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November 09, 2007

National Diabetes Awareness Month

220pxinsulincrystalsNovember is National Diabetes Awareness Month and I'm going to observe it this year.

I'm going to post a little bit about diabetes, and I'm also going to--this month--finally get on the insulin pump. I have an appointment with a new doctor on Monday and I'm going to get the ball rolling. Yay!

But first, what IS diabetes? I find that most people don't know, and don't realize that they don't know because it never occurs to them to think about it. It has something to do with not eating sugar, they think. You can't eat sugar.

Frankly, I've heard some really stupid things about diabetes, and seen even stupider things on TV and in the movies (there was a scene from Night Court where someone went into insulin shock, so they cured her by giving her more insulin. Nice logic there.)

Okay, here goes: you know how when you eat, your food is broken down in your mouth, stomach, and intestines? The protein is broken down into amino acids and you get vitamings and mingerals, and all that good stuff? Plus fat?

Well the most biggest part of your food is carbohydrates. Bread, pasta, corn and beans, taters and roots. Fruits. All of these things deliver carbs. And sugars are also carbs, of course. Sugar is a kind of carb. Everybody knows this, after Atkins and South Beach.

What a lot of people don't seem to know is that ALL carbs either get broken down into sugar (glucose) or get passed through your system and out the other end (fiber). The glucose that was your sandwich or your mac 'n' cheese is absorbed from your intestine into your bloodstream, and circulates around your body as ... blood sugar! (or blood glucose, "BG".)

The BG is taken up by the body's cells out of the bloodstream and burned for fuel (or stored in the liver and muscles for fuel later.) That's the simple version, anyway. But this doesn't happen automatically. For the cells to receive and use the blood glucose, the hormone insulin has to be present. Insulin binds to the cells and activates their receptors so that they can use sugar. Without insulin, the BG just circulates and circulates without being used, until it is eventually excreted out the usual channels (urine, sweat, tears). Without insulin, no matter how much you eat, you starve to death.

Diabetes is, quite simply, a disease that keeps insulin from triggering your cells to receive sugar.

There are three ways this can happen, and therefore, three kinds of diabetes:

  1. Type 1: the body's immune system identifies the beta cells in the pancreas that produce insulin as foreign, and release antibodies to attack them. Over time, they destroy all or part of the body's ability to produce insulin. Type 1 diabetes is caused by the lack or insufficiency of insulin.

    Type 1 requires insulin injections for treatment and is therefore often called "insulin-dependent diabetes."

    Also, Type 1 tends to occur in children or younger adults who are otherwise healthy, is genetic, and is probably triggered by a standard viral disease like a flu. Type 1 is not preventable with lifestyle changes. (There are some experimental treatments that can be given to people at great risk for Type 1 diabetes, but this involves compromising your immune system and/or taking preventive insulin shots.)

    About 10% or less of chronic diabetics are Type 1.

  2. Type 2: for a variety of reasons, the body becomes desensitized to insulin, and can't use it effectively. This is often accompanied, later, by some impairment of ability to produce insulin. Type 2 is caused by the inability to use insulin.

    Type 2 can be treated with, in order of severity: diet and exercise, drugs to stimulate insulin production, insulin injections to supplement insulin production.

    Type 2 is also genetically influenced. Type 2 is the kind of diabetes that we are seeing a surge in as a result of the obesity epidemic, and can be influenced or even caused by lifestyle. "Can be," I said, though. Some people have such a strong predisposition to Type 2 that they can be doing everything right and still get it. And some people can be obese, and do everything wrong, and NOT get it. So there are no guarantees.

    90% or more of chronic diabetics are Type 2.

  3. Gestational: experienced by pregnant women with a genetic tendency to Type 2 diabetes. Hormones present during pregnancy cause them to become desensitized to insulin, as in Type 2. Usually resolves after birth.

There's a huge confusion between Type 1 and Type 2, and people are starting to shame diabetics because of misperceptions. So let me repeat: TYPE 1 DIABETES HAS NOTHING TO DO WITH LIFESTYLE AND IS NOT PREVENTABLE.


The other big misconception is that insulin is a cure for diabetes. If you've read the above, you'll have noticed that taking an insulin shot doesn't seem like something that'll cure anything. The cures would have to involve: for Type 1 some way to keep the immune system from destroying the beta cells, and for Type 2 and Gestational some way to make the body sensitive to insulin again.

All injected insulin does is mimic the natural action of the body ... mimic it badly, I might add. It's much easier for your body to regulate itself automatically than for you to do it by hand, consciously.

Okay, I'm bored with this topic now. Will write more later.

By the way, I'm a Type 1. Have been since I was 11.

Oh, and the image at the top is of insulin crystals. Pretty, no?


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hey, thanks for posting this, wonder woman. there's so much media hype about the diabetes epidemic, but so little fact included in that hype. it's really important to hear folks talking rationally about this disease.

and best of luck with the new pump!

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