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Disbetes
SIMPLE WORDS ABOUT DIABETES
NORMAL FUNCTIONING
Lets look at the chronic illnesses, DIABETES. First, it is important to know about normal metabolic functioning. We eat food and we make energy. We can only exist if our circulating sugar levels are within a very narrow range. Too high or too low and we are in a heap of trouble!
When our bodies are working well, our blood sugar levels return to normal.
We have a meal. The food we eat breaks down chemically into a type of sugar called glucose. Each molecule of glucose enters the bloodstream as part of the digestion process. As blood sugar levels increase, the pancreas responds by releasing the hormone insulin, which allows glucose to leave the bloodstream and enter various tissues, where it fuels the body’s activities. Some glucose is taken up and stored by the liver for later use. When the sugar supplied from the last meal is more or less used up, insulin levels drop, which keeps the sugar in the blood from falling further. Then we experience hunger. Also, the sugar that was stored in the liver is released back into the bloodstream with the help of another hormone called glucagon. Insulin and glucagon are both produced by two different cells in the pancreas.
This smooth shifting of sugar into and out of the bloodstream is crucial to our survival. The cells in our bodies, particularly those of the brain and the rest of the central nervous system, must receive a steady and consistent supply of sugar. The blood sugar concentration should remain constant----usually between 60 and 100 milligrams per deciliter of blood.
Your pancreas is located behind your stomach. It has two functions: it makes digestive juices and it makes hormones. Insulin is made in cells in the middle. These are called "Islets of Langerhans" named after the German physician, Paul Langerhans, who discovered them in 1869. The term "hormone" (from the Greek, meaning "rouse to activity") was coined in 1904 as science advanced. In 1922, insulin (which is Latin for "islet") was isolated. By 1926, insulin was being injected. There are now nine types of insulin available, providing treatment options for people who would otherwise be dead.
TYPE I DIABETES DEFINED
Insulin dependent diabetes mellitus, IDDM, is also known as Type I diabetes. The age of onset is usually under 25 years and the persons body build is usually lean. Symptoms come on quickly. By the time symptoms cannot be ignored, the beta cells which produce insulin have been nearly destroyed. A current theory about why this happens is related to a virus and an immune response that destroys beta cells.
SYMPTOMS
Symptoms of the disease are extreme thirst and voluminous urine production, increase in appetite but loss of weight, itchy skin, and infections. In the late stage, sugar spills into the urine. Since this should not happen, a blood test for glucose can identify diabetes earlier than can urine testing. As with all chronic diseases, early diagnosis and treatment can prevent disability and even death.
Precise food intake and measured insulin by injection and an exercise regimen must be followed so balance is maintained. A person with IDDM must assume responsibility for self managing the disease and making necessary changes in lifestyle to prevent complications. Two potential life threatening emergency conditions, "insulin shock" and "ketoacidotic coma" are related to too much or too little insulin. This can be caused by irregular food intake, by medication mistakes or by infection. Non-compliance or defiance is the usual culprit.
Two more definitions are important to understand diabetes. The term "diabetes mellitus" originated in the Greek language. Diabetes, meaning pass through or siphon, refers to the copious amounts of urine produced in the disease. Mellitus, from mel, meaning honey, for the sweet taste of the urine due to the abnormal presence of glucose. It was common to use all the senses in ancient diagnostics which yielded this valuable clue regarding diabetes
TYPE II DIABETES, SERIOUS BUSINESS
Non-insulin dependent diabetes mellitus is also known as Type II or adult onset diabetes. NIDDM is perhaps more "serious" than IDDM because so many people who have it treat themselves so poorly. Because NIDDM is controlled with diet and oral medication, people treat it with less attention than it deserves.
Consider these facts about NIDDM from the Johns Hopkins Medical Letter:
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The number of cases of NIDDM mushroomed from 10 million in 1983 to 15 million in 1995.
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Half are undiagnosed.
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If untreated, blindness, heart disease, kidney disease, amputations and nerve damage can occur.
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Diabetes is the 4th leading cause of death by disease in the U.S.
The beginnings are insidious and gradual. Ninety percent of all people with NIDDM have morbid obesity (20% over ideal weight). Most patients are diagnosed after age 45 but do not consider their condition serious until age 60.
TESTS
A screening test for glucose is readily available If a reading is high, your personal doctor will order different blood tests to determine the diagnosis. If you have diabetes, your doctor will give you a diet and an exercise prescription. Oral medication will follow if diet and exercise are not enough. These medications work to either enhance the action of the insulin you still produce or to slow the digestion of carbohydrates you have consumed. You will probably have many follow up appointments at first, until you adjust to your new lifestyle.
Lifestyle changes are preferable, easier and less expensive. You must exercise and it is never too late to begin a healthy program. Weight loss, healthy eating, exercise, medication and a positive mental attitude are the only way s to prevent deterioration and complications from diabetes.
NO BORDERLINE
There is no such thing as a "borderline diabetic". The attitude conveyed by this term is that "it is not that bad". Diabetes is a serious health condition with which you can live quite well. If YOU want to live, YOU have to do some work. YOU have to learn all there is to know about your condition. YOU have to eat right, take your medicine, exercise and rest. Want to know more? Here is a list to get you started.
INFORMATION AND LIFESTYLE CHANGES
The first source of information or assistance is your physician or nurse. If you are sincerely interested in taking your diabetes seriously, they will be very happy to answer or research answers for you.
The library in your town is the second stop for additional information. Much information is available that is non-technical, meant for people who want to understand the concepts without necessarily wanting to understand the technicalities.
A third source of information, is the Governor’s State University Library. (534-5000). Because there are two health schools affiliated with the University, their library holdings about health are larger than local sources. Reference librarians exist to help patrons find resources.
The fourth source is the American Diabetes Association, (312) 346-1805. If you are reading this online, go to the American Diabetes Association website, www.ada.org
The final words about diabetes relate to maintaining your resolve and humor about living with a chronic illness. Yes, it is an adjustment, but adjusting is a better choice than allowing an unnecessary disability to occur.
For further information:
American Diabetes Association
American Dietetic Association