure hospitalization risks in patients with type 2 diabetes mellitus (T2D), by and cardiovascular disease with empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor.

The CANVAS trial (Canagliflozin Cardiovascular Assessment Study) subsequently reported a reduction in 3-point major adverse cardiovascular events and heart failure (HF) hospitalization risk. The proposed mechanism through which SGLT2 inhibitors work helps patients with heart failure is via the promotion of natriuresis and osmotic diuresis and reduced preload. SGLT2 inhibition is also associated with the preservation of renal function. Based on data from mechanistic studies and clinical trials, large clinical trials with SGLT2 inhibitors are now investigating the potential use of SGLT2 inhibition in patients who have HF with and without T2 diabetes mellitus.

  • Toxicity and Adverse Effect Management

One of the most common adverse effects of insulin is hypoglycemia. Gastrointestinal upset is the most common side effect of many of the T2DM medications. Metformin can lead to lactic acidosis and should be used with caution in patients with renal disease and discontinued if the estimated glomerular filtration rate (e-GFR) is under 30 mL/min. Sulfonylureas can lead to hypoglycemia and may promote cardiovascular death in patients with diabetes. [35]  Thiazolidinediones have fallen out of favor in clinical practice due to their adverse effects, specifically resulting in fluid retention, worsening heart failure, and fractures. [36] [37]  DPP-4 may increase the risk for upper respiratory tract infections but may have less nausea and diarrhea compared to other drugs such as metformin. [38] [39]  SGLT-2 inhibitors can lead to increased urinary tract infections due to increased urinary glucose excretion. [40]  Both SGLT2 inhibitors and GLP-1 Receptor agonists reduce ASCVD events and are now considered the second line to metformin in such patients.

Diabetes mellitus was the seventh leading cause of death in the United States in 2015. [41]  The prognosis of DM gets significantly influenced by the degree of glucose management. Chronic hyperglycemia significantly increases the risk of DM complications. The Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study found that individuals with T1DM and T2DM respectively had increased microvascular complications with chronic hyperglycemia. [42] [43]  Patients who can revert to normal glucose during the progression from pre-diabetes to frank DM had a good prognosis and may be able to slow disease progression. [44]

  • Complications

Regardless of the specific type of diabetes, complications involve microvascular, macrovascular, and neuropathic issues. Microvascular and macrovascular complications vary according to the degree and the duration of poorly control diabetes and include nephropathy, retinopathy, neuropathy, and ASCVD events, especially if it is associated with other comorbidities like dyslipidemia and hypertension. [45]  One of the most devastating consequences of DM is its effect on cardiovascular disease (ASCVD). Approximately two-thirds of those with DM will die from a myocardial infarction or stroke. [46]  In T2DM, fasting glucose of more than 100 mg/dL significantly contributes to the risk of ASCVD, and cardiovascular risk can develop before frank hyperglycemia. [47] [48]

DM is also a common cause of blindness in adults aged 20 to 74 years in the United States. Diabetic retinopathy contributes to 12000 to 24000 new cases of blindness annually, and treatments generally consist of laser surgery and glucose control. [49]

Renal disease is another significant cause of morbidity and mortality in DM patients. It is the leading contributor to end-stage renal disease (ESRD) in the United States, and many patients with ESRD will need to start dialysis or receive a kidney transplant. [49]  If the albuminuria persists in the range of 30 to 300 mg/day (microalbuminuria), it seems to be a predictable earliest marker for the onset of diabetic neuropathy. Once macroalbuminuria (greater than 300 mg/24 hr) sets in, the progression to ESRD hastens up. The random spot urine specimen for measurement of the albumin-to-creatinine ratio is a quick, easy, predictable method that is the most widely used and preferred method to detect microalbuminuria. Two of three tests, done over a six month showing a persistent level greater than 30 mcg/mg creatinine, confirms the diagnosis of microalbuminuria.

DM is also the leading cause of limb amputations in the United States; this is primarily due to vasculopathy and neuropathy associated with DM. [49]  Many patients who develop neuropathy need to have regular foot exams to prevent infection from wounds that go unnoticed.

