DIABETES

“There’s no diabetes that’s not bad. It’s all serious.”—Anne Daly, American Diabetes Association.

Like many people who think that they are reasonably healthy, they ignore the nagging symptoms. They might blamed the persistent thirst on the antihistamines they take. They might attribute the frequent urination to an excess intake of water. And the tiredness—well, what working adult does not get exhausted?

However when a blood test confirms that diabetes is the culprit, It may be difficult to accept the diagnosis. Upon learning that they have diabetes, some experience a flood of emotions, including depression and even anger. These are natural responses to what seems an unfair blow. With support, however, those with diabetes can adapt.

Why Serious

Diabetes has been called “a disorder of the very engine of life,” and for good reason. When the body cannot metabolize glucose, a number of vital mechanisms can break down, sometimes with life-threatening consequences. “People don’t die directly from diabetes,” says Dr. Harvey Katzeff, “they die from complications. We do a good job of preventing complications, but a poor job of treating [them] once they occur.”

Is there hope for those who are afflicted with diabetes? Yes—if they recognize the seriousness of the disorder and submit to a program of treatment.

Diet and Exercise

Although Type 1 diabetes cannot be prevented, scientists are studying the genetic risk factors and are trying to find ways to suppress an immune attack. “With type 2, the picture is much brighter,” says the book Diabetes—Caring for Your Emotions as Well as Your Health. “Many of those who might be genetically susceptible avoid showing any sign of this disease simply by eating a balanced diet and exercising regularly, thereby staying physically fit and keeping their weight within normal limits.”

Underscoring the value of exercise, the Journal of the American Medical Association reported on a large study involving women. The study found that “a single bout of physical activity increases insulin-mediated glucose uptake [by the body’s cells] for more than 24 hours.” Hence, the report concludes that “both walking and vigorous activity are associated with substantial reductions in risk of type 2 diabetes in women.” The researchers recommend at least 30 minutes of moderate physical activity on most if not all days of the week. This can include something as simple as walking, which, says the American Diabetes Association Complete Guide to Diabetes, “is probably the best, safest, and least expensive form of exercise.”

Keep Learning

The more those with diabetes learn about their disease, the better equipped they will be to manage their health and increase their prospects of living a longer, healthier life. Effective education, however, calls for patience. The book Diabetes—Caring for Your Emotions as Well as Your Health explains: “If you try to learn everything at once, you are likely to get confused and not use the information effectively. Besides, much of the most useful information you will need to learn isn’t found in books or pamphlets. It has to do with . . . how your blood sugar varies with changes in routine. This can be learned only over time, through trial and error.”

The Importance of Family Support

It is beneficial when family members learn about diabetes, even taking turns attending medical appointments with the sufferer. Knowledge will help them to be of support, recognize important symptoms, and know how to respond.

Loving family members should strive to be supportive, kind, and patient—qualities that can help an ill person face life’s challenges and can even influence for the better the course of their disease. Family and friends need to understand that as blood-sugar levels fluctuate, diabetes can affect one’s moods.

Diabetes can be managed successfully, especially if the sufferer has cooperation from friends and family members.

Additional Points of Interest

Excess fat in the midriff (the apple-shaped body) seems to pose more danger than fat on the hips (the pear-shaped body).

Smokers put themselves at an even greater risk, for their habit damages the heart and circulatory system, and it narrows blood vessels. One reference states that 95 percent of diabetes-related amputations involve smokers.

Medical authorities recommend that people with diabetes always carry an identification card and wear identification jewelry. In a crisis these items can save a life. A low-sugar reaction, for example, can be misinterpreted as a different medical condition or even as an alcohol problem.

The Role of Glucose

Glucose fuels the body’s trillions of cells. To enter the cells, however, it needs a “key”—insulin, a chemical released by the pancreas. With Type 1 diabetes, insulin is simply not available. With Type 2, the body makes insulin but usually not enough. Moreover, the cells are reluctant to let insulin in—a condition called insulin resistance. With both forms of diabetes, the result is the same: hungry cells and dangerous levels of sugar in the blood.

In Type 1 diabetes, a person’s immune system attacks the insulin-producing beta cells in the pancreas. Hence, Type 1 diabetes is an autoimmune disease and is sometimes called immune-mediated diabetes. Factors that can trigger an immune reaction include viruses, toxic chemicals, and certain drugs. Genetic makeup may also be implicated, for Type 1 diabetes often runs in families, and it is most common among Caucasians.

With Type 2 diabetes, the genetic factor is even stronger but with a greater occurrence among non-Caucasians. Australian Aborigines and Native Americans are among the most affected, the latter having the highest rate of Type 2 diabetes in the world. Researchers are studying the relationship between genetics and obesity, as well as the way excess fat seems to promote insulin resistance in genetically susceptible people. Unlike Type 1, Type 2 diabetes occurs mainly in those who are over 40 years of age.

The Role of the Pancreas

About the size of a banana, the pancreas lies just behind the stomach. According to the book The Unofficial Guide to Living With Diabetes, “the healthy pancreas performs a continuous and exquisite balancing act, managing to sustain smooth, stable blood-sugar levels by releasing just the right amount of insulin as glucose levels wax and wane throughout the day.” Beta cells within the pancreas are the source of the hormone insulin.

When beta cells fail to produce enough insulin, glucose builds up in the blood, causing hyperglycemia. The opposite—low blood sugar—is called hypoglycemia. In concert with the pancreas, the liver helps manage blood-sugar levels by storing excess glucose in a form called glycogen. When commanded by the pancreas, the liver converts glycogen back into glucose for use by the body.

The Role of Sugar

It is a common misconception that eating a lot of sugar causes diabetes. Medical evidence shows that getting fat—regardless of sugar intake—increases the risk among genetically susceptible individuals. Still, eating too much sugar is unhealthy, since it provides poor nutrition and contributes to obesity.

Another misconception is that people with diabetes have an abnormal craving for sugar. In reality, though, they have the same desire for sweets as most others. When it is not controlled, diabetes can lead to hunger—but not necessarily for sugar. People with diabetes can eat sweets, but they must factor their sugar intake into their overall diet plan.

Recent studies have shown that a diet high in fructose—sugar derived from fruits and vegetables—can contribute to insulin resistance and even diabetes in animals, regardless of their weight.

Diabetes Simplified

PANCREAS

↓ ↓ ↓

Healthy Person Type 1 Diabetes Type 2 Diabetes

After a meal, the The insulin-producing In most cases

pancreas responds beta cells in the the pancreas

to increases in pancreas are attacked produces a

the glucose content by the immune system. limited amount

of the blood, As a result, insulin of insulin

releasing the proper is not produced

amount of insulin