Diabetes – Disorder Of Carbohydrate Metabolism

Diabetes is truly a chronic lifelong disorder, a disorder of carbohydrate metabolism with millions going undiagnosed because they are unaware that they have the disorder. Carbohydrates are used by the body to produce energy with glucose being the main source of fuel for the body.

Carbohydrates are digested and converted to glucose which enters the blood stream and into every cell of the body; however to enter these cells insulin is needed, a hormone manufactured and stored by the pancreas.

If insulin is being properly produced then glucose is moved from the blood stream into the cells that utilize it. When diabetes is present, the pancreas produces little or no insulin and glucose accumulates in the blood resulting in hyperglycemia which is the abnormally high blood glucose level that characterizes diabetes mellitus.

Although glucose in the blood is in abundant supply, it can’t get to the cells which are starved for fuel, a worse situation is created because the cells which are starving for fuel then send a signal to the liver to make more glucose which is then dumped in the blood stream which increases the hyperglycemia, the kidneys which are supposed to reabsorb glucose can’t handle the excess so it is excreted in the urine giving the urine a classic odor that is associated with diabetes and that can be measured through testing.

The body then turns to other fuel sources once it can’t use glucose and begins to use fat and protein, which when fat is used results in dangerously high acidity levels in the blood from keto-acidosis, the excessive use of protein which is used to build muscle mass results in a muscle wasting disease and weakness.

As time goes on persistently high levels of glucose in the blood leads to other health concerns such as high blood pressure, heart disease and kidney disease. As a result of high levels of glucose in the blood damage results to the body’s proteins and its tissues in the eyes, nerves, blood vessels, and kidneys.

These damages can lead to conditions such as peripheral vascular disease in the legs and feet, eye deterioration leading glaucoma and to eventual blindness, kidney disease resulting in kidney failure, and nerve damage called neuropathy which leads to loss of sensation in the extremities, the disease can lead to gangrene and eventual amputations due to poor blood circulation.

Diagnosis

The disease is diagnosed by measuring plasma glucose concentration after an overnight fast or as part of an oral glucose tolerance test (OGTT).

The symptoms include:

• Polyuria – excessive urination

• Polydipsia – excessive thirst

• Unexplained weight loss sometimes accompanied by polyphagia which is excessive eating.

• Blurry vision

• Fatigue

Types of Diabetes

There are three main types of the disease

• Type 1 – usually diagnosed in children and young adults and was known previously as juvenile or insulin dependent (IDDM). In this type the body fails to produce insulin.

• Type 2 – usually diagnosed in adults and was known previously as adult-onset or non-insulin dependent (NIDDM). In this type the body fails to produce enough insulin or the cells ignore the insulin.

• Gestational – usually diagnosed in pregnant women who have never had diabetes, due to the development of hyperglycemia during pregnancy.

There is also a stage before the onset of the type 2 disease called pre-diabetes where the fasting glucose level is higher than normal but not yet high enough for a diagnosis of the disease. However, there may already be some long term damage to the body, especially the heart and circulatory system.

Hypoglycemia – Low Blood Sugar

When there is excess insulin low blood sugar results called hypoglycemia, this is as a result of too much glucose entering the cells. The onset of hypoglycemia can lead to irritability, hunger, headache, shakiness, rapid heartbeat, and weakness. If the blood glucose level drops further, this can lead to coma and death.

Risk Factors

Type 1 Risk Factors

• A parent of sibling with the disease

Type 2 Risk Factors

• Age greater than or equal to 45 years

• Being overweight with a BMI greater than or equal to 25 kg/m squared

• A parent or sibling with the disease

• Sedentary lifestyle

• Part of certain ethnic groups (African American, Native American, Asia American, Pacific Islander or Latino)

• Identified for the pre-condition

• Gestational type of the disease

• Hypertension with a blood pressure greater than or equal to 140/90 mm Hg