Some of the most important questions one can ask in life are Who?, What? When? Where? How? and Why? In the field of healthcare these questions are equally important. Let us ask these questions in regard to diabetes mellitus (the complications of elevated blood glucose).
Who? Diabetes can occur in other mammals, other than humans. It can occur in dogs, cats, and primates. Reptiles have been reported to develop diabetes, but it is rare among these animals.
What? Diabetes mellitus is defined as the elevated amount of sugar (glucose) in the blood.
When? Diabetes, of the Type 2 variety, sometimes referred to as Adult-Onset Diabetes, occurs as a person age and develops slowly over a period of years. Type 1 diabetes is sometimes referred to as Juvenile Diabetes, as it is a deficiency of insulin from birth. This article is mainly looking at Type 2 diabetes.
Where? To the extent that blood can infiltrate an organ, then that organ or tissue will be exposed to elevated glucose levels.
Why? The incidence and prevalence of diabetes parallels the changes in dietary habits of a civilization. As the diet has increases in sugar and refined carbohydrates so does the occurrence of diabetes. Refined carbohydrates are also known as simple or processed carbohydrates. There are two main types: Sugars: refined and processed sugars, such as sucrose (table sugar), high fructose corn syrup and agave syrup. Refined grains: these are grains that have had the fibrous and nutritious parts removed. Examples of refined grains are white bread, pizza dough, pasta, pastries, white flour, white rice, sweet desserts, and many breakfast cereals.
How? Of all the questions, this may be the most important in conjunction with “Why?”. In other words, how does the elevated levels of sugar in the blood cause its destructive effects on the body? The answer seems to have been known for decades and it is glycation. Glycation is the irreversible attachment.
of sugar to a protein or a lipid (fat) molecule. Glucose, fructose, and their derivatives can form an irreversible bond and cause the molecule to which it is attached to not function properly. These are known as advanced glycation end products, AGE for short. These AGEs can form anywhere protein is located. Now we know how chronic elevated blood sugar slowly but eventually will lead to premature death. AGEs are thought to be responsible for atherosclerosis (hardening on the arteries), cardiac dysfunction (heart disease), nephropathy (kidney damage), hypertension (high blood pressure), diminished eyesight, inflammation, and even cancer.
A familiar test for monitoring diabetes is HgA1C, which measures the amount of sugar in the blood over a period of time, such as 3 months. This test is useful because a diabetic can reduce their blood sugars in the short term by not eating before their physician tests their blood for glucose. The A1C test looks at the amount of elevated sugar for a longer period of time and is a better indicator of blood sugar control. This test is a measure of the glycation of sugar on the protein hemoglobin. This test was first proposed to monitor diabetics as early as 1976. In addition, glycated hemoglobin has its own negative effects as it causes damage through inflammation, promotes cell damage, the formation of plaques in the blood vessels, and binds to nitric oxide that causes blood vessels to not dilate , thus increasing blood pressure.
Now we know the Who, What, Where, Why, and How of glycation, the additional question that must be asked is What Can be done about it? The answer, for the most part, is to reduce our consumption of foods that increase our blood sugar on a chronic basis. The simplest method is to adopt eating low glycemic foods. A column in the future will focus on the Glycemic Index of foods.
A useful book that addresses this subject is The Case Against Sugar by Gary Taubes.
Prosper and be in health.
What do you think?