Diabetes Understood: Mechanics, Symptoms and the Importance of Proactive Teamwork

One of the most important public health problems in America is the dramatic increase in the incidence of Type II diabetes mellitus. This disease can cause short-term severe health problems, but more often results in severe long-term health risks. When diabetes affects the kidneys, the eyes, the heart, the blood vessels and the brain, often these events will cause permanent organ damage.

Diabetes is described in the ancient world, first seen in Egyptian writings from about 1500 BC. “Diabetes” means “heavy urine”, as the disease, when untreated, causes frequent urination (polyuria) and thirst (polydipsia). “Mellitus” is a Roman word that refers to the sweetness of the urine in people with diabetes, urine that contains too much sugar or glucose.

How does diabetes occur? It is a disease of metabolism, the biochemistry that allows our bodies to convert sugar, or glucose, in our food to energy that our body cells can use to grow and sustain themselves.

The sugar that we eat gets absorbed through our gut, and enters the bloodstream. In order to be of use to us, however, the glucose needs to cross the membranes around cells. The molecule that transports the glucose is called insulin.

Insulin is a protein made by special cells in the human pancreas. The pancreas is a small organ in the back of the abdomen, and it produces the molecule, or hormone, insulin when the sugar level in the blood increases. The insulin is released into the bloodstream and the gut, and does its magic.

In the last 40 years, Type II diabetes has become an epidemic. In this problem, the pancreas actually produces more insulin than normal. But the insulin doesn’t work as well as it should in getting glucose into the cells, because the cells have developed “insulin resistance”. And the cause of this resistance? Obesity.

Type II diabetes is associated with a much higher incidence of heart disease due to atherosclerosis, or blocked arteries, and disease of the arteries also due to cholesterol deposition inside of artery walls. It is a major cause of kidney failure, leading to the need for dialysis, and blindness due to disease of the retina. It can also cause problems with nerve transmission, leading to numbness or “pins and needles” in the feet, as well as increasing susceptibility to infection.

It is vitally important to identify and treat diabetes. A simple blood test will give the answer. Modern treatment has improved dramatically, and there are now many different options of medication, many oral, to treat diabetes.

In spite of all of the terrible problems that diabetes can cause, modern medications, along with diet and exercise, have markedly improved the prognosis for most patients. Anyone concerned that they may have diabetes should get tested. Anyone with a diabetes diagnosis should create a good partnership between themselves and their healthcare provider. It will go a long way toward allowing for a long and happy life.

Arnold B. Meshkov, M.D., is board certified in internal medicine, cardiology and echocardiography. For more information, call 215-517-1000 or visit AbingtonCardiology.com. November 2017

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