Diabetes. It's an insidious disease. When many people think about the term diabetes, they think about sugar, and nothing else. While, essentially, diabetes refers to a deficiency in the way your body handles sugar, we need to think about food, in general, when discussing diabetes. For many people with the disorder or disease, their blood sugar remains well within a tolerable range, well below 200 mg/dl; but there are those who, for one reason or another, have difficultycontrolling their blood sugar, and that leads to problems. So, let's look at the real problems with diabetes and help define just what it is.
Diabetes refers to the body's inability to handle sugar, mainly glucose, which is the simplest for of sugar available for the body to use. If you recall or had any biology in school, then you might remember Kreb's Cycle. Glucose, a simple six-carbon sugar, enters the cell and goes through a series of changes (Kreb's cycle) which ultimately releases energy, in the form of ATP (adenosine tri-phosphate). This is the "gas" for the cell to stay alive and function. Well, along comes diabetes, which, in its simplest terms, refers to a problem getting sugar (glucose) out of the blood and into the cell (through the cell membrane). In order to enter the cell, glucose (the sugar) must "attach" itself to a "receptor" on the cell wall, which allows it to be transported through the cell membrane. The "vehicle" used for the transport is called insulin.
Insulin is a protein (hormone) which is manufactured and released by the pancreas, an endocrine organ which sits above and to the right of the gallbladder (under the liver). If your pancreas does not secrete any insulin (or not enough), then you have diabetes, and you blood sugar will be high (defined as blood sugar above 140 mg/dl, two hours after eating). There are two "basic" forms of diabetes: Type I and Type II. Type I diabetes means that the pancreas does not secrete any insulin; Type II means that the pancreas doesn't secrete enough or the insulin secreted does not perform that well. Keep in mind that this is a very broad view of the disease and that there are a lot of variations of the above two types. For discussion in this medium, however, we will use the two types and define the problems from there.
Ok, so what does this mean to you? What is the big deal about all of the sugar? Well, for one thing, the cells will eventually die if they are not afforded glucose. Yes, that means brain, heart, liver, and skin cells. The first organs to "go" are the eyes; a poorly controlled diabetic will eventually start complain about bad vision; the next organ affected (usually) is the heart, then the brain. Heart attacks, strokes, vascular disease, and other very serious problems are all associated with diabetes. People with poorly controlled diabetes can suffer from serious vascular problems affecting the extremities (as in legs and feet, especially) and can end up having a leg or a foot amputated. This becomes serious, and it's all due to sugar. Since the lack of sugar (glucose) also affects the nervous system (nerve cells need energy too), a person with diabetes might step on a piece of glass and not feel it; a small cut which never really heals becomes infected. Later, even within days, the infection leads to gangrene; it is then noticed too late, and the "patient" ends up in the hospital with a serious infection in the whole foot. Since the cells in the foot (by that time) are dead, the foot cannot be saved, and it's amputated. Serious, huh? You betcha!
If you are diabetic, whether it's type I or type II, you ought to realize that it's not just the amount of sugar that you eat that becomes the problem. All food, whether it's a steak, pork chops, a roll, ice cream, a cookie, or even squash, is "turned into" either protein, fat, or sugar, once metabolized. If the food you eat is stored as fat, it could be used later by the body; in that case, a "fatty acid" is cleaved from the fat chain, and turned into - you guessed - sugar. Food that is "changed into" protein is used by the body to make "more of you" - but can also be broken down again and used - as sugar. Remember, we are all nothing more than Carbon and Water! So, it's not so much "what" you eat, but "how much" you eat. The mainstay of diabetes control is diet, exercise, and weight control. Take your insulin (as prescribed by your doctor), monitor your blood sugar (with the glucometer) as recommended by your doctor or nurse, and stay on your strict diet. Exercise. Your need for exogenous (insulin from a source other than your own pancreas, as in injections) can be decreased if you exercised; let your doctor tell you when to alter your insulin dose. And, by all means, remember to follow up with your doctor when he or she wants you to. Adherence to a strict plan for you will help control your diabetes, but education (from whatever source) is the "best" medicine, besides your insulin, of course.
For people with Type II diabetes, there are a number of medicines (pills) which are used to help control your blood sugar. These medicines are called hypoglycemics, and work very well, although diet, exercise, and weight control are still very much needed. A newer medicine, called Glucophage, was released late last year. Talk with your doctor.
Diabetes is a disease. It has a large amount of very serious complications. It is also a disease that can be controlled. If you have diabetes, take care to remember your medicines, and eat right. If you think you may have diabetes, then check with your family doctor. There's help available for you, as well as a large number of support groups. It's your body. Take care of it.
For more information about diabetes, check out the following URL on the Internet; this a wonderful site, full of answers to questions, many articles, and links to other areas on the Internet:
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