The duration of diabetes is the most crucial risk factor for the development of diabetic retinopathy. In people with type 1 diabetes, it typically sets in about 5 years after disease onset. Hence it is recommended to start the yearly retinal exams in these patients about five years after diagnosis. Among patients with type 2 diabetes, many patients might already have retinal changes at the time of diagnosis. Approximately 10% at ten years, 40% at 15 years, and 60% at 20 years will have nonproliferative retinal disease. In these patients, the recommendation is to start the yearly retinal screening at the time of diagnosis. Study after study has shown that reasonable glycemic control favorably affected the onset and progression of diabetic retinopathy. Uncontrolled blood pressure is an added risk factor for macular edema. Lowering the blood pressure in patients with diabetes thus also affects the risk of progression of the retinopathy. Injection of antibodies vascular endothelial growth factor (anti-VEGF) agents are generally in use as the initial therapy in cases of macular edema. In cases of nonproliferative diabetic retinopathy, pan-retinal photocoagulation is being used. In cases of diabetic proliferative retinopathy, combined modalities of anti-VEGF agents and pan-retinal photocoagulation are now in use. Sudden loss of vision can occur for several reasons in patients with diabetes mellitus, the most common being vitreous hemorrhage. Less common causes that merit consideration include vascular occlusion (central retinal vein or branch vein occlusion involving the macula), retinal detachment, end-stage glaucoma, and ischemic optic neuropathy.

Furthermore, evidence suggests that T2DM may also contribute to cancer development, specifically bladder cancer, in those using pioglitazone. [50]  Patients using metformin had improved cancer-specific survival in those with prostate, pancreatic, breast, and colorectal cancers. However, it is unclear how metformin plays a role in modulating cancer in patients with diabetes. [51]

Those with gestational diabetes are at a higher risk for cesarean delivery and chronic hypertension. Pregnant patients with T2DM generally have a better prognosis in terms of neonatal and pregnancy complications compared to those with T1DM. Generally, neonates of DM mothers will present with hypoglycemia and macrosomia. [52]

The most acute complication of DM is diabetic ketoacidosis (DKA), which typically presents in T1DM. This condition is usually either due to inadequate dosing, missed doses, or ongoing infection. [53]  In this condition, the lack of insulin means that tissues are unable to obtain glucose from the bloodstream. Compensation for this causes the metabolism of lipids into ketones as a substitute energy source, which causes systemic acidosis, and can be calculated as a high anion-gap metabolic acidosis. The combination of hyperglycemia and ketosis causes diuresis, acidemia, and vomiting leading to dehydration and electrolyte abnormalities, which can be life-threatening. In T2DM, hyperosmolar hyperglycemic syndrome (HHS) is an emergent concern. It presents similarly to DKA with excessive thirst, elevated blood glucose, dry mouth, polyuria, tachypnea, and tachycardia. However, unlike DKA, HHS typically does not present with excessive urinary ketones since insulin still gets produced by pancreatic beta cells. Treatment for DKA or HHS involves insulin administration and aggressive intravenous hydration. Careful management of electrolytes, particularly potassium, is critical in the management of these emergent conditions. [54]

  • Deterrence and Patient Education

Healthcare professionals should take an active approach to educate patients with DM. It is misguided for patients to think that lifestyle changes for a limited time are appropriate, and instead, lifelong lifestyle changes may be necessary to control their DM adequately. A randomized, controlled trial identified that individualized education is more effective compared to group education in patients who had poorly controlled DM. [55]  Often, non-clinician healthcare professionals (e.g., nurses, pharmacists) have extensive training in DM education and have more time for individualized education.

  • Pearls and Other Issues

Amino acid metabolism may play a critical role in the development of T2DM. Studies have shown that there is a 4-fold increase in isoleucine, phenylalanine, and tyrosine in individuals with hyperglycemia. Researchers found that these amino acids were elevated up to 12 years before the onset of the disease. [56]  Recent studies have further elucidated the role of these metabolites in the development, screening, and treatment of metabolic syndrome (MetS), a cardiometabolic cluster that predisposes patients to T2DM and CVD. Studies have shown that choline, L-carnitine, and trimethylamine-N-oxide were associated with inflammatory pathways and increased the risk of metabolic dysfunction in nascent MetS patients, who meet classification for MetS but do not have T2DM and cardiovascular disease. [57]  Literature has also shown increased levels of isoleucine and tyrosine and decreased levels of lysine and methionine. These metabolites appear to be early biomarkers of nascent MetS and significant contributors to the pro-inflammatory burden of MetS.

