Diabetes mellitus, or diabetes as most of us know, is a disorder in which the islets in the pancreas fail to secrete adequate insulin, or it can be the body’s decreased ability to use insulin.
Diabetes mellitus, in Greek, means ‘a passing through of sweetness.’ This relates to the passing of sugar-rich urine — a distinctive symptom of the disease.
Diabetes is a serious problem. It is sometimes fatal. It is the leading cause of death worldwide too because of the damage it causes to the cardiovascular system [heart].
In a healthy individual, food is digested to release glucose into the blood. This causes the beta cells in the pancreas to release insulin into the bloodstream. Insulin, as you know, helps in the transportation of glucose from the blood to the liver and muscle cells.This can be released later into the blood for metabolism. When the pancreas fails to produce adequate amounts of insulin, or if there is insulin ‘resistance,’ diabetes could set in. Either way, the consequences are dangerous.
There are two types of diabetes, insulin-dependent diabetes mellitus [IDDM]. This is also known as juvenile-onset diabetes, or type-1 diabetes, and non-insulin-dependent diabetes mellitus [NIDDM], also known as maturity-onset diabetes, or type-2 diabetes.
Environmental and genetic factors contribute equally to either forms of diabetes. However, as life’s several paradoxes would underscore, the precise cause of diabetes, apart from what we know, is not known yet.
In either types, there is a set norm: there is excess sugar in the blood, or hyperglycaemia. This needs to be expelled by the kidneys.
PRIMARY SYMPTOMS
- Excessive thirst
- Frequent urination
- Weight loss
- Excessive hunger.
In type-1 diabetes, the body’s immune system damages the pancreas beta cells resulting in low insulin levels.
To prevent death, insulin injections, as you may know, are needed. This is also one reason why it is called insulin-dependent diabetes mellitus [IDDM].
As a matter of detail, ‘early-onset’ diabetes is most common in people under 20 years old. It persists throughout life. Now, you will understand why it is called juvenile-onset diabetes.
Do you know that in untreated IDDM individuals, the cellular metabolism is similar to that of a starved person too? Can anything be dangerous than this?
This state is present because insulin is not available to help glucose reach into the body cells to produce the fatty acid, adenosine triphosphate [ATP], for your energy needs. As you may know, most cells use fatty acids.
Triglycerides [you have heard the expression] are stored in adipose [fat] tissues which are catabolised to yield fatty acids and glycerol. The breakdown of fatty acids causes a by-product of organic fatty acids called ketones, or ketone bodies. The build-up of ketones in certain diabetics causes a fall in blood pH. It is called ketoacidosis.
When left untreated, it can cause diabetic coma and death.
Weight loss is often a result of the breakdown of stored triglycerides. When lipids [e.g., cholesterol] are deposited on the walls of blood vessels, they are transported by the blood from the cells’ storage depots. This leads to atherosclerosis [hardening of the arteries] and heart problems, such as:
- Cerebrovascular insufficiency [decreased blood supply to the brain]
- Ischaemic heart disease [reduced blood supply to the heart muscle]
- Peripheral vascular disease [related to blood vessels located outside the heart and brain]
- Gangrene [tissue death]
- Severe kidney problems from damage to renal blood vessels
- Loss of vision due to cataracts [clouding of the lens in your eye], because excess glucose attaches itself to lens proteins
- Damage to the retina [light sensitive tissue lining the inner surface of the eye] — and its blood vessels. This could lead to blindness.
There is no need to panic, provided you pull up your socks and redefine, or reinvent, yourself and your lifestyle.
Type-1 diabetes is often treated with a classical, time-honoured method of self-monitoring blood glucose levels, up to six-seven times a day, insulin injections, up to three times a day, in certain individuals, exercise and regular meals containing 45-50 per cent carbohydrates and less than 30 per cent fats.
This regimen will help keep the levels of insulin and sugar in the blood normal.
While it may possible to have a pancreas transplant today, the fact is immune-suppressive medications must be taken for life. This is because not everyone can opt for transplant procedure though.
Eating foods containing carbohydrates such as white rice, potatoes, bread and cereals will ‘up’ one’s blood sugar and insulin levels. This sugar-raising effect of a food is called the glycaemic index. This is used to measure how quickly carbohydrate is absorbed by the body.
Studies have found that people with type-1 diabetes have better control over their blood sugar levels by following a low-glycaemic-index-diet.
It may also be mentioned that diabetics with neuropathy [diabetic nerve damage] have found their condition improved by following a vegan type of diet — i.e. avoidance of all meat, eggs and dairy products.
