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Type I Diabetes
Although there are a few types of diabetes, Type I and II diabetes are the most common in the humans, because of the
amount of people with these 2 types. Note that there are more individuals with
type II diabetes than type I, as we shall see why as we read on.
Type I diabetes has several names, as we list below.
diabetes mellitus
insulin-dependant diabetes (abbreviated IDD)
juvenile onset diabetes
brittle diabetes
growth-onset diabetes
ketosis-prone diabetes
These names all refer to type I diabetes and some of the names have evolved
as descriptive terms and can be misleading. For example, juvenile onset diabetes
is used synonymously with type I diabetes. However, all juveniles with diabetes,
do not have to have type I diabetes, as we shall discuss.
Type I diabetes is simply a disorder or carbohydrate (sugar) metabolism.
When we consume sugars, they are normally absorbed through the intestines, and
carried into the blood. Once sugars (eg., glucose) are in the blood, they are transported
and stored in the liver, and muscles for later use. Some of the glucose is immediately
used as fuel. For example, the primary fuel for the brain is glucose, and without it,
we would lapse into unconsciousness within minutes. Therefore, we can see how important
glucose is and thuat there must be a constant level maintained in our blood at all times,
even when we haven't eaten much.
The levels of sugar in our blood are controlled by a few hormones.
Insulin is
the hormone responsible for storing sugars when we have just consumed a large
sugar (carbohydrate)-containing meal. Insulin prompts the sugars to leave the
blood and become stored primarily in the muscle and liver. Of course, the
level of insulin secreted is also controlled by the amount of sugar we consume. If
too much insulin was secreted by the pancreas, then too much sugar would be removed
from the blood and thus, blood sugar levels would fall to dangerously low levels.
This of course, is dangerous since the brain requires specific blood glucose levels
to supply it with energy. Therefore, we can see that blood sugar levels must
be carefully maintained. This is another example of
homeostasis.
In life,
many disease states develop from either too much or too little of something and
diabetes is no exception. In type I diabetes, there is an insufficient supply of
insulin. As we discussed, insulin is needed to maintain storage of glucose.
Therefore, if we do not make enough insulin for any reason, sugar levels will not
be able to be properly maintained. When this occurs, sugars cannot be effectively
removed from the blood, and accumulate. This is detrimental, because increased amounts
of sugars in the blood can cause problems for the walls of blood vessels in a
fashion similar to cholesterol Sugars can stick to the walls of blood vessels,
and hence, damage organs over time. Excess sugars can also bond to cholesterol and
"cross-link" it to the wall of a blood vessel, contributing to the artery clogging
process we know as atherosclerosis.
"Why do type I diabetics have less insulin?"
Insulin is produced in a small organ called the pancreas. The pancreas
is seated adjacent to the stomach and is the size of a "small strip of
steak". Insulin as well as other hormones are produced in the pancreas.
Wnen needed (eg., after a meal),
the pancreas liberates insulin, which is quickly used up in the blood. The
pancreas, like other organs in the body, is susceptible to insults such as infection,
other disease processes, and even chemicals that we may encounter (eg, ethanol or drinking
alcohol for consumption). Viruses, such
as the mumps, and others have been known to cause damage to the pancreas. If the pancreas
is damaged, then it cannot produce sufficient amounts of insulin. Of course, the degree
of diabetes, depends on how much damage was suffered by the pancreas. For example, if a
person had a partly damaged pancreas, then it may still produce 50 percent of the insulin
required by the body. The rest would have to be supplied by injection. This is why
type I diabetes is also called insulin-dependant diabetes (IDD). In other words, the
individual "depends" on extra insulin from a needle to obtain a sufficient amount.
If an individual with IDD did not obtain the extra insulin, then blood sugar levels would
rise. And this is how we monitor a person with IDD. If we take a small drop of
blood from the finger, we can check how much sugar is in it. If the level is too
high, we know that either the person is eating more sugars than they need, or is not
getting enough insulin at the correct times. These blood tests are very helpful for
monitoring the blood sugar levels. And this also helps long term. If a person keeps
their blood sugar levels near normal over the years, then they can
maintain very good health. This is important and is sort of "preventative
medicine". We can easily check our sugars by purchasing a "blood sugar testing
kit" from our local pharmacy or chemist. These kits come with a sterile lancet used
to "prick" or "poke" the finger and obtain a small drop of blood. The drop of blood is
placed on a small strip of paper and inserted into the battery operated machine that comes
with the kit. The machine does all the work by "detecting" the amount of sugar in the
blood and digitally displaying it for us to read. You can also purchase strips that can
test the urine for sugars, etc.
What is the normal level of blood sugar?
The normal level of glucose in the blood is between 3 and 6 millimoles per litre (Well,
over the last few years, the value has been changed from 6 to 8, probably due to
reflections on western diets).
This means for each litre of blood, the average person has this much glucose in it.
When the level of glucose rises aboue the norm, we call it hyperglycaemia (huperglyemia).
Hyper means "greater than", and simply tells us that the person has a greater than
normal amount of sugar in the blood. If a person take too much insulin accidently,
they can cause too much sugar to leave the blood, and this is called hypoglycaemia
(hypoglycemia). Hypo simply means "less than". Many people naturally suffer from hypoglycaemia,
or low blood sugar as well. When their blood sugar levels fall, they
can develop symptoms of hypoglycaemia, such as irritibility, depression,
increased heart rate, weakness, sleepiness, and sweating.
For many of these people, simply cosuming some sugar or a light carbohydrate-
containing snack will correct the hypoglycaemia. However, clinical investigations
are always recommended, in the case of other possible metabolic disorders.
Type II Diabetes
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