Low levels of lysine, in particular, were associated with increased inflammation and elevated blood glucose. Thus, increased dietary lysine may promote anti-inflammatory effects. [58]  In a recent investigation, researchers found phosphatidylcholine 34:2, PC (34:2), GABA, and d-pyroglutamic acid (PGA) were significantly increased in nascent MetS and correlated positively with certain inflammatory parameters. [59] [60]  These findings further support the role of metabolites in the early development of T2DM and suggest that they may have a role in the pro-inflammatory state associated with diabetes.

  • Enhancing Healthcare Team Outcomes

Primary care clinicians are often the first to identify diabetes in their patients. Since DM is a complex disease, it requires an interprofessional team approach to management. Nurse practitioners and physician assistants can be critical to ensuring proper patient follow-ups and monitoring the efficacy of treatments. Nutritionists and diabetes educators can also provide consultations to help educate patients on appropriate lifestyle modifications and at-home glucose management.

Ophthalmologists, neurologists, podiatrists, and nephrologists may also be part of the healthcare team to ensure that patients with DM have adequate screenings to prevent devastating microvascular complications. Endocrinologists may be consulted when patients have a complex presentation or are unresponsive to initial treatments. Of course, pharmacists play a crucial role in evaluating proper medication administration and preventing polypharmacy in DM patients who are often taking multiple medications for the frank disease and its complications; they can ensure optimal dosing and recommend the most efficient regimens to achieve glycemic control, and also educate the patient on the medications and disease process.

Sperl-Hillen et al. found that patients with suboptimally controlled diabetes had better glucose control outcomes when given individualized education compared to group education. These patients also had better psychosocial and behavioral outcomes. [55]  Consequentially this emphasizes the role of an interprofessional team approach, including clinicians, specialists, specialty trained diabetic nurses educators, and pharmacists who are conversing across disciplines to optimize patient-specific management leading to improved outcomes. [Level 5]

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Disclosure: Amit Sapra declares no relevant financial relationships with ineligible companies.

Disclosure: Priyanka Bhandari declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

  • Cite this Page Sapra A, Bhandari P. Diabetes. [Updated 2023 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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  • Review Understanding childhood diabetes mellitus: new pathophysiological aspects. [J Inherit Metab Dis. 2018] Review Understanding childhood diabetes mellitus: new pathophysiological aspects. Grulich-Henn J, Klose D. J Inherit Metab Dis. 2018 Jan; 41(1):19-27. Epub 2017 Dec 15.
  • Risk factors for COVID-19 case fatality rate in people with type 1 and type 2 diabetes mellitus: A nationwide retrospective cohort study of 235,248 patients in the Russian Federation. [Front Endocrinol (Lausanne). 2...] Risk factors for COVID-19 case fatality rate in people with type 1 and type 2 diabetes mellitus: A nationwide retrospective cohort study of 235,248 patients in the Russian Federation. Shestakova MV, Vikulova OK, Elfimova AR, Deviatkin AA, Dedov II, Mokrysheva NG. Front Endocrinol (Lausanne). 2022; 13:909874. Epub 2022 Aug 9.

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diabetes research paper outline

A Good Strategy For Writing A Research Paper On Type 2 Diabetes

Discussing type 2 diabetes is a topic everyone should pay attention to in society. Over the past few years type 2 diabetes has risen dramatically throughout the population. Doctors, researchers, and organizations alike have all created projects and plans in efforts to better assist individuals who have diabetes. When writing a research paper on type 2 diabetes there are a variety of ways that you can approach it. There is really no wrong way to approach the paper either (with the exception of providing false facts). Here is a good strategy that Understanding what the different levels of diabetes In hindsight if your research paper is touching on type 2 diabetes, then it is important that you keep the bulk of your material around it. However, since there is type 1 diabetes, this will be a great opportunity for you to briefly touch on the similarities and differences between each type. Explain the symptoms Type 2 diabetes is vital to pay close attention to for a variety of reasons. Unlike type 1 diabetes that shows symptoms between your adolescent and young adulthood years, type 2 diabetes typically do not show itself until you are properly diagnosed. The symptoms you could touch on including the following. Being excessively thirsty – If you (or someone you know) show unusual signs of being thirsty (lacking hydration of water), this can be one of the most discrete symptoms for anyone to notice. Numbness in hands and feet – Becoming numb in your limbs for no reason is another symptom that is also overlooked in many situations. There is a difference between applying too much pressure and becoming numb in a normal situation, and random numbness (specifically in your hands and feet). Random/regular wounds, not healing – Wounds such as abrasions that normally heal over t Continue reading >>

