Diabetes affects nearly 30 million people in the United States alone. Both Type 2 diabetes mellitus and pre-diabetes are disorders that cause high blood sugar. The mainstay in the management of these conditions remains lifestyle modification. Understanding how certain foods we eat place a stress on the pancreas and predispose someone to high blood sugar levels is an important part of avoiding and treating these conditions.
How does insulin work?
In order to understand more about blood sugar problems, we need to review what a hormone is. Hormones are proteins secreted from areas in the body called glands. Hormones help to transmit messages to more distant sites, allowing specialized communication between cells. Insulin is a type of hormone that causes storage of energy. Insulin is produced by specific cells in your pancreas, a small organ located in the center of your abdomen, just below your stomach. Insulin levels rise in response to the different types of sugar consumed in your diet. Rising insulin levels allow sugar to enter the cell, and be saved as energy to be used later.
Diabetes mellitus, or diabetes for short, are a group of conditions where blood sugar (or glucose) is elevated due to decreased insulin levels or the decreased ability of the body to use the insulin that is present. In this lesson, we will discuss pre-diabetes and Type 2 diabetes, using an old fashioned locomotive train as an example. Think of the pancreas as if it were a steam engine on a shiny, jet black, and fiery red train, heading out for a beautiful ride through the mountainside. Insulin, in this example, will be the smoke that the train engine produces as it chugs, out of the station, and along its journey. ALL ABOARD! Passing through the valley, the train glides along its track. The steam engine works effortlessly, and continuously produces small puffs of smoke.
What causes diabetes?
If it travels up a hill, the smoke increases, but only by a small amount, and for a short time. This represents the normal everyday function of the pancreas. When the pancreas is not overworked, it continuously churns out small amounts of insulin; a small hill represents a meal we may eat, which results in insulin levels going up temporarily.
Later during the trip, the train begins traveling up a very steep mountain. Quickly, the engine kicks into gear. As the train climbs, the engine works harder. As it burns more fuel, the smoke produced really begins to pick-up. However, while headed up the mountain, the speed of the train is slowed only a little. On board, the passengers are unaware of the effort required from the engine. This is pre-diabetes! As a person gains weight, the insulin does not work as well, a process called insulin resistance. The pancreas compensates by churning out more insulin. The individual feels fine, and the blood sugar is only minimally affected.
If the train has to continue up the mountain for an extended period of time, the engine will start to burn out, the smoke output decreases, and the train eventually will slow down. When the pancreas can no longer keep up with continued weight gain over time, insulin production falls, and the blood sugar begins to rise, leading to diabetes. Diabetes that occurs in the setting of weight gain is called Type 2 diabetes mellitus. As the amount of body fat increases, a resistance to insulin’s action builds up. Eventually, the pancreas tires, and insulin production falls, leading to more elevated blood sugar levels.
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