Diabetes mellitus is a metabolic disorder in which insulin – a hormone secreted from the pancreas – is either unavailable or ineffective in fulfilling its role. Its job is to enhance cellular uptake of glucose (sugar), amino acids, and fatty acids after eating. Some examples of complex carbohydrate sources are cereals, bread, and grains, and a couple of examples of simple carbohydrate sources are juices and desserts. When we eat these foods, they are broken down to their most simple form – glucose – to nourish our cells. If the body’s ability to secrete or manufacture insulin is impaired, we cannot benefit from the nutrients we consume.
Types of Diabetes
There are two types of diabetes mellitus. Insulin-dependent diabetes mellitus (IDDM), also known as Type I, typically occurs in people younger than 20. The pancreas loses the ability to produce insulin, and the person must inject insulin to provide their cells with adequate nutrition. The second type, non-insulin-dependent diabetes mellitus, or Type II, typically develops in persons older than 40. Initially, the pancreas produces insulin; however, the cells become insulin-resistant and respond less sensitively. Suppose a person with type II diabetes is careful and regulates her blood sugar through diet and regular exercise. In that case, she may never need oral insulin-producing agents, which enhance the body’s insulin production. If she does not pay attention to her lifestyle, however, she, too, may end up injecting insulin somewhere down the road.
Risk factors for NIDDM are genetics, age, and obesity. Obesity increases NIDDM risk because an obese person requires higher amounts of insulin to maintain normal blood glucose levels. As body fat increases, insulin resistance increases, which results in impaired glucose uptake. Not all obese people develop NIDDM, but it can increase your risk for it and other health problems.
In both types of diabetes, the impaired glucose uptake by the cells leads to hyperglycemia or high blood sugar. This means the glucose remains in the bloodstream rather than entering the cells. The symptoms of hyperglycemia are fatigue, acetone breath (“fruity” in smell), glucose in the urine, increased urination, intense thirst, and weight loss. If hyperglycemia continues, the cells cannot get enough energy, and the body breaks down fatty acids for fuel. As a result, ketone bodies are made by the liver and accumulate in the blood. If too many ketones accumulate, a potentially fatal diabetic coma can result.
Meals and Snacks
A person with diabetes has to eat regular meals and snacks to maintain blood sugar levels. Otherwise, they can become hypoglycemic or have low blood sugar levels. This occurs when meals are skipped, after heavy physical activity, when not enough food is eaten, or from too much insulin. Signs of low blood sugar are confusion, dizziness, irritability, nervousness, shakiness, shallow breathing, and sweating. This is known in a person with IDDM as insulin reaction or insulin shock. The way to correct this is by consuming food with easily absorbed glucose: juices or a piece of hard candy. Checking the blood sugar to see if it is back to within normal limits is extremely important. If not, eating additional carbohydrates will help restore blood sugar to normal. Otherwise, if care is not taken to get the blood sugar back to normal, the person can go into shock and die.
Many health complications can result from diabetes if a person does not take proper preventative precautions. Atherosclerosis, the hardening of the arteries, is common in people with diabetes. Diminished blood flow can lead to heart attacks or strokes. Combined with obesity and high blood pressure, the risk for heart attack or stroke increases greatly. The blocked arteries also can reduce circulation to the legs and feet. A loss of circulation to the limbs can cause tissue death and ulcers. If it is not caught and treated quickly, the limb may have to be amputated.
Another complication of diabetes is poor blood circulation through the capillaries. The result is further reduced blood supply to organs, such as the kidneys, or vision loss. Many people with diabetes end up suffering from kidney disease and need transplants or must go on dialysis.
Nerve tissue also takes a beating from diabetes, resulting in a condition called neuropathy. The nerve tissues deteriorate, which initially creates a painful, prickling sensation in the feet and hands. Eventually, a total loss of sensation in the limbs occurs. Injuries to the feet are most common, and if unnoticed or untreated, can become life-threatening.
A person with diabetes needs to approach this condition seriously – too much is at stake. The way to do this is by meeting with a registered/licensed dietitian and her doctor or a nurse certified in diabetes education. The dietitian should create a customized meal plan, which breaks down daily needs. The doctor or nurse should educate the patient on the medication (if needed) taken and how to regulate it to avoid high and low blood sugars. They also should teach how to test the blood sugar to see how high or low it is. Testing your blood sugar is very important! This helps regulate your food and insulin intake.
Exercise is crucial to preventing neuropathies and vascular problems. Exercise has an insulin-like effect and can even reduce the amount of insulin needed. However, it is really important to coordinate meals and insulin dosages with exercise. Be sure to review proper procedures with a doctor and dietitian to maintain blood sugar levels during a workout.
A person with diabetes must learn how to balance meals and snacks. A well-rounded meal with protein, carbohydrate, fruit, vegetables, dairy, and fat sources should all be incorporated. As mentioned, a dietitian should create the right meal plan for you, and you should learn how to balance the amount of carbohydrates, simple and complex, eaten at every meal.
People used to think a person with diabetes could not have sugary foods. All carbohydrate sources – fruit, bread, pasta, juice, candy, etc. – are broken down in our bodies to glucose. The source of carbohydrates, or sugar, is not the issue. The issue is moderation and regulation. A person with diabetes can incorporate regular sweet foods in their diet, but they should have good control over their blood sugars and understand what diabetes is all about. There are many diabetics out there who don’t understand what the condition is and choose not to educate themselves on the subject. Ignorance is not bliss in this situation! Someone living with diabetes can enjoy a very normal life and eat all the wonderful foods out there, but he has to be patient and willing to learn.
The seriousness of diabetes mellitus cannot be stressed enough. Prevention is so important for those who have this condition. Continuous education through current research is very important as well. Literature is available through the American Diabetes Association.