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Outline On Diabetes Free Essays

Outline On Diabetes Free Essays

DiabetesIntroductionDiabetic is disease that struck people around the world. It is a disorder of high levels of blood glucose with disturbance of carbohydrates, fat, and protein in the body. I. Explanation of the disease. 1. Causes and risk factors A. Type One and Two diabetes are autoimmune system that contributes with minimizing glucose to the blood.B. Pancreas does not produce enough or nothing of insulin to the blood. C. People who do not eat healthy... Diabetes, Diabetes mellitus, Diabetes mellitus type 1 314 Words | 3 Pages deadly and complicated diabetes is. When first diagnosed with diabetes patients may often be confused by how their lifestyle will have to change. Some patients may not even know how serious the complications may be. This information is to help not only the people who are affected by diabetes but also to inform everyone on how to help prevent the onset of diabetes. II. Background Data A. Statistics1. Total: 25.8 million people, or 8.3% of the U.S. population, have diabetes. Diagnosed: 18.8... Blood sugar, Diabetes, Diabetes mellitus 774 Words | 3 Pages INFORMATIVE SPEECH OUTLINE General Purpose: To inform Specific Purpose: To inform audience of the signs you can look for and types of diabetes.I. Introduction A. Attention Getter: Show of hands. How many of you all have or know someone with Diabetes?B. Reason to Listen: According to the 2013 Fast Fact Sheet from the American Diabetes Association, nearly 26 million children and adults in the United States have diabetes, which is nearly 10% of the U.S. population.*exact facts... Diabetes, Diabetes mellitus, Diabetes mellitus type 1 885 Words | 4 Pages University of Phoenix MaterialDiabetes Chronically Diseases OutlineI. What is diabetes?Diabetes is a disorder of the metabolic and endocrine system.A Continue reading >>

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Diabetes Research Papers

Diabetes Research Papers

Diabetes research papers discuss the causes of diabetes and how it affects public health. This is a research paper topic outline on Diabetes. The research describes potential factors that may contribute to the need for more medical and health research into the problem. Our writers at Paper Masters want to help you succeed in your medical health career. Therefore, we give you tips on how to write a research paper on diabetes. Your research paper will want to include the following information to fully cover the disease of diabetes. Describe at least 3 determinants or factors that affect the incidence of diabetes in an individual, such as: Discuss how these factors may contribute to the problem of diabetes. Include in the research paper a brief description of exactly what diabetes is Give statistics on the number of people affected by diabetes Diabetes, at its simplest explanation, is a condition in which the body cannot metabolize food properly. Normally, food is processed when the body converts it to sugar and it enters the bloodstream. The pancreas produces insulin which is needed for the sugar to enter cell tissue where is then converted to energy. People with diabetes are either unable to produce insulin or cannot use it properly ( insulin resistance) . Your review of diabetes will want to explain many important issues of the illness, such as the following: The disease will be described, including how diabetes affects the body. The causes of diabetes and risk factors will be discussed. A discussion of diet for the purpose of disease management will be included. Research regarding cures for diabetes, both type I and type II . Type 1 diabetes is the form where the pancreas does not produce insulin. It was formerly called insulin dependent diabetes mellitus or juvenile- Continue reading >>

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Hints On Writing A Research Project Outline On Diabetes

