Visions of Sugar (Plums)

“Sugar diabetes” or diabetes mellitus is the common condition wherein the body is unable to correctly process sugar.  There are two major subgroups of diabetes.  Type I is juvenile-onset or insulin-requiring diabetes.  Type II is adult-onset or non-insulin requiring diabetes.  Type II diabetes is becoming more common, even in younger age groups.  This is mostly related to an increase in obesity, in children and adults.

Our bodies depend on glucose (“sugar”) for energy.  Glucose is available in the foods we eat.  The body breaks down carbohydrates, proteins and fats into glucose for immediate energy use or converts it to a storage form for later use.  Eating stimulates the body to produce insulin, which is made in the pancreas.  This hormone allows the glucose you’ve eaten to get into the cells where it can be used as energy.  Without insulin, the glucose stays in the bloodstream and cannot get into the cells for energy production.  

This is the basic problem in diabetes.  Type I diabetics don’t make insulin and require an external source (daily shots).  Type II diabetics may still be producing insulin, but their bodies are less responsive to it.  They are said to be “insulin resistant.”   Simplistically, insulin is a key to unlock the door into each cell, allowing glucose to go in.  In the case of Type II diabetes, the locks have been changed and sugar stays in the bloodstream.

Most early symptoms of diabetes are due to this excess of sugar in the bloodstream.  A high blood sugar level draws fluid out of the cells and into the circulation.  This leads to an increase in urine output (polyuria).  Loss of fluids leads to excessive thirst (polydipsia).  Further, since the cells are “starving” for energy, the individual may experience fatigue, weight loss and feel hungry (polyphagia) all the time.  Other symptoms directly related to high blood sugar levels include blurred vision, frequent yeast and bacterial infections, and slowed healing of wounds.   

Individuals with Type I diabetes are usually diagnosed young, peak age 11-13 years old.  Without insulin this disease is fatal.  The lack of insulin, and therefore glucose to the cells, causes the body to metabolize other substances to try to meet its energy needs.  These products cause toxicity, excess acid (acidosis) and death.  This is not the case in Type II diabetes.  These individuals generally will not experience acidosis, but can still experience severe symptoms and complications of high sugar.

The cause of diabetes is unknown.  Individuals with Type II diabetes usually have a family history of the disease.  Also, persons with high blood pressure, low HDL (good) cholesterol, high triglycerides, and women who experienced high sugar readings during pregnancy are at higher risk for the disease.  Obesity tends to play a strong role in the development of Type II diabetes. Anyone who is overweight and has any of the above risk factors should take active steps to prevent progression to diabetes.  The most effective means of reducing your risk is regular daily exercise and healthy diet.

Many individuals with early Type II diabetes may not have obvious or severe symptoms.  This, unfortunately, causes some to down-play the seriousness of their disease and the need for tight control of their sugar.  However, diabetes is the leading cause of blindness and kidney failure and contributes to the early development of heart and vascular disease.  This is why early detection, prevention and proper treatment are essential.  

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


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