Understanding Diabetes

Understanding diabetes is the first step in controlling and coping with the disease. Knowledge, diet, and exercise are key to understanding how to kick diabetes.

Diabetes interferes with the body’s ability to metabolize sugar and carbohydrates, leading to elevated levels of blood sugar. Chronically high blood sugar contributes to serious problems, including cardiovascular disease, peripheral neuropathy, vision loss, and even amputation of toes, fingers, and limbs.

One out of 3 people with type 2 diabetes are not even aware they have the disease.

Symptoms of the onset of diabetes include increased thirst, frequent urination, dry mouth, weight gain, or loss, and a sense of insatiable hunger. Elevated blood sugar levels are also manifested by blurred vision and fatigue, particularly following meals. Since the disease attacks blood vessels and nerves in the sex organs, both men and women experience problems with sex. Erectile dysfunction is common, affecting between one and two thirds of male diabetics. Female sexual issues are also noted by vaginal dryness.

Risk factors include cigarette smoking, obesity, and lack of exercise.

The pancreas secretes the hormone insulin, which allows the body to derive energy from glucose. Carbohydrates are broken down into sugars in the stomach. As glucose enters the circulatory system, it stimulates the pancreas to release insulin. In turn, insulin enables the body’s cells to convert glucose into energy.

Type one diabetes is characterized by a failure of the pancrease to create insulin. Type 2 diabetes results from either inadequte production of insulin by the pancreas, or the inability of the body’s cells to fully utilize the insulin that is produced, or insulin resistence. Under those circumstances too much glucose remains in the blood, not absorbed by the body.

The disease is diagnosed with couple of blood tests. One is known as the hemoglobin A1c test. This measures the level of glycosylated hemoglobin in the blood. This is the amount of hemoglobin bound to glucose, and indicates average blood glucose levels over a period of several months. According to American Diabetes Association (ADA) guidelines, hemoglobin A1c levels under 7% represent optimal control among non-pregnant patients. For the purpose of screening for the presence of diabetes, levels below 5.7% are normal. Levels between 5.7% and 6.4% are consistent with increased risk of developing diabetes, a condition known as prediabetes. Levels of 6.5% or greater suggest the diagnosis of diabetes mellitus.

Another common blood test is the fasting blood glucose test. This test is performed before the patient takes the first meal of the day. A fasting blood glucose level over 126 is abnormal, as are random daytime levels over 200. Such elevated levels are consistent with the presence of diabetes.

Diet and exercise are important in the management of diabetes. Controlling blood sugar levels with a healthy diet, particularly limiting the intake of simple carbohydrates, reduces the risk of complications from diabetes.

Regular exercise can help lower blood glucose levels, and blood pressure. I’ve never been much of a fan of exercise. But it makes perfect sense. If your body is not using the fuel represented by all that glucose flowing through your arteries and veins, what is it going to do but keep flowing around or piling up in the form of fat. Neither of those are good things. So we need to burn that fuel with physical activity — something our ancestors and younger selves knew as “work.” The sedentary lifestyles we “enjoy” today, playing such roles as desk-jockeys or couch potatoes, do not promote the burning of such fuel. Of course, beyond blood sugar control, moderate exercise also helps reduce body fat and promote cardiovascular health.

Stress also contributes to both blood pressure and blood glucose levels. Persons with diabetes should work on reducing stress levels.

Where diet and exercise are inadequate to maintain healthy blood sugar levels, a variety of oral medications are available, short of having to inject insulin. These may aid in insulin production, help the body better utilize insulin, or partially block the digestion of starches.

Where the pancreas cannot produce insulin (type 1 diabetes), or if the body’s production of insulin is totally inadequate even with other medications, then insulin treatment become necessary. This may be accomplished by injections or even by use of an insulin pump.

Monitoring blood glucose levels through regular testing becomes a daily routine for diabetic patients. This is particularly true with insulin treatment. Excessive insulin results in dangerously low blood sugar levels, while inadequate amounts of insulin leads to life threateningly high blood sugar. Uncontrolled blood sugar levels can lead to loss of consciousness, seizures, or even death.

I have gone through life thinking of diabetes as more of a bother, than as a serious disease. From my earliest years I witnessed my maternal grandparents coping with it by daily injections of insulin. I’ve had friends and acquaintances who mentioned they have it, but I never got the impression, even from them, that it was all that serious. It is “just something you live with” — that is, something other people have to live with. In spite of being diagnosed as being “pre-diabetic” years ago, and even suffering some of the symptoms, including peripheral neuropathy pain, it still never occurred to me that this was anything more than a nuisance.  What I have learned all too recently is that it really is a much bigger deal!

I recently came across a great book by by nutritionist and kinesiologist Max Sidorov, written in cooperation with doctors at the International Council for Truth in Medicine, medical professionals who actually seem to care about curing or preventing disease. It is refreshing to hear medical professionals speak from that perspective. My take on medicine, in general, is that there is very little interest in curing disease, or even preventing it for that matter, among those who make their living treating disease. This is perhaps more true among those directly tied to the pharmaceutical industry, than with individual physicians. But even there — as evidenced by the doctor who was recently convicted and sent to prison for knowingly treating patients for diseases they did not have — one does not thrive in any business by eliminating customers.

Pharmaceutical companies know it is more profitable to treat symptoms of disease, than to cure disease. I used to run a dating service. It was amazingly successful, helping individuals become couples, and even resulting in numerous marriages. The problem was, every time I had a success, I lost two customers. Imagine how difficult it would be for the pharmaceutical companies to keep customers if they were ever successful in curing a disease!