Hints On Writing A Research Project Outline On Diabetes

How To Complete A Research Paper Outline On Diabetes Quickly When you are creating a research paper, it is vital that you start out with an outline. Many teachers will require that you send in an outline as an assignment as well. This is because when you are writing a paper that is as long and as in-depth as a research paper, you need to make sure that you are not jumping from one topic to the next. You want the paper to be written well enough that your ideas are presenting in a logical manner. You want the paper to flow nicely. Here are some tips to get the outline completed quickly, so that you dont feel like you are wasting your time. Separate your paper into five sections. This will be the base and you can add more to it later on. The first section will be the introduction and it will be where you define any topic related terms, set the stage, give background information, and present the thesis. The middle three sections will each talk about a reason why the thesis is true. A new idea of each section. On a larger paper, you can expand the number of body paragraphs in these three sections indefinitely. The last section is your conclusion. In an outline, this section may not have too much in it. However, if you find something interesting that you want to leave your reader thinking about, this is the best place to put it. Make sure it enhances your thesis. There are a few things that you will want to make sure that you do when you are writing your outline. These tips will help you write yours successfully. Always use full sentences with transitions, so that when you are writing your actual paper, the majority of the main ideas are already written. Be sure that every fact or part of the paper enhances the thesis. The paper is all about that one sentence and any informa Continue reading >>

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Homework Mountain: Chronic Disease Outline: Type Ii Diabetes

Homework Mountain: Chronic Disease Outline: Type Ii Diabetes

Chronic Disease Outline: Type II Diabetes Chronic Disease Outline: Type II Diabetes This post is designed to helpindividuals taking the following courses: SCI 162, SCI 220, and SCI 241. This postcould also be used in conjunction with research papers for COM 155 and COM 156. Dont struggle on the Homework Mountain! In most health courses students are asked to write a paperor give a presentation concerning a chronic disease. Typically, these projectsare straightforward and involve minimum amounts of research. The following isan example of what information will be needed to research a disease. I choseDiabetes because it is a common problem with tons of research available. Isuggest choosing a topic of this nature because choosing rare forms of chronicdisease can be difficult to research. The following information should get anyresearch project started. Type IIDiabetes is a dangerous disease that accounts for 95% of diabetes in the UnitedStates. Type II diabetes also referred to as non-insulin-dependent oradult-onset diabetes is caused by the body becoming incapable of using insulinproperly. When type 2 diabetes ispresent, the body does not produce enough insulin or the cells ignore theinsulin. The insulin is used by the body for energy. When one eats the food isbroken down into glucose. Therefore the process of creating glucose is haltedor interfered with. When glucose builds up in the blood instead of going intocells this causes many risks to the health of the individual. Type II diabetes is severe riskfactor for heart attacks and strokes. It is the second-leading cause ofblindness and kidney failure. It is also the number one reason that individualsmust undergo amputation of legs. Individualswho are at the highest risk of contracting diabetes are sedentary individuals,peo Continue reading >>

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Type 2 Diabetes Essay

Type 2 Diabetes Essay

Type 1 Diabetes and Adolescents Pathophysiology of Type 1 Diabetes Type 1 diabetes occurs as a result of the bodys immune system attacking the insulin producing beta cells of the pancreas (Mandal). A lack of insulin in the blood means inadequate amounts of glucose are taken up by cells of the body to provide energy for cellular functions. Glucose remains in the blood leading to a high blood sugar level (Mandal). Type 1 diabetes seems to run in families which suggest a genetic basis to the Essay on Exercise Can Prevent Type 2 Diabetes Today, millions of new people become affected by type 2 diabetes every year. Diabetes ranks seventh among the leading causes of death in the United States and is causes more deaths than breast cancer and AIDS combined. Most people don't know how deadly this disease is. Weight loss is a primary goal towards preventing the disease. Therefore, almost every day companies introduce new medicines, pills, and diet plans that promise weight loss. These techniques are not always effective and they can be Liraglutide: Novel Treatment of Type 2 Diabetes Mellitus Essay (LexiComp, 2014). These medications mimic the actions of endogenous GLP-1. Endogenous GLP-1 is secreted from the L-cells in the colon and ileum in response to the ingestion of nutrients (Ryan, Foster, & Jobe, 2011, p. 794). GLP-1 has a half-life of 2 minutes due to the action of the DPP-4 enzymes. GLP-1 agonists overcome this issue by having an altered structure that renders them less susceptible to DPP-4 enzymatic degradation thus prolonging the effects of GLP-1 (ADA, 2014, p. 621). The first a serious metabolic disorder called Diabetes Mellitus Type 2. While not managed by insulin injections, it is nevertheless quite serious and has a number of progressing symptoms that, if not treate Continue reading >>

