Diabetes

What is Diabetes Mellitus?

Diabetes Mellitus, more commonly referred to simply as diabetes, is the inability of the body to use blood sugar (glucose) for energy due to inadequate amounts of, or loss of sensitivity to, the hormone insulin.

Normally blood sugar rises after a meal as glucose is absorbed into the blood stream, causing the pancreas to produce enough insulin to return the blood sugar level to its normal range. Diabetic individuals are either unable to produce enough insulin or their cells have become resistant to insulin, meaning they are unable to move glucose from the bloodstream to the cells, and thus cannot maintain a normal blood glucose level. Because of this, cells have to use other sources of energy, which may lead to a build-up of toxic by-products in the body. The most dramatic of these is acetone, which can be smelled on the breath as pear drops or nail varnish remover. Unused glucose accumulates in the blood and urine, leading to high blood sugar levels and symptoms such as passing lots of urine, thirst and loss of weight. Excess glucose can diminish the biological effectiveness of various proteins in the body. For example, when glucose binds to haemoglobin (the iron-containing pigment of the red blood cells), the oxygen-carrying capacity of haemoglobin is reduced.

Diabetes is a Silent Killer

Diabetes can lead to heart and kidney disease, atherosclerosis, hypertension, strokes, cataracts, retinal haemorrhages, neuropathy, gangrenous infections, loss of hearing, blindness, and even death.

It is one of the most common long-term diseases occurring in the Western world, affecting more than 1 in 20 people and it sometimes runs in families.  An estimated 17 million people in the United States suffer from diabetes and one-third of these people are unaware they have it. About 500,000 new cases are reported each year. Diabetes kills 180,000 Americans annually, which makes it the seventh leading cause of death.

Many of these individuals first become conscious that they have diabetes when they develop one of its life-threatening complications, such as heart attack, stroke, or kidney disease and overall, the risk for death among people with diabetes for these catastrophic complications is about four times that of people without diabetes. In addition to an earlier death, diabetes carries with it significant risks for serious complications such as blindness, the need for dialysis, and limb amputation.

Types of Diabetes

There are two major forms of diabetes, insulin-dependent juvenile diabetes (Type I) and non-insulin-dependent adult-onset diabetes (Type II).

Type I Diabetes

Usually developing suddenly in childhood or adolescence, this form of diabetes occurs when the pancreas produces too little insulin or none at all. As a result, glucose builds up in the bloodstream and spills over into the urine, while the body literally “starves” because the cells cannot get the nourishment, which is provided by glucose, to produce energy for the cells’ normal functions.  Although dietary measures are also important, at this time it must be treated with insulin injections administered daily (sometimes several times a day, usually before meals) and must be timed so that the peak action of the insulin will occur when the sugar from the meal elevates the blood glucose to its highest level.

Symptoms of Type I diabetes include excessive thirst, hunger, urination, and dehydration, often accompanied by weight loss.

Type II Diabetes

Type II diabetes is by far the most common form of diabetes. The pancreas continues to secrete insulin but cells in the body become resistant to its effects. This form of diabetes mainly affects people over the age of 40 and is more common in overweight people. It develops slowly and often goes unnoticed for many years. Sometimes the condition may be treated with dietary measures alone, but oral drugs and sometimes insulin injections may become necessary.

The symptoms of Type II diabetes are the same as Type I except there is no weight loss.

A Note about Gestational Diabetes

Diabetes mellitus can sometimes develop during pregnancy; about 5% of all pregnant women receive diagnosis. This condition is called gestational diabetes and is usually treated with insulin to maintain the health of the mother and baby. Gestational diabetes usually disappears after childbirth; however, women who have had it are at increased risk of developing type II diabetes in later life.

Recent research has confirmed that even small elevations in blood sugar during pregnancy can lead to sick babies. High birth weight babies have an increased risk for obesity and diabetes later in life, and women carrying large babies are at increased risk for premature delivery and C-section delivery. This may meant that many pregnant women who have increased blood sugar levels (estimated up to 15%), may be treated in the near future.

Causes of Diabetes

Although a genetic predisposition appears to govern susceptibility to both types of diabetes, the pattern of inheritance is complicated. The child of a person who has type I diabetes is at greater risk of developing the same type of diabetes. However, most affected children do not have a parent with diabetes and a number of other factors can also be involved. Diet and obesity are key elements in the cause of Type II diabetes. Autoimmune processes, in which antibodies created to fight allergies or certain infections react against the body itself, may also play a role in causing both types of diabetes. Type II diabetes is a growing problem in societies that are becoming more affluent. In such societies, food intake increases, leading to a rise in the number of overweight people and the prevalence of this condition. In some cases, destruction of the insulin-secreting tissues occurs after inflammation of the pancreas during acute pancreatitis.

An estimated 85% of all Type II diabetics are overweight when diagnosed and the main cause of obesity is poor diet, the key factor is not how much but what is consumed. Largely at fault are processed foods, which are high in calories and stripped of valuable fiber and essential nutrients. Sensitivities to certain foods, as well as viral infections, can result in lower insulin levels in Type II diabetes, causing inflammation and autoimmune damage to the insulin-producing cells of the pancreas. Stress and the individual’s ability to manage stress are also important factors affecting the course of diabetes and insulin requirements. Stress can result in the production of adrenaline and cortisol, which increases blood sugar and thus interferes with diabetic control.

Treating Diabetes

For anyone with diabetes mellitus, the aim of treatment is to maintain the level of glucose in the blood within the normal range without marked fluctuations. This aim may be achieved with dietary measures, a combination of diet and insulin injections or of diet and pills that lower blood glucose levels. Treatment is usually life-long and you will have to take responsibility for the daily adjustment of your diet and medication on the basis of daily blood sugar tests, which you perform yourself.

Practitioners of alternative medicine combine diet, supplemental nutrients, exercise, and weight loss to help control diabetes and prevent or delay the onset of serious complications.

A diet emphasizing foods high in complex carbohydrates and fiber, such as whole grains, legumes, and vegetables, reduces the need for insulin by slowing and controlling the release of glucose into the bloodstream. The fiber in plant foods can also be beneficial for diabetics by absorbing water in the body, and forming a natural sponge in which food particles are suspended.

A vegetarian diet of whole grains and whole fruits and vegetables (rather than juices, which are rapidly absorbed) can be helpful for many diabetics. The American Dietetic Association had published research showing that a vegetarian lifestyle reduces the incidence of diabetes and heart disease.

What is the Outlook?

If cardiovascular complications develop, diabetes mellitus can cause high blood pressure and heart attacks. However, advances in monitoring blood glucose levels, combined with a healthy lifestyle, have made diabetes easier to control, allowing people to lead a more normal life.