Diabetes Mellitus

Diabetes Mellitus

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Introduction


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Of the 15 million Americans who have Type II diabetes, more than a
third are unaware of it. Another 21 million Americans have a greater
than 50/50 chance of developing the disease because they have impaired
blood-sugar metabolism. This year alone more than 187,000 people will
die of Type II diabetes, also called non-insulin-dependent diabetes
mellitus (NIDDM), making it the sixth leading cause of death by
disease. Each day, over 2,200 people are diagnosed with this chronic
life debilitating, expansive, and pro-aging disease.

What is Diabetes?
Glucose is a simple sugar found in food. It is an essential nutrient
that provides energy for the proper functioning of the body cells.
After meals, food is digested in the stomach and the intestines into
glucose and other nutrients. The glucose in digested food is absorbed
by the intestinal cells into the bloodstream, and is carried by blood
to all the cells in the body. However, glucose cannot enter the cells
alone. It needs assistance from insulin in order to penetrate the cell
walls. Insulin therefore acts as a regulator of glucose metabolism in
the body.

Insulin is called the "hunger hormone". As the blood sugar level
increases following a carbohydrate rich meal, the corresponding insulin
level rises with the eventual lowering of the blood sugar level and
glucose is transported from the blood into the cell for energy. When
the blood glucose levels are lowered, the insulin release from the
pancreas is turned off. When the blood sugar level drops below a
certain level, hunger is felt. This often occurs a few hours after the
meal. In normal individuals, such a regulatory system helps to keep
blood glucose levels in a tightly controlled range. Cravings for sweets
frequently form part of this cycle, which can lead to snacking, often
for more carbohydrates. If the cravings are not fulfilled, sensations
such as hunger, dizziness, moodiness, and a state of "collapse" can
result.

This system of auto regulation and homeostasis is the function of the
pancreas and it works around the clock. Dysfunction of this auto
regulation system - either inability of the pancreas to secrete any or
insufficient insulin, or pancreas overload from too much sugar ingested
over a long period of time, or over compensatory mechanism, or a
combination of these, results in the lack of insulin, and hence high
blood sugar. This is the hallmark of diabetes mellitus (commonly called
diabetes)

Two Types of Diabetes Mellitus
Type I diabetes mellitus is also called insulin dependent diabetes
mellitus (IDDM), or juvenile onset diabetes mellitus. It is an
autoimmune disease in which the pancreas produces no insulin at all,
and the patient relies on insulin medication for survival. Type I
diabetes tends to occur in young, lean individuals, usually before 30
years of age. Approximately 10% of the patients with diabetes mellitus
have IDDM. There is no cure for this type.


Type II diabetes mellitus is also referred to as non-insulin dependent
diabetes mellitus (NIDDM), or adult onset diabetes mellitus (AODM). It
is a metabolic disorder resulting from the body's inability to make
enough, or properly use, insulin. 90% of all Diabetes Mellitus are of
Type II. Type II diabetes mellitus occurs mostly in individuals over 40
years old. The incidence of type II diabetes increases with age. Unlike
type I diabetes mellitus, 80% of type II diabetic patients are obese.
Type II diabetes mellitus also has a strong genetic tendency.

It is nearing epidemic proportions, due to an increased number of
elderly people, a greater prevalence of obesity and a sedentary
lifestyle. In type II diabetes, patients can still produce insulin, but
do so inadequately. The pancreas in these patients not only produces an
insufficient amount of insulin, but also releases insulin late in
response to increased glucose levels. Some type II diabetics have body
cells that are resistant to the action of insulin (Insulin Resistance).
Finally, the liver in these patients continues to produce glucose
despite elevated glucose levels.

Type II diabetes once hardly ever struck before middle age, and the
older you are the more at risk you are. Now it is striking younger
people.


Symptoms of NIDDM
The early symptoms of untreated diabetes mellitus are related to
elevated blood sugar levels, and excretion of it to the urine. High
amounts of glucose in the urine can cause increased urine output and
lead to dehydration. Dehydration causes increased thirst and water
consumption. Some untreated diabetic patients also complain of fatigue,
nausea, and vomiting. Patients with diabetes are prone to developing
infections of the bladder, skin, and vaginal areas. Fluctuations in
blood glucose levels can lead to blurred vision. Extremely elevated
glucose levels can lead to lethargy and coma (diabetic coma).

The most unrecognized symptom of NIDDM is weight gain. High insulin
levels prohibit the release of serotonin, a neurotransmitter in the
brain that informs the body to slow down eating. Without serotonin,
there is a tendency to overeat, which then leads to a spiral of
excessive sugar intake. A viscous cycle of hyper-insulinemia resulting
in insulin resistance is set up. This in turn creates a "carbohydrate
addict" whose craving for a higher sugar intake continues to increase.
The same dietary factors that cause NIDDM lead to obesity. Eating
refined carbohydrates such as sugar, or carbohydrates that easily
converts into sugar such as yam, potato, or rice, creates more glucose
than the body can handle. Excess glucose then gets stored as fat. As
diabetes sets in, so does lethargy and inactivity, contributing further
to the vicious cycle of weight gain and worsening of diabetes.