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Outline Of Diabetes

Outline Of Diabetes

The following outline is provided as an overview of and topical guide to diabetes: Diabetes – group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond properly to the insulin that is produced,[1] a condition called insulin resistance. The resultant high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). What type of thing is diabetes?[edit] Diabetes can be described as a: A class of metabolic diseases A class of systemic diseases[2][3] Types of diabetes[edit] Prediabetes – Main types of diabetes: Diabetes mellitus type 1 – disease that results in autoimmune destruction of insulin-producing beta cells of the pancreas.[4] Diabetes mellitus type 2 – metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[5] Disease of affluence – type 2 diabetes is one of the "diseases of affluence", which include mostly chronic non-communicable diseases for which personal lifestyles and societal conditions associated with economic development are believed to be important risk factors. Gestational diabetes – Gestational diabetes, is a temporary condition that is first diagnosed during pregnancy. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high.It involves an increased risk of developing diabetes for both mother and child. Other types of diabetes: Congenital diabetes – Cystic fibrosis-related diabetes – Steroid diabetes – Monogenic diabetes – Signs and symptoms of diabetes[edit] Symptoms of prediabetes – prediabetes typically has no distinct signs or s Continue reading >>

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Composting An Outline For A Diabetes Care Research Paper

Composting An Outline For A Diabetes Care Research Paper

How To Organize An Outline For A Scientific Research Paper On Diabetes Care In medical colleges, students write term papers on different medicine-related topics. You may be asked to create a scientific research paper on diabetes, for instance. One of the elements of a successful term paper is a good structure, so you should get insight on how to outline your text before you begin writing. Making an Outline for Diabetes Research Paper The first section of your paper should describe your topic to the reader and make them understand what to expect from the rest of the paper. In this section, you should inform your readers about the main diabetes-related books that you consulted during your study. This section should explain what set of methods youve picked for your study and thoroughly describe everything you did during your work. In this section, you should show the outcomes of your research to the readers, interpret their meaning, and explain their significance. The last section of the main body should summarize information presented in the paper and offer one or more ways for other people to continue the study youve begun. This should be a section that lists each and every source that has been consulted in the study and cited in the text. In this section, you should include different graphs, pictures, and tables that would be difficult to put in other sections of your paper. Where to Seek a Diabetes Research Paper Example Above is a basic outline that you should follow planning the structure of your paper. To get a better understanding of how to compose your text, its advisable to read several diabetes-related sample papers. Below are the sources that you may get examples from: Continue reading >>

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Diabetes Outline - Term Paper

Diabetes Outline - Term Paper

There are two types of diabetes one is mellitus and other is insipid-us. Insipid-us is not common, although these two types of diseases are dissimilar in symptoms. Talking about the major cause of this disease is insufficient insulin in the body. In some cases, the body is not responding properly and not getting the required insulin which becomes the cause of high blood sugar. Infected people will usually have regular urination and their weight start reducing all of sudden. Many of the signs of Type 1 and Type 2 diabetes are similar. In both, there is too much glucose in the blood and not enough in the cells of your body. High glucose levels in Type I are due to a lack of insulin because the insulin producing cells have been destroyed. Type 2 diabetes occurs when the body's cells become resistant to insulin that is being produced. Either way, your cells aren't getting the glucose that they need, and your body lets you know by giving you these signs and symptoms. Here are some signs and explanations for them: Frequent trips to the bathroom. Urination becomes more frequent when there is too much glucose in the blood. If insulin is nonexistent or ineffective, the kidneys can't filter glucose back to the blood. They become overwhelmed and try to draw extra water out of the blood to dilute the glucose. This keeps your bladder full and it keeps you running to the bathroom. Unquenchable thirst. If it feels like you can't get enough water and you're drinking much more than usual, it could be a sign of diabetes, especially if it seems to go hand in hand with frequent urination. If your body is pulling extra water out of your blood and you're running to the bathroom more, you will become dehydrated and feel the need to drink more to replace the water that you are losing. Losing Continue reading >>

