Diabetes Mellitus

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The Disease

The ancient Chinese in 1500 BC knew that the urine of patients with “the wasting condition” was sweet. They also recognize that these people drank copious amounts of fluids, and urinated literally gallons of urine daily. The latin for honey is meil, and mellitus is derived from there. And diabetes means “to run over”, so diabetes mellitus is simply “running over with honey”, or, lots of sweet urine.

So why is the urine of diabetics so sweet? First, one must understand that sugar, or more specially, glucose, is the primary source of energy for the body. The food we eat that is starchy, sugary, or made of carbohydrates, is broken down by the body of glucose. The glucose enters the blood stream and is distributed to the various cells of the body for their use as an energy source. Very few cells, however, can simply grab this glucose without help. The help comes in the form of a great, huge, “controller” molecule called Insulin. When the level of glucose rises in the blood, insulin is secreted (from an organ called the pancreas), which helps the cells take the glucose out of the blood, the blood glucose levels falls, and the insulin secretion drops.

In the glucose is not taken out of the blood, i.e. if there is either no insulin, or inadequate insulin, then the blood glucose level becomes increasingly higher. The kidney, which filters our blood but never allows sugar to escape, becomes overloaded, at which point glucose starts to “spill over”, therefore “sweet urine”.

The 1903 Medicology Textbook says “The most positive influence in diminishing the disease belongs to opium”. There was no cure – just make them feel good.

The Problems

  1. HYPOGLYCEMIA – Not enough sugar in the blood. This is defined as blood glucose levels less than 3.0mmol/L. There are many symptoms usually due to lack of sugar to the brain. The treatment is to elevate the blood sugar level, and this is done by eating some form of sugar immediately – fruit juice, candy, chocolate bars, soft drinks, honey, sugar cubes – and followed by a regular meal within the next hour.
  2. HYPERGLYCEMIA – Too much sugar in the blood. This is defined as blood glucose levels above 13.0mmol/L and is an indication that your diabetes is out of control. The best treatment is to return to your daily diabetic plan – which includes proper diet, proper exercise, medication adjustment and monitoring blood glucose levels.
  3. SMALL BLOOD VESSEL DISEASE – When blood glucose levels stay high over a period of time, the small blood vessels may be damaged. High blood glucose levels stiffen red blood cells, making it more difficult for them to enter the tiny blood vessels. These “stiff” blood cells bang agains the walls of the vessels causing damage, weakness and eventually, bursting. When these tiny blood vessels are damaged, the organs that they supply with blood will become damaged also. This is why uncontrolled or poorly controlled or poorly controlled diabetes is associated with eye problems (retinopathy), kidney problems (nephropathy), sensory nerve problems like numbness, tingling, pain (neuropathy), and circulation problems in the fingers and toes.
  4. LARGE BLOOD VESSEL DISEASE – Diabetics tend to be more susceptible to developing atherosclerosis – a hardening and thickening of blood vessel walls due to deposits of cholesterol. These deposits cause vessels to narrow, with subsequent reduced blood flow that possibly can lead to high blood pressure, strokes, heart attacks and poor circulation in the hands and feet. Atherosclerosis can be prevented, or at least slowed down, by lifestyle changes – meal plans low in sugar and fat, regular physical activity, smoking cessation and reducing alcohol consumption.

Is Diabetes serious?

If left untreated or improperly managed, diabetes can result in a variety of complications, including:

  • Heart disease
  • Kidney disease
  • Eye disease
  • Problems with erection(impotence)
  • Nerve damage

The first step is preventing or delaying the onset of these complications is recognizing the risk factors, as well as signs and symptoms of diabetes.

 

What are the risk factors for diabetes?

if you are aged 40 or older, you are at risk for type 2 diabetes and should be tested at least every three years. If any of the following risk factors apply, you should be tested earlier and/or more often.

Being - a member of a high-risk group (Aboriginal, Hispanic, Asian, South Asian or                     African Descent)

- over weight (especially if you carry most of your weight around your middle)

Having - a parent, brother or sister with diabetes

- health complications that are associated with diabetes

- given birth to a baby that weighed more than 4kg(9lb)

- had gestational diabetes (diabetes during pregnancy)

- impaired glucose tolerance or impaired fasting glucose

- high blood pressure

- high cholesterol or other fats in the blood

- been diagnosed with any of the following conditions: polycystic ovary syndrome, acanthosis nigricans (darkened patches of skin) and schizophrenia.

 

How is Diabetes treated? 

People with diabetes can expect to live active, independent and vital lives if they make a lifelong commitment to careful diabetes management, which includes the following:

  • Education – diabetes education is an important first step. all people with diabetes need to be informed about their condition.
  • Physical Activity – regular physical activity helps your body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.
  • Nutrition – what, when and how much you eat all play an important role in regulating blood glucose levels.
  • Weight Management – maintaining a healthy weight is especially important in the management of type 2 diabetes.
  • Medication – type 1 diabetes is always treated with insulin. Type 2 diabetes is managed through physical activity and meal planning and may require medications and/or insulin to assist your body in controlling blood glucose more effectively.
  • Lifestyle Management – learning to reduce stress levels in day-to-day life can help people with diabetes better manage their disease.
  • Blood Pressure – high blood pressure can lead to eye disease, heart disease, stroke and kidney disease, so people with diabetes should try to maintain a blood pressure level below 130/80. To do this, you may need to change your eating and physical activity habits and/or take medication.

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