Diabetes Explained

If you are reading this you are probably already a diabetic or know someone who is (these days, who doesn't?) so you likely know what a pancreas is. But if not, here is a picture:

 

Cute little thing, isn't it? It actually reminds me of a slice of homemade corned beef. Mmmm...

Without getting too medically complex, the pancreas produces two hormones your body needs: insulin and glucagon. These are produced in a cluster of cells called the islets of Langerhans. Glucagon is produced by the alpha cells in the islets of Langerhans and Insulin is produced by the beta cells. In my case, the beta cells no longer produce insulin.

Among other things, insulin is used for regulating the level of glucose in your blood. It does this by stimulating your body cells to use the glucose in your blood. Glucose is essentially the gasoline which fuels your body. Insulin is the key to unlocking the gas tank. Here is a diagram:

 
The process should work something like this:

1. you eat something,
2. the carbohydrates in the food are changed into glucose molecules
3. the glucose molecules go into your bloodstream to be transported throughout the body (which raises your blood sugar level)
4. when the glucose gets to a cell that needs energy, insulin allows the cell to take the glucose (which lowers your blood sugar level)
5. your body gets the energy it needs

Problems arise at step #4. If your body's pancreas does not create insulin, then the cells have no "key" to use to allow the glucose in the bloodstream to be used. This type of diabetic is known as a type 1 diabetic or an insulin-dependent diabetic. Alternatively, if your body's pancreas makes insulin but for some reason the cells are resistant to it (much as rust in a key hole can make opening a door difficult), your body can't use the glucose. This type of diabetic is known as a type 2 diabetic or an insulin-resistant diabetic.

Regardless of the mechanism, the result is essentially the same. Without a way for the cells to use the glucose in the bloodstream, the blood sugar level continues to rise higher and higher. The brain, which uses most of the body's glucose, will continually send out signals that it needs energy ("I'm hungry! I'm hungry!") which causes the person to eat more, which in turn puts even more glucose into the bloodstream raising the blood sugar level even higher. To keep alive the body will begin to consume itself by switching to alternative fuel sources, stored energy (i.e. fat) and then ultimately begin eating lean muscle tissue (i.e. the heart) and anything else it can until either the body is nothing more than a bag of skin and bones and the person starves to death or the person dies of heart, lung or other organ failure.

Or, such as in the case of a type 2 diabetic, the body will continue to pump out insulin to try and get the glucose it needs. Enough of the insulin will usually "work" so that the body won't shut down, but will instead remain in a state of hyperglycemia (too much sugar). This does a number of things, primarily slowing or stopping circulation in the smaller blood vessels of the body. This is why diabetes is the primary cause of blindness, amputations, strokes, etc. On the bright side, type 2 diabetics don't have to worry about their body eating itself. This is because another function of insulin is to store fat. So all that extra insulin that was being made is put to good use by storing the glucose in the fat cells of the body. They get bigger, the person gets fatter. If left uncontrolled, the person will eventually die of heart failure or a stroke--morbidly obese, likely lacking a leg or two and probably blind.

Now I imagine you are probably wondering how YOU can get such a fun medical condition as diabetes. It's not as hard as you think: you either get stuck with it or you choose to get it. Getting "stuck" with diabetes means that for some reason your pancreas decides to stop producing insulin. Perhaps you are born with a bad pancreas or it otherwise somehow breaks (auto immune disease? accident?). In such a case you become a type 1. Bum deal.

Most people, however, "choose" to get diabetes by simply eating too much crap food and not getting any exercising. They become type 2 diabetics, and unless you have been living in a cave for the past 5 years you know that this is "an epidemic" in the Western world. That's because we are all fat and lazy. So if you'd rather not die morbidly obese, blind and legless you might want to consider getting off the couch and stop eating junk food. Your call.