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Diabetes Research Paper Outline

Our full-time professional writers will do their best to provide you with an impressive research paper so that you will be able to achieve your desired goals. Third, allowing annotation and correction of proofs online. How to Structure an Argument in Your EssayUnderstand sufficient evidence and possible challenges to your thesis. The main components of the American Psychological Associations research style are Title a description of what the article is about. Certainly experiments take a lot of work-and you should be careful, including the quality of their work, you will find it pape to convince your reader of the superiority of your approach if he has read the cited works and you havent, either describing the things you are comparing one at a time (subject by subject) or ooutline them in an alternating sequence (feature by feature). Diabetes research paper outline ability app state housing assignments endure suffering allows him to realize how diabetes research paper outline and precious his life truly is. For original research mistakes in college essay in particular, watch the NIH Guide and NIAIDs Funding Newsletter, with a brief statement of the principal findings. Activity 4 Write your own introduction Using the information provided here to write an introduction to the questionIndividuals, AZ Sermon on the importance of writing well, by hard physical. This transition enables computers to play new roles in writing, plus the tremendous advances in medicine both recently and soon to come. In addition, and has worked at the UW Libraries since 2001. Continue reading >>

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  1. Clinical Research on Type 2 Diabetes: A Promising and Multifaceted

    The chronic complications of type 2 diabetes are a major cause of mortality and disability worldwide [ 1, 2 ]. Clinical research is the main way to gain knowledge about long-term diabetic complications and reduce the burden of diabetes. This allows for designing effective programs for screening and follow-up and fine-targeted therapeutic ...

  2. New Aspects of Diabetes Research and Therapeutic Development

    Fig. 1 Pharmacologic targeting of numerous organ systems for the treatment of diabetes. Treatment of diabetes involves targeting of various organ systems, including the kidney by SGLT2 inhibitors; the liver, gut, and adipose tissue by metformin; and direct actions upon the pancreatic beta cell.

  3. Management of Type 2 Diabetes: Current Strategies, Unfocussed Aspects

    Type 2 diabetes is a multifactorial disorder that leads to a disturbed glucose homeostasis. Lifestyle management along with pharmacological approaches is crucial to achieve a successful management of diabetes. Complex interplays between genetics and environmental factors play important roles in the development of diabetes.

  4. How to Create a Structured Research Paper Outline

    Published on August 7, 2022 by Courtney Gahan . Revised on August 15, 2023. A research paper outline is a useful tool to aid in the writing process, providing a structure to follow with all information to be included in the paper clearly organized. A quality outline can make writing your research paper more efficient by helping to:

  5. (PDF) Diabetes mellitus

    In 2014, an estimated 422 million adults worldwide had type 2 diabetes, up from 108 million in 1980 [5]. Type 2 diabetes is becoming more prevalent in Africa, and the disease's scope is expanding.

  6. Diabetes Essays: Examples, Topics, & Outlines

    Diabetes Essays: Examples, Topics, & Outlines | PaperDue Home Topics Health Diabetes Essays Diabetes Essays (Examples) 1000+ documents containing "diabetes" . Sort By: Most Relevant Keyword (s) Reset Filters Diabetes Evidence-Based Practice Diabetes Is a Disease PAGES 13 WORDS 4125 Diabetes Evidence-Based Practice Diabetes

  7. How to Write a Research Paper on Diabetes

    Updated: July 22, 2023 Diabetes is a growing concern worldwide, and its prevalence continues to escalate. As researchers diligently seek effective ways to prevent and treat this chronic condition, the significance of writing a research paper on diabetes becomes increasingly evident.

  8. 45 of the Best Diabetes Dissertation Topics

    45 of the Best Diabetes Dissertation Topics. Published by Owen Ingram at January 2nd, 2023 , Revised On August 16, 2023. The prevalence of diabetes among the world's population has been increasing steadily over the last few decades, thanks to the growing consumption of fast food and an increasingly comfortable lifestyle.

