2014-08-30

Non-Insulin Dependent Diabetes (Type 2 Diabetes)

What is the cause?  How do we prevent and treat it?

Non-Insulin dependent or Type II diabetes has reached epidemic proportions around the world.  Over 50% of the population that has this disease does not know they are affected.  Elevated blood sugars over a long period of time begin to effect bodily organs; including the heart, kidneys, eyes, liver, and peripheral vasculature and nerves.  There is a increase in heart disease (angina, heart attack), stroke, blindness, fatty liver, kidney failure, lack of circulation to the lower extremities leading to gangrene and amputation of the lower limbs, and decrease pressure and pain sensation of lower extremities due to peripheral nerve damage.  There can also be pain in the extremities due to nerve damage.
Immediate initiatives must be taken to treat high blood sugars.  Normal blood sugar control occurs due to secretion of insulin by pancreatic Beta cells.  Type 2 diabetes is caused by an inadequate amount of insulin being released, and insulin resistance.  Insulin works by attaching to receptors (special areas on the surface of the cell) on muscle and fat cells.  Glucose is picked up and transported inside where it is utilized for energy.  Patients with Type 2 diabetes are not able to transport the glucose into the cell.  This is called “insulin resistance”.  There are many theories to why this occurs.  What we do know is the following:

1) Type II diabetes is related to obesity.  Obesity has increased astronomically in the past 10 years.  As obesity has increased, so has the diagnosis of Type II diabetes.

2) Weight loss decreases level of blood sugars.

3) Decreasing fat intake reduces the amount of glucose in the blood

4) Exercising increases a certain protein in muscle that causes the cells to increase their uptake of glucose into the muscle cell which decreases blood sugars

Let’s briefly take a look at fat intake as a factor leading to insulin resistance.  A single human cell is made of many parts which carry out their specific responsibility in keeping the body alive and functioning properly. When a certain part of the cell stops functioning properly, the cell will eventually die.  Not only does this process affect one cell, it can do so in all the cells of the body thus resulting in death. All cells need glucose for energy which are necessary for the body to maintain strength, fight bacterial and viral infections, produce blood, live, breath, move, detoxify and excrete waste from the body.  Mitochondria are the specific portion of the cell that is important to convert glucose into the forms of energy that the body needs to live.  There are times when glucose is not available and the mitochondria use  fat cells to produce energy for the body.  This way of producing energy burns a lot more calories and takes more work in order to produce the same amount of energy than by utilizing glucose.  Under normal circumstances when  glucose is available, the mitochondria  prefer utilizing  it.  In Type II diabetes, the mitochondria continue to use fat as an energy source and not glucose.  There seems to be a “signal” that the mitochondria sends  to the surface of cells to prevent them from taking up glucose.  There is plenty of insulin, but the signal that the mitochondria sends out in the presence of fat cells over rides the presence of insulin.  This is the ”insulin resistance”  that is seen and  the glucose level in the blood increases.  With the higher amount of energy and work that it takes for the mitochondria to produce energy by utilizing fat, they burn themselves out (stop working properly) 

Type II diabetes can be treated in its early stages by exercise, decreasing carbohydrate and fat intake.  If the excess excretion of insulin does not decrease, and there is not a decrease in the mitochondria burning fat to produce energy, the Beta cells of the pancreas, and the mitochondria will eventually die.  This is when insulin will be required to control the blood sugars, organ failure will occur, resulting in death. 
It is my hope that everyone will be screened for abnormal elevation of their blood sugars and that preventive measures will start today to reduce or prevent the detrimental complications that occur with this disease.

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