Diabetes Dangers

You may have heard that diabetes is one of the fasting-growing diseases in this country. Why the sudden popularity – is this the medical equivalent of a pet rock? Should we worry or invest?

Here we’re talking about Type 2 diabetes, more commonly called adult-onset diabetes. This is a whole different beast than Type 1 or juvenile diabetes (insulin dependent). It’s 10 times more common, and thankfully, a lot less serious than insulin dependent diabetes.

Why talk about Type 2 diabetes? Because it’s largely preventable.

A few basics: glucose is a particular type of sugar that your body runs on. It is the common fuel for everything that takes energy, from running and jumping to simply thinking. It’s the gas in your car. Your body is understandably particular about having enough circulating glucose; you may need some at any moment, like making the next heartbeat.

Sugarphoto © 2006 Uwe Hermann | more info (via: Wylio)

A large percentage of what you eat is simply to supply fuel for your body’s needs.

Glucose in the blood stream does you no good – it needs to get into your cells, which are the little engines of life. Insulin’s job is to make glucose go into cells where it provides energy for all of life’s processes.

When there is too much glucose in the blood stream, the kidneys try their hardest to retain it, but it leaks out in the urine. This leakage of glucose brings water with it, resulting in the usual symptoms of diabetes: thirst, frequent urination and weight loss.

Why weight loss? You are urinating sugar. On the surface this seems the ideal situation – eat and drink all you want, and get rid of the excess sugar. Where do I sign up?

Unfortunately, this is not the type of weight loss you need. You want to lose fat, not fuel. Also, the complications of diabetes make this a much less desirable diet plan. Think heart disease, kidney disease and stroke.

So why does being overweight lead to diabetes anyway?

Obesity causes resistance to insulin. It changes the cells so the insulin you have doesn’t work as well. Since the insulin doesn’t work as well, you transport less fuel into your cells. The cells are literally starving while the blood glucose level climbs.

An interesting segue: cyanide, the poison used in the gas chamber, is a drastic example of a similar mechanism. In the presence of cyanide, your cells can’t use the fuel you have. You starve to death in the land of plenty.

Kind of makes you think twice about that donut, doesn’t it? Sorry about that.

So if you are obese and you don’t want diabetes, you can make more insulin or eat less food (glucose). Unfortunately, there are limits to creating more insulin. The cells can become so resistant to insulin that you can’t make enough to do the job.

So why is diabetes such a bad thing anyway? To put it simply, high blood sugar wreaks complete havoc on your blood vessels. The tiniest blood vessels get the worst of it. They get inflamed and plug up (atherosclerosis). There are lots of tiny blood vessels in the kidneys, the brain and the heart. When these blood vessels plug, the cells they supply die. Some of those cells are my favorites – the ones in the brain, heart and kidneys. When these cells die, it’s called a stroke, a heart attack or kidney failure. There are also some tiny vessels in the eye, so your sight doesn’t fair too well either.

You probably have heard that this type of diabetes runs in families. There is an inherited tendency for Type 2 diabetes. If one of your parents is diabetic, you have a much higher risk of developing Type 2 diabetes. It is only a tendency – it is far from a certainty. Type 2 diabetes is unusual in normal weight adults, even with a family history of diabetes. It’s difficult to change your parents, but you can certainly do something about excess body weight.

So now you know enough about Type 2 diabetes to take charge of your fate. A little care about diet and exercise will keep you on friendly terms with your favorite cells.

Take care,

Dr. B

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