Before delving into the specifics of diabetes, it is first important to briefly explain the physiology of human sugar metabolism. When a person ingests simple or complex carbohydrates, they are broken down and absorbed by the small intestine. When this occurs, the sugar enters the blood stream, which causes a spike in the blood sugar level. Cells of the pancreas respond to this spike of blood sugar by secreting the hormone insulin into the blood stream. Insulin binds to insulin receptors on the cells of the body to take up the blood sugar and utilize it for energy. This serves to power the body cells, while taking up excess sugar from the blood stream.
There are two types of diabetes found in people, termed type one and type two diabetes. Type one diabetes is usually diagnosed when the patient is still a child. That is why it is sometimes called juvenile diabetes. With this form of diabetes, the body lacks the ability to make insulin. Without insulin, the body cells have no signal to take up sugar. In type two diabetes, the body does not produce enough insulin to signal the body cells to take up blood sugar, or, the body cells have defective insulin receptors that simply ignore the insulin.
Type one diabetes is an inherited genetic condition. Type two diabetes often occurs due to genetic factors, but can also be the result of life style, such as eating a diet rich in simple carbohydrates (sugar), obesity, and lack of excersise. Regardless of the type of diabetes a patient is affected with, the end result is that this whole physiological process is compromised. This results in the body cells being starved of energy, while excess sugar remains in the blood stream.
The effects of diabetes on the rest of the body are far reaching. When the blood sugar does not get taken up by the cells, as previously mentioned, they become starved for energy. If they are starved long enough, they will being to die. This is most problematic with the cells of vital organs, such as the heart, liver, kidneys, and brain. Brain cells are most sensitive to energy deprivation, and are among the first to die. Unlike the cells of many other organ systems, brain cells cannot be replaced - once they are gone, they are gone for good.
Specifically, diabetes increases the patient's likelihood of stroke or heart attack. At the level of the kidneys, diabetes interferes with the kidney's ability to eliminate waste products. When the sugar is high enough to spill over from the bloodstream into the kidneys, it ends up in the urinary bladder and predisposes to urinary tract infections (bacteria thrive in sugar rich environments). Diabetes predisposes to blindess, secondary to a high rate of cataracts and glaucoma, due to its effects on the metabolism of the eyes. Diabetes also effects the brain and central nervous system. As previously mentioned, brain cells die from energy starvation, which can lead to brain and nerve damage. When the sugar gets very high, the diabetic can become very disoriented and weak due to its effect on the brain cells - a condition called diabetic neuropathy. Diabetes also predisposes to skin infections, some quite severe. Uncontrollable, even gangrenous infections contribute to a high rate of amputees among diabetics, when compared to non-diabetics.
All of these clinical syndromes to be sure sound horrific, and they certainly can be very trying to a diabetic patient. However, it is important to realize that these complications are often quite preventable with treatment and life style management. With type one diabetes, the patient will invariably have to regulate the blood sugar with regular insulin injections. The proper dose is attained by intitial careful monitoring of blood sugar in reponse to doses of insulin. This will often have to be adjusted throughout the life of the diabetic, however, regulation can be kept optimally consistent by follwing importan diet and lifestyle guidlines (see below in the type two diabetes discussion, as life style changes will be the same).
In type two diabetes, insulin doses have to be given in advanced cases, however, in mild to moderate cases, dietary managment alone, or dietary management combined with oral medications that stimulate insulin production, are often successful. Dietary management serves to make the patient feel better by keeping the blood sugar level consistent, but also can serve to prevent or slow the worsening of the diabetes. Dietary management consists of eating smaller, frequent meals, for example, 6 smaller meals per day, as opposed to three larger meals per day. This also includes limiting the intake of simple carbohydrates while favoring more complex carbohydrates, eating a diet high in protein and low in fat, and drinking 8, 8 ounce glasses of water per day. Along with this dietary program, the diabetic should also excercise regularly, as this lowers body fat, increases lean muscle mass, and also contributes to blood sugar regulation.
If dietary and lifesyle management alone is not enough to manage mild to moderate cases of type two diabetes, the addition of aforementioned insulin production stimulant medications can help. Examples of these types of drugs are Glucotrol, Diabeta, and Amaryl.
Diabetes is without question a very serious disease. However, if one is diagnosed with diabetes, one should not despair. With determination, good diet, adequate excercise, and marvels of modern medicine, diabeteics today can live long, fullfilling lives.
