There is another form of diabetes, Diabetes Insipidus, where increased urine production is caused by inadequate secretion of vasopressin by the pituary gland. It is not respond to insulin so we will not be discussing this form of diabetes. When we mention the word diabetes, we will be referring to Diabetes Mellitus.
Diabetes is either the lack of insulin in our bodies (Type I Diabetes) or our bodies are resistant to the insulin we produce (Type II Diabetes). Here is a more clinical definition:
Diabetes Mellitus (DM) – A general term referring to all states characterized by hyperglycemia.
- Type 1 – An autoimmune mediated destruction of insulin producing beta cells in the pancreas, resulting in an absolute insulin deficiency.
- Type 2 – A multifactoral syndrome with the combined influence of genetic susceptibility and of environmental factors, the best known being obesity, age, and physical inactivity, resulting in insulin resistance in the cells requiring insulin for glucose absorption. This form of diabetes is strongly inherited.
A person with type I diabetes must inject insulin since the body produces minimal or no insulin. In type II diabetes, the beta cells produce insulin, but our body's cells do not respond normally to it so more insulin is needed. This extra insulin can come by stimulating the beta cells to produce more, the goal of oral diabetic medications, or by supplementing with injected insulin. Type II diabetes is usually first treated by lifestyle changes, such as losing weight, healthy eating and exercise. Type I diabetes is always treated with injected insulin.
As we mentioned in a previous blog entry, Insulin - The Sugar Police, Insulin is remarkably similar in a number of animal species and can be used directly to treat diabetes. In fact, it was not too many years ago that all insulin was from animal sources. The two primary sources were bovine or beef insulin and porcine or pork insulin. Bovine insulin differs from human in only three amino acids, and porcine insulin differs in only one. Biosynthetic "human" insulin is now manufactured by recombinant DNA (rDNA) technology using bacteria to produce human insulin.
Diabetes is the 6th leading cause of death
in the United States
in the United States
Insulin generally comes as rapid acting, long acting or delayed acting forms. Regular (rapid onset, short-acting) and NPH (slower onset, longer duration) human insulins are the most commonly-used preparations. Others are Lente and Ultra-Lente (much slower onset and longer duration). A mix of NPH and Regular Insulin called 70/30 is also available.
Modified forms of human insulin, changing the amino acid sequence slightly or adding other molecules to the insulin chain, are also available. The modifications improve the absorption or duration of action characteristics of the insulin to give better overall glucose control. They are usually referred to as "insulin analogues". The rapid acting analogs are modified to prevent the formation of dimers and hexamers, making the insulin molecule more quickly absorbed and faster acting. The extended release analogs have additional molecules attached to the insulin chain, resulting in slower absorption and increased duration of action.
Examples include:
Rapid acting (response in 15 minutes or less)
- Insulin lispro
- Insulin glulisine
- insulin aspart
- Insulin glargine
- Insulin detemir
Both long duration analogues are taken only once daily, and are used in treating type I diabetes as the basal insulin. A combination of a rapid acting and a long duration insulin is used to achieve an insulin profile that mimics that of the body´s own insulin release.
Unlike many medicines, insulin currently cannot be taken orally. It is destroyed in the gastrointestinal tract and must be given subcutaneous injection. Pre-filled insulin pens and pumps are available to simplify the injection regimen. Work is ongoing to develop an insulin nasal spray and stem cell researchers are looking to create replacement beta cells.
By reducing the concentration of glucose in the blood, insulin is thought to prevent or reduce the long-term complications of diabetes, including damage to the blood vessels, eyes, kidneys, and nerves. Everyone's body reacts to insulin in different ways. The onset, peak and duration of the different types of insulin will vary by individual.
Some Myths about diabetes:
Myth I: Sugar or eating sweets is the cause of diabetes. - It's not the sugar, it's too many calories and a lack of exercise for type II diabetes. Type I is due to a loss of insulin producing cells.
Myth II: Type I diabetics can't have anything sweet. - Fast-acting insulin therapies and intensive monitoring protocols can allow for the occasional treat.
Myth III: Type I diabetes, or juvenile diabetes, only affects the young. - Type I diabetes can affect anyone at any age although it is more common in younger people.
Myth IV: Only obese people get diabetes. - Obesity is the leading risk factor for type II diabetes but patients with type I diabetes are often otherwise very healthy.
Myth V: There is no treatment for Type II diabetes. - Type II diabetes can be delayed and even prevented with lifestyle modifications including exercise and a healthy diet.
There are a number of famous people with type I diabetes. The list includes:
- Ernest Hemingway - Author (For Whom the Bell Tolls; A Farewell to Arms; The Sun Also Rises)
- James "Catfish" Hunter - MLB Baseball Hall-of-Famer (baseball)
- Nick Jonas - Jonas Brothers
- Jackie Robinson - Baseball player
- Mary Tyler Moore - Actress (Dick Van Dyke Show, Mary Tyler Moore Show, Ordinary People); diabetes advocate
The prevalence of diabetes is increasing every year. It is the 6th leading cause of death in the U.S. and 36% of American families cope with diabetes. Hopefully with continued advances in insulin, a trend towards healthier lifestyles and other new therapies, we will be able to get this disease under control.
Proverbs 16:24 - "Kind words are like honey — sweet to the soul and healthy for the body. (NLT)"
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