When you avoid meat and dairy products, the chances of developing heart disease and kidney problems, which diabetics are susceptible to, are relatively reduced.
As for diabetics who smoke, they are definitely at a higher risk of developing heart disease and kidney problems.
Diabetics who consume excess amounts of alcohol are, of course, at a still higher risk of developing problems with their eyes.
DIET
Good, healthy, balanced nutrition helps best in diabetics.
The following food supplements have been suggested to help in type-1 diabetes:
- Acetyl-l-carnitine and alpha-lipoic-acid [ALA] [especially in diabetic neuropathy]
- Antioxidant complexes
- Biotin
- Chromium picolinate
- Co-enzyme Q10
- Evening primrose oil
- Flaxseed
- Fish oil [EPA/DHA]
- L-carnitine
- Magnesium
- Selenium
- Vitamin A
- Vitamin B1 [thiamine]
- Vitamin B3 [niacinamide only; for prevention of type 1 diabetes]
- Vitamin B6 [pyridoxine]
- Vitamin B12 [cobalamin]
- Vitamin C
- Vitamin D
- Vitamin E [for prevention of diabetic retinopathy and neuropathy]
- Zinc.
TYPE-2 DIABETES
Non-insulin-dependent diabetes mellitus [NIDDM], or type-2 diabetes, is known as maturity-onset diabetes too. It typically occurs in obese individuals over 30 years of age, albeit some obese children have been diagnosed with type-2 diabetes due to lack of exercise and poor diet.
The clinical symptoms of NIDDM as also high glucose levels can be controlled by:
- Exercise
- Weight loss
- Diet.
There are some speciality medicines that could be used to stimulate the pancreatic beta cells to produce adequate insulin. Speak to your physician today to find out what meds suit you best.
Some type-2 diabetics have sufficient amounts of insulin in the blood. Diabetes occurs in them not because of shortage of insulin, but because cells become desensitised due to ‘down-regulation’ of insulin receptors.
Ketosis rarely develops in NIDDM.
Eating foods containing carbohydrates, as mentioned below, will elevate blood sugar and insulin levels.
- White rice
- Potatoes
- Bread
- Cereals.
This sugar-raising effect of a food, as you now know, is called the glycaemic index. It measures how quickly carbohydrate is absorbed by the body.
Individuals whose diet consists of a high amount of sugary foods and foods with high glycaemic index are more prone to develop type-2 diabetes.
In people, whose diet consists of a high amount of foods which have a low glycaemic index, there is a low risk of developing type-2 diabetes.
Typical foods with a low glycaemic index that you should eat are as follows. You would also do well to make them a part of your daily diet plan.
- Oats
- Fruits
- Beans
- Peas.
Most important: if you wish to prevent or control type-2 diabetes, it is best to:
- Avoid processed and fast-junk/snack foods which are typically high in sugar
- Eat high fibre whole foods such as oats, fruits, vegetables [e.g., bitter gourd, or karela] and seeds which have a low glycaemic index
- Regular exercise, especially walking for 30 minutes a day, 4-5 days a week, to reduce excess weight is fundamental
- High fibre supplements, such as psyllium [isabgul], guar gum, oat bran, pectin and fenugreek seeds, are beneficial to people suffering from type-2 diabetes
- Stop smoking
- Cut down; better limit, or avoid, alcohol.
The following supplements are often beneficial in type-2 diabetes:
- Alpha-lipoic-acid [ALA]
- Biotin
- Brewer’s yeast
- Chromium picolinate
- Co-enzyme Q10
- Evening primrose oil
- Fenugreek [seeds]
- Fish oil [EPA/DHA]
- Flaxseed
- Fructo-oligosaccharides [FOS]
- Inositol
- L-carnitine
- Magnesium
- Manganese
- Medium-chain triglycerides
- Multivitamins and multiminerals
- Psyllium [isabgul]
- Quercetin
- Starch blockers
- Taurine
- Vanadium
- Vitamin B1 [thiamine]
- Vitamin B12 [cobalamin]
- Vitamin B3 [niacin]
- Vitamin B6 [pyridoxine]
- Vitamin C
- Vitamin D
- Vitamin E
- Zinc.
The best thing to do is simple. Speak to your doctor today to formulate a personalised diet and supplement plan, along with appropriate medications, to manage your diabetes well. This is also simply because new advances in medicine is keyed to the fact that that most diabetics can lead long, active, vibrant, and healthy lives.
