According to the Centers for Disease Control and Prevention (CDC), in 2011 it was projected that 25.8 million people in the United States suffered from diabetes (equating to about 8.3% of the US population) with 18.8 million people diagnosed with diabetes and a projected 7.0 million people who were undiagnosed. (More statistics) In 2010, about 27% of US residents over the age of 65 had diabetes, with about 1.9 million people over the age of 20 newly diagnosed with diabetes in that same year. For the sake of this post, let’s generalize the statistics and trend in order to say that generally, about one in every twelve people in the US suffer from diabetes. That is a lot of people! And it is a huge disease burden not only to the individual, but also to the community and nation as a whole. Diabetes is a terrifying disease that can result in kidney failure, non-traumatic lower limb amputations, and blindness due to vascular insufficiencies and neuropathy. It is a major cause of heart disease and stroke, and the seventh leading cause of death in the US. It is no wonder that there has been so much emphasis on diabetes in my medical education as it will surely gain an even greater prevalence in my generation of practicing medicine.
So now that I’ve scared you with statistics, how does diabetes work anyway?
I’m not exactly sure how I came to this revelation, but I recently opened some old notes on my iPod touch to find a statement that read “diabetes is like tower defense.” And slowly but surely, I am realizing why I wrote that. I love tower defense (TD) games. The first game that I bought for my iPod touch was a game called Fieldrunners. It has great graphics, great mechanics, and it’s one of the more polished TD games that I’ve played. That being said, the idea of Field Runners and every other TD game is to create a network of defense (a maze of super destruction) to defeat multiple enemies as they come out of an entrance before the enemies can reach their targeted destination. Every time you “leak” an enemy, you lose life points, and depending on which game you’re playing determines the amount of life that you start out with in order to stay alive.
Much of the overall concept of TD games can relate to diabetes (in this post, specifically referring to diabetes mellitus type II – DM II) in a very relevant way. One of the major consequences of DM II and a way in which diabetes was initially tested for (in ancient times), was the presence of glucose in urine (now instead of having to taste glucose in our patients’ urine, we use the serum hemoglobin A1C laboratory tests). The reason for this is that the beta cells in our pancreas produce insulin which tells our body to absorb glucose after we eat. When our insulin receptors get desensitized or lose their function (either due to diet in type II DM or autoimmune in type I DM), the glucose in our blood after we eat remain in our blood and are not absorbed by our body. When an overwhelming amount of glucose remains in our blood, the nephrons in the kidney which filter toxins, but reabsorbs necessary nutrients such as glucose, aren’t able to reabsorb the glucose fast enough. As such, normally people do not urinate glucose, but in diabetes, glucose “leaks” out into the urine and is excreted instead of absorbed. This is one of the first signs of diabetes, and as we know, uncontrolled diabetes can lead to immense suffering and eventually mortality if untreated. In the context of TD games, when too much glucose (the enemy) starts “leaking” out into our urine (the exit) due to poor host responses (poor defense), we know that we’re in trouble.
So just as how I started this post – diabetes is a serious health problem. My heart goes out to people who suffer from diabetes – I cannot even imagine how it is to live with it; but hopefully this post helps to educate the medical topic, as well as one of my gaming interests.