Diabetes and Sugar Round 2

Round 2 of Sugar vs. The human body

Well, it should not surprise the readers of my blog on sugar, that it is only appropriate to follow up with a column on diabetes; these topics really go hand in hand.  Diabetes is typically defined as too much sugar in the blood either by an inability for the body to produce enough insulin, a resistance to insulin by our cells, consuming too much sugar and carbs, or a combination of the three.  The American Diabetes Association estimates there are 79 million Americans who are “prediabetic”, meaning they have elevated levels of blood sugar but not high enough to be diagnosed a diabetic.  There are approximately 18.8 million children and adults diagnosed with diabetes in the United States and an estimated 7  million undiagnosed.  If you are doing the math that is about 1 out of every 3 Americans, and by some estimates we are heading to about 1 out of every 2 Americans will be either prediabetic or diabetic. In 2007, diabetes contributed to a total of 230,000 deaths in the US; that is more deaths than breast cancer.  Diabetes, in 2007, cost the united states an estimated $218 billion between medical costs, disability, work loss, and premature deaths. 

Types of Diabetes

Diabetes is broken down into 2 most common types and a few other less common types.  Diabetes type 1, or what used to be called juvenile diabetes or insulin dependent diabetes, is someone who can not produce insulin; it is estimated that about 5% of diabetics have this type.  More common is the type 2 diabetes, which used to be called adult onset diabetes or non-insulin dependent diabetes, but due to the increase in children with type 2 diabetes the name has changed.  In type 2 diabetes, either the body does not produce enough insulin to handle the blood sugar load or the body’s cells become insulin resistant, as in metabolic syndrome. 

There are many smaller classifications of diabetes, two of them being gestational diabetes and “brain type” diabetes.  Probably the most common of these smaller group of diabetics is gestational diabetes, which is diabetes only while a woman is pregnant; however this seems to increase a woman’s risk for diabetes later in life.  Most recently, a 2005 discovery suggests that the brain can also produce insulin and when problems arise in that process there is a link to Alzheimer’s disease.  These researchers also stated that typically these patients also have type 1 or 2 diabetes in addition to this “brain type” diabetes.

What is insulin?

First off, complete text books can be written about insulin and its bodily functions, so for the simple purpose of this blog we will look at one function of insulin.  Insulin is a hormone produced in an organ called the pancreas, which is located behind your stomach; insulin is particularly produced in cells of the pancreas called beta cells in the islets of Langerhans.  When we eat, our body breaks down some of our food into basic sugar molecules, which our body eventually uses to produce energy inside of cells.  Insulin takes the sugar, from the blood, into cells, like a key unlocking a door to the inside of a cell.  However, some people have cells that are resistant to insulin, or the insulin key doesn’t work every time; some experts suggest giving these people more insulin while others suggest a healthy lifestyle avoiding all sugar (like soda and refined carbohydrates), exercise, weight loss, appropriate quality and quantity of sleep, etc is best.

Most common tests for diabetes

When insulin takes the sugar out of the blood, this reduces the amount of sugar in the blood, and this is what we are checking when we check the blood for glucose levels. Another simple test is a urinalysis, checking for glucose in the urine. Hemoglobin A1c is also a common test which is used to calculate the percentage of red blood cells that sugar is sticking to; being that red blood cells circulate for 3 months this test gives us an estimate as to the amount of sugar in the blood for the past 3 months.  The new kid on the block is continuous glucose monitors, where a device is placed on the skin that monitors real time blood glucose and sends the data to either your phone or a device. This real time data is really helpful in understanding what meals are spiking someone, and how long it takes to reduce the blood glucose levels back down to appropriate levels. When sugar does not get into the cells, it can cause damage to our body.    Often some of the first signs are visualized by ophthalmologists on our eye’s retina. 

Symptoms of uncontrolled diabetes

frequent urination
unusual weight loss
extreme fatigue
frequent infections
blurred vision
slow wound healing
diabetic coma
unusual thirst

extremity numbness
kidney disease
heart disease
high blood pressure
difficulty sleeping

extreme hunger
pregnancy complications
dental disease
keto acidosis
skin sores and infection
nerve damage
Alzheimer’s disease

My Opinion

I like to boil things down to small parts.  Generally, this topic can be boiled down to two thoughts.  Simply put there are things that are in our control and there are things that are out of our control.  Unfortunately, for the estimated 5% of diabetics, who are type 1 diabetic Americans, there is not much they can do as far as being able to produce there own insulin at this time; some research suggests what a mother eats, or doesn’t eat, during pregnancy can reduce risk of type 1 diabetes, but that ship has already sailed by the time you have been diagnosed. 

However, great news, living a healthy lifestyle is one of the many things that is in your control.  Type 2 diabetes is largely preventable through a healthy lifestyle.  The term healthy lifestyle can be fairly vague so here is a brief summary of lifestyle modifications which currently appear to reduce the risk of diabetes and complications for those with diabetes: avoid all sugar and sweeteners, cut out alcohol, eat little to no grains like breads, rice, and cereal, avoid starchy foods like potatoes, exercise 30 minutes daily, take vitamin D, get rid of the excess weight,  eat low glycemic load food (glycemic load is a scale of the foods we eat, in correlation to portion size, that shows how much and how fast sugar from food will enter the blood, often called a blood sugar spike following a meal) allowing our body an easier time to deal with the sugar, reduce stress, get good quality and quantity of sleep, and there are a few supplements that have shown to be helpful. As always consult with your healthcare provider, nutritionist, or dietitian, prior to making any lifestyle modifications.  Also, understand that just because you can take insulin, or other medications, to lower blood sugar, this does not mean it is okay to eat sugar, high carbs, or alcohol; and just because you use an artificial sweetener, or indigestible sugar, this does not make it okay to eat a pie.  The bottom line here is that for the most part it seems that diabetes is largely preventable.  This should be the goal of any individual just to avoid the negative health issues, but this should be a goal on a wider scale to begin to reduce healthcare costs.

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