The sweetest disease…

We have all heard about it….the infamous disease of glucose metabolism…DIABETES MELLITUS. But what does the general population really know and understand about this complex and very serious disease? Please complete the poll before you continue reading!!

OK so now its time for some of the facts….

To start with, how about some background info? In order to understand how diabetes works, we need to get an idea about the mechanisms of metabolism (dont worry I’ll be brief…). We know that food is fuel for our bodies, but how does that happen? When we eat food, our body sends signals to the pancreas that there is food on board, so it starts to produce insulin, which is required to turn the food into a usable source of fuel for our body. The primary nutrient we are concerned with is glucose.
When we digest food, our body absorbs the glucose into the blood stream. However, the blood does not provide a direct way for the glucose in the blood to get to the cells (brain, muscle, etc) that need the energy. When the amount of glucose in the blood rises, the pancreas secretes insulin to bring the glucose to the cells. Its like trying to get to an island, and the only way to get there is by boat. Insulin is the boat.

When we are monitoring blood glucose, we are looking to see that there is a not an excess of glucose hanging around in the blood not getting transported to the cells. Think of it as if a bunch of people are waiting to get to the island. Normally, as more people come, more people should be taken to the island so there isnt a bunch of people waiting around. If we see that more and more people are coming and waiting around to get to the island, we should suspect a problem.

There might be a problem with the transporter (insulin), where there is not enough boats to take the people (glucose) to the island (the hungry cell). This situation is usually seen in  type 1 diabetes. In this case, insulin injections are required. On the other hand, if there are enough boats (insulin) available to transport people (glucose), but there is still a backup of people waiting, there might be a problem getting entry to the  island itself. This is usually the case with type 2 diabetes. The resources that are needed are available, for some reason, the cell doesn’t recognize the glucose. This is usually seen with older age, but is more frequently being seen with obesity in younger populations. Because insulin production is adequate in these individuals, insulin injections is generally not necessary. However, people with type 2 must adhere to strict diets in order to control blood sugars. It is critical to analyze the nutritional components of every single meal to avoid overconsumption of glucose products, that can skyrocket blood sugars and cause hyperglycemia. You may be wondering what all the fuss is about having high blood sugars. Is sugar really THAT bad? Ohhh yeah. Hyperglycemia is associated with a imbalances of the blood chemistry, resulting in a cascade of compensation mechanisms in attempt to return to homeostasis. By trying to compensate, the body must work harder to get rid of the excess sugar in the blood. The heart works harder to increase the blood pressure to filter more blood through the kidneys so glucose can be excreted in the urine. Thats the beauty of the body, right? It fixes itself. Until the next meal. Then it begins again. It may not be significantly damaging right away, but can you imagine the workload the body must endure every day, every meal? And dont think you are benefiting from burning calories. Remember the body is already having trouble getting the fuel it needs to function the right way. Because of the hyperglycemia, the body is demanding more energy requirements. But it is not going to use up all the precious stores of glycogen, no no that is reserved for the brain. Your body must find another source of energy, breaking down protein, storing fat, making more waste in the bloodstream. As if the body wasnt already working hard enough to filter the blood! Now, if the cells are not getting the right kind of fuel, they may not be able to function normally, leading to all sorts of chaos. More specifically, the heart may start becoming weaker from working so hard. The kidneys are becoming burnt out from all the filtering, and harmful waste products get left in the blood stream. In attempt to deliver more and more blood for filtration, blood pressure continues to rise, causing damage to the delicate vasculature of the brain, eyes, and capillaries and compromising circulation.

Blood flow to the distal extremities is impaired, and decreased oxygenation to the tissues often results in chronic pain (diabetic neuropathy), and decreased sensory abilities (leading to frequent injuries and skin infections).

As impaired oxygenation continues, tissue becomes ulcerated and necrotic, and very susceptible to serious infections. Because of the impaired sensation, tissue deterioration often goes unnoticed (particularly on the bottoms of the feet), and severe infection and necrosis has already taken place, requiring amputation. SUCKS.

So now that you are royally grossed out, what can you do to prevent diabetes? Sometimes, diabetes is inherited, especially type 1. But in all circumstances, adoption of a healthy lifestyle can significantly reduce your risk of disease.

Obesity is one of the most important factors associated with development of diabetes, and implementing a healthy diet and regular exercise to reach ideal body weight has been found to significantly improve outcomes, even when diabetes is already present. Reducing cholesterol and fat intake, treat high blood pressure, and for God’s sake quit smoking!

Another type of diabetes is Gestational diabetes, which is associated with many risks for pregnancy complications. Here is a great video I found from that explains it nicely. 


2 thoughts on “The sweetest disease…

  1. Add a little something to your knowledge bank, just in case you don’t learn it in school. A very rare type of diabetes can be caused by a genetic mutation in a single gene called Monogenic Diabetes. This type is actually an umbrella type covering all single genetic mutation types of diabetes which (most of the time) are non-autoimmune types of diabetes. Even more rare is the Neonatal Diabetes which can cause intra-uterine growth restriction and babies will have odd, often unexplainable symptoms at birth. Most will be diagnosed within the first 6 months of life though there are cases diagnosed later than that. They often have all of the classic symptoms of DKA but it may go undiagnosed because it is so rare that even pediatricians may not notice it. Just a little something to stick in the back of your brain just in case you ever run across an unusual case like this. Visit my website where I have more information and sites you can visit.

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