Insulin, Sugar, and Diabetes
Diabetes is not one thing. It is a class of diseases marked by high blood sugar levels. High blood sugar results from low insulin production or cells demanding more insulin. Insulin is the hormone that regulates blood sugar levels.
Insulin shortage
Insulin shortage comes from low insulin production or cells requiring more insulin to act. In the second case, the cells demand more insulin before they take up sugar.
Tiny insulin islands
The pancreas produces insulin. It sits right behind the stomach. Only tiny knots of cells in the pancreas produce insulin. These knots are called islets of Langerhans, after the man who discovered it. Though these cells make up only 1% of the pancreas, they use 10% of the blood flow. These tiny, barely visible areas are responsible for insulin production.
Type I
Type I diabetes involves low insulin production. It used to be called juvenile diabetes because it is usually diagnosed in childhood.
Two types of Type I
Type I diabetes has two types. In most cases, Type I diabetes results from the body’s immune system attacking and destroying the insulin-making cells in the pancreas. About 1 out of 6 cases of Type I diabetes is not caused by an immune problem but simply low insulin production.
Immune attack
In the autoimmune type of diabetes, the immune system destroys the part of the pancreas that produces insulin. For unknown reasons, Type I diabetes is becoming more common. Genetic factors play a role in developing Type I diabetes. Being born via C-section increases the risk of Type I diabetes by about 20%. Viral infections and some infant antibiotics seem to be linked to Type I diabetes.
Many causes for Type I
Type I diabetes is a multi-factor disease with no single cause, but evidence points to a bacterial link. Many factors are related to establishing a healthy set of bacteria, both in the gut and on the skin. A gut farm out of balance has wide-ranging results, even contributing to autoimmune diseases. When Type I diabetes is caused by the immune system, the antibodies attacking the pancreas can be found in the bloodstream.
Insulin resistance type II
When blood sugar goes up, the pancreas adds insulin to the bloodstream. Insulin attaches to cells and helps them take up sugar from the bloodstream. When the cells won’t take up sugar when the insulin signals it, the blood sugar doesn’t go down. This is Type II diabetes.
Pre-diabetes
Usually, Type II diabetes develops slowly over many years. Before it is diagnosed, there is often weight gain. Four out of 5 people diagnosed with Type II diabetes are overweight. Pre-diabetes is sometimes called metabolic syndrome. In this stage, your cells are becoming resistant to insulin, and blood sugar starts to creep up. This can cause a weight gain cycle as high blood sugar increases insulin levels, increasing fat storage. The extra weight causes cells to require even more insulin to take sugar from the blood.
Risk factors
Type II diabetes has genetic markers. If one of your parents has Type II diabetes, your risk is 4 times as high. Some people naturally produce less insulin, so they are more likely to get diabetes. Carrying a lot of extra weight is also a risk factor.
Test for silent symptoms
At the start, diabetes has no symptoms. You have to get tested to know if you have it. Get tested if you are over 45 and haven’t had your blood sugar levels tested. It is especially important if you have close family with diabetes or carry a lot of extra weight..
Damage discovered
The other way diabetes is discovered is when it has already damaged eyes, kidneys, nerves, and blood vessels. Most of the damage can be prevented if you make changes early in the disease. Most often, damage from diabetes doesn’t show up for 10 years. If you wait for symptoms, a lot of damage has already been done.
Insulin management
Insulin management is the key to diabetes. Less insulin is required if fewer carbs are eaten, especially refined carbs or sugar. Diet is one way to manage insulin. A popular drug, metformin, helps control insulin levels. Exercise is another way.
Exercise burns sugar
Muscle cells are the primary users of sugar in the blood. When you exercise, your muscles use up energy stored in their cells. Once their stored energy is consumed, they are more likely to pull sugar out of the bloodstream. That is why exercise is so helpful for diabetes. When you move, your muscles burn energy, and the muscle cells get hungry for more sugar and take it up from the bloodstream. Inactivity leads to muscle cells that don’t want to take up sugar from the blood.
Metformin
Metformin is the most used drug for diabetics. It magnifies the effect of insulin in lowering blood sugar. It is almost always prescribed when diagnosed with diabetes. Other medications can help manage high blood sugar. Many have harmful side effects and should only be used when there are no alternatives. Take care to manage diabetes while you still can. Early on, a healthy diet and exercise can make a big difference. See the Fast Living article in this issue for an eating program that can help with diabetes. If diabetes progresses, your body will no longer be able to produce enough insulin, and eventually, insulin shots may be required.
Diabetic damages
If blood sugar is poorly controlled over the years, organs can be damaged. This damage results from damaged blood vessels in the organs. Although it’s not known how high blood sugar damages blood vessels, it is clear that long-term high blood sugar causes such damage.
Eye damage
Diabetes is the most common cause of adult blindness. At first, there are no symptoms of the damage, but eventually, some blurring of vision occurs. Annual eye exams are recommended for anyone with diabetes to catch damage early while some treatment options are still available.
Kidney damage
Diabetes is also the most common cause of chronic kidney disease, dialysis, and kidney transplants. Because of the many tiny blood vessels in the kidneys, kidneys are prone to damage from high blood sugar. Kidney damage is best diagnosed and monitored with a urine sample test. Because of the risk of kidney damage, diabetics must manage blood pressure, as high blood pressure also strains the kidneys.
Nerve damage
Neuropathy is damage to nerves, most often in the hands and feet. The first signs are usually a loss of sense of touch. Diabetic nerve damage can also affect the nerves that manage digestion and other automatic body processes. The loss of sense of touch on the feet often leads to foot damage, as loss of pain sensation makes foot damage likely. Eventually, the nerve damage progresses to the loss of foot muscle and reflexes. A doctor can assess your sense of touch on your hands and feet to monitor nerve health using special instruments. A foot exam is recommended before you notice any damage and every year after that. Diabetes is a leading cause of amputation, so take this seriously.
Large vessel damage
Diabetes increases the risk of stroke, heart attack, and other kinds of heart disease. With diabetes, it is crucial to manage cholesterol levels through diet, exercise, and other means if necessary. A daily baby aspirin might also make sense if you have diabetes but check with your doctor.
Immune weakness
People with diabetes are more prone to infection from bacteria and fungus. High blood sugar weakens immune cells, making your body less able to fight off infections.
Symptom Management
If you have diabetes, make sure you get annual check-ups for eyes, feet, and kidneys. Keep your blood sugar under control with diet, exercise, and, if necessary, drugs. Use lanolin lotion on your feet to keep the skin supple. Nerve pain can be managed by a cream containing capsaicin, a pepper extract known to help with nerve pain. (Lakota Diabetic Foot Pain is one such cream)
Choose Quality
We have all made poor choices in the past. We can’t change what we did yesterday, And we can’t control the future. It’s out of our hands. What we can control is what we do today. Today, choose health. Choose healthy eating, regular exercise, good sleep, and an open heart.
