LAZY PANCREAS

DIABETES MELLITUS

DIBETES: BASIC TERMS

You probably know diabetes has something to do with sugar and something to do with insulin. You probably also know that diabetics are supposed to follow a certain diet and possibly lose weight. But what is diabetes, really?

Let’s start with the basics. These are two common types of diabetes associated with high blood sugar levels, called diabetes mellitus type 1 and diabetes mellitus type 2. For simplicity I will just call them type 1 and type 2.

THE TWO TYPES OF DIABETES

There are two types of diabetes, with entirely different causes and treatments. The differences between type 1 and type 2hinge on how each type develops. Type 1 diabetes is deficit of insulin caused by a loss function of certain cells in pancreas. The type 2 diabetes develops from insulin resistance. Type 1.5 is a condition that involves a little bit of both process.

Type 1(Insulin dependent diabetes mellitus) usually begins in childhood and requires treatment with insulin shots multiple times a day. Insulin is a hormone that helps control blood sugar. Without insulin, a person’s blood sugar levels can eventually rise high enough to cause extreme dehydration and electrolyte depletion, which can put them into a coma. Type 1 diabetics need insulin injections to prevent this from happening.

Type 2 usually begins later in life, and usually in people who have been overweight for years. It was earlier believed that the type 2 was just like type 1, and needed to be treated similarly. A few years later scientists realized that type 2 diabetes produced more insulin than normal, but insulin didn’t help to control blood sugar the way it should. It was as if the hormone insulin had stopped working in the body of type 2 diabetics. But nobody could explain why?, at that time. It was like insulin had developed resistance in the body.

It is now clear that type 2 diabetes is not due to insulin deficiency. The origin of type 2 diabetes are rooted in defective energy metabolism. When your metabolism is healthy, your body is able to fuel most of your activity using your body fat stores. Over time, compounds in vegetable oils accumulate in your body fat so that it can no longer provide your body with enough energy. Gradually, your body shifts from a fat-based energy economy to a sugar-based energy economy.

When your metabolism is healthy, you can burn body fat. When you can burn body fat, your body can also produce a special kind of brain energy called ketones. Ketones are a special kind of fuel that prevents your brain from needing sugar. You don’t get ketones from food; your liver makes ketones for your brain. As long as your brain can get ketones, you always have plenty of energy and you don’t get hungry that often.

Type 2 diabetes is much more common than type 1 diabetes. It is often discovered by chance. It is typically gradual in onset and occurs mainly in the middle-aged and elderly, frequently mild, slow to ketosis and is compatible with long survival if given adequate treatment. Its clinical picture is usually complicated by the presence of other disease processes.

Insulin resistance syndrome (Syndrome X)

In obese patient with type 2 diabetes, the association of hyperglycemia, hyperinsulinemia, dyslipidemia and hypertension, which leads to coronary artery disease and stroke, may result from a genetic defect producing insulin resistance, with latter being exaggerated by obesity. It has been proposed that insulin resistance predisposes to hyperglycemia, which results in hyperinsulinemia (which may or may not be of sufficient magnitude to correct the hyperglycemia) and this excessive insulin level then contributes to high levels of triglycerides and increased sodium retention by renal tubules, thus inducing hypertension.

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