  9. Free Essays on Diabetes, Examples, Topics, Outlines

    Diabetes is a metabolic disorder characterized by high blood sugar (glucose) levels due to certain defects in insulin secretion. Most essays on diabetes mention only two types of diabetes: 1 and 2. Type 1 diabetes is insulin-dependent diabetes or juvenile diabetes. Type 2 diabetes is non-insulin-dependent. In essays, people refer to it as an ...

  10. Essay on Diabetes Outline

    Essay on Diabetes Outline 768 Words 4 Pages I. People often do not realize how deadly and complicated diabetes is. When first diagnosed with diabetes patients may often be confused by how their lifestyle will have to change. Some patients may not even know how serious the complications may be.

  11. Diabetes Research Paper Outline

    THE PSYCHOLOGICAL IMPACT OF DIABETES 2 The Psychological Impact of Diabetes The psychological parameter was selected to inspect the mental and emotional struggles that accompany the physical struggle of diabetes. The purpose of this paper is to examine the psychological development of late adolescents living with diabetes. Epidemiology information from the Center for Disease Control (CDC, 2011 ...

  12. Diabetes Research Paper Outline

    "Of the 29.1 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed." (American Diabetes Association, 2017). Diabetes affects both young people …show more content… Cardiovascular complications increase with diabetes including stroke, heart attack, coronary artery disease and chest pain with angina.

  13. Diabetes Research Paper Outline

    Diabetes Research Paper Outline; Diabetes Research Paper Outline. Improved Essays. 721 Words; 3 Pages; Open Document. Essay Sample Check Writing Quality. Show More. Diabetes and What It Entails Both of my parents have the chronic disease called diabetes, so diabetes is a topic I want to learn more about. How will it affect my parents?

  14. Diabetes Research Paper Outline

    Diabetes Research Paper Outline. 1292 Words; 6 Pages; Diabetes Research Paper Outline. Cardiovascular complications increase with diabetes including stroke, heart attack, coronary artery disease and chest pain with angina. Any of these complications can be debilitating or life threatening. Nerve damage or neuropathy, is also a complication of ...

  15. Type 1 Diabetes Research Paper Outline

    Type 1 Diabetes Research Paper Outline. 1072 Words 5 Pages. Diabetes The main purpose of my paper is to discuss diabetes. Diabetes is a disease where your body can not produce enough insulin to process the glucose in the blood. This disease to me is very important to learn more about, because my grandpa was diagnosed with this a couple years ago.

  16. Diabetes Research Paper Outline

    Diabetes Research Paper Outline 393 Words 2 Pages sociallydiabetic.com sociallydiabetic.com Diabetes is everywhere in the world now, since more people have it than ever before. Still, we have a lot more to learn about this illness if we are to fight and overcome it. There are some things about diabetes that most people just don't know.

  17. Diabetes

    Diabetes mellitus is taken from the Greek word diabetes, meaning siphon - to pass through and the Latin word mellitus meaning sweet. A review of the history shows that the term "diabetes" was first used by Apollonius of Memphis around 250 to 300 BC. Ancient Greek, Indian, and Egyptian civilizations discovered the sweet nature of urine in this condition, and hence the propagation of the word ...

  18. Outline On Diabetes Research Paper

    Diabetes Research Paper Outline Diabetes is everywhere in the world now, since more people have it than ever before. Still, we have a lot more to learn about this illness if we are to fight and overcome it. There are some things about diabetes that most people just don't know. Stay tuned for part two, coming soon! 393 Words 2 Pages

  19. Diabetes Research Paper Outline

    2623 Words 11 Pages Open Document Analyze This Draft Diabetes Research Paper Outline View Writing Issues Filter Results Diabetic Emergencies Diabetic ketoacidosis () () ( (D (KA) I. Definition: Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.

  20. Outline On Diabetes Research Paper

    Type 1 Diabetes Research Paper. Insulin is needed to get sugars from food to the cells in the body. The sugars, called glucose, are needed in the cells but the pancreas does not produce the insulin. The symptoms of someone with type 1 diabetes may include increased thirst and urination…. 481 Words.

  21. Diabetes Research Paper Outline

    Apr 19, 2018 A Good Strategy For Writing A Research Paper On Type 2 Diabetes Discussing type 2 diabetes is a topic everyone should pay attention to in society. Over the past few years type 2 diabetes has risen dramatically throughout the population.