Diabetes Mellitus and Diabetes Diet Care

Diabetes Mellitus is a word derived from Greek word Diabetos which means Siphon, Mellitus means Sweet, i.e. "flowing of sweet liquid."

There is mention of this disease by Ayurvedic physician Susruta in Ayurveda in about 400 B.C. and he had described it as "Honeyed urine." Charak, another physician of that time was also well aware of this disease (A.D.G.) A.D.

At present there are about 150 million people in the world with diabetes and many more may not be aware of their problem. It is expected that by the year 2000 this number would be around 176 million. Many more may not be aware about this disease and they may come to know only while undergoing tests for some problem or when they develop some complication of this disease.

What is Diabetes?

Main items of food are carbohydrates, proteins, fats, vitamins, minerals and water. Whatever food we take, from stomach it goes to small intestine then to large intestine. Many enzymes which come from stomach, gall bladder, liver, small Intestine and pancreasomet gland, mix with food to make it more digestible. Carbohydrates are converted into glucose which gets into the blood stream and ultimately to cells of body to provide energy. This process of absorption of glucose from intestines and to enter into the cells of body is regulated through the "hoemone" called Insulin, secreted by gland called 'Pancreas'. In the deficiency of this hormone (Insulin), glucose will not enter into the cells and would remain in blood stream. Thus Blood Sugar will remain high and this sugar will pass in urine. As cells do not get sugar, there will be no energy. Person would feel weak and this will result in weight loss.

Normal Blood Sugar Level

Normal fasting Blood Sugar should be between 60 mg to 110 mg per 100mi of Blood. Blood Sugar 2 hours after food should be less than 140mg/ 100mi of Blood. When Blood Sugar is above this level it means person is suffering from Diabetes.

When the Blood Sugar is persistently high it circulates through kidney and other organs of body as it is not entering the cells.

Kidney cannot cope with this increased level of glucose and glucose escapes into the urine. Glucose will not appear in the urine until and unless Blood Sugar is above 180mg/i00mi of Blood.

When there is absolute deficiency of Insulin fats also escape from fat cells and this fat is converted into Ketones, an acidic substance, by then more and more Ketones are released by liver into blood circulation it leads to Ketoacidosis. Ketones appear in urine. Ketones are not present in urine of a normal person.

So you have read above about Insulin Hormo,ne which is very essential for the entry of glucose into cells and in the absence of this Hormone Blood Sugar level rises, sugar appear in urine and in the severe deficiency of this Hormone, i.e. insulin ketones also appear in urine which is a dangerous stage.

Insulin is secreted from Beta Cells of Pan crease gland located in the abdomen. How and why it stops functioning it is not known.

There are many factors which may be responsible for this stage which are discussed below.

Heredity

You must have observed that this diesease runs in family. Many members of one family are suffering from diabetes. From parents, through genes it is transmitted to children, children will have defect in the Beta Cells which produce Insulin and so they become prone to develop diabetes.

This is commonly seen in type II diabetes as compared to Type I diabetes.

Chances of Developing Diabetes

There are 25 to 30% chances of developing diabetes in the children of Type II diabetic patients.

If both parents are Type II diabetic then chances are 75%. (HLA Antigens are associated with type I diabetes, further study is going on.)

Viruses. There are some studies which say that children who suffered from various virus diseases in childhood develop diabetes.

Obseity (Motapa). Obesity certainly predispose the individual to Diabetes specially Type II.

It is said that if person is 30 to 40% over weight than the weight indicated in standard height and weight tables, efficacy of Insulin is decreased by 30 to 40%.

There is insulin resistance. Although these patients are having high levels of insulin in the blood yet their Blood Sugar levels are high.

Diabetes Diet

It has been observed that people who eat more refined sugars and diet rich in carbohydrate are prone to develop Diabetes. Incidence of Diabetes is higher in Indians who have migrated to U.K. or USA than the local inhabitants. The reason is that they might be having genetic predisposition and by consuming more sugar and carbohydrates in diet, they become obese, which itself is a risk factor for developing diabetes.

Diet rich in fibre reduces the incidence of Diabetes.

Drugs

Many drugs predispose Diabetes. Drugs like steroids used for Allergy and Asthma problems can aggravate diabetes.

Diuretics

Drugs which increase urine flow are used for high Blood pressure can also aggravate diabetes. These drugs lower Postassium which interfere with Insulin release thereby causing high Blood Sugar.

Oral contraceptives also increase Blood Sugar levels.

Lifestyle

Persons who are having borderline diabetesm i.e. Diabetes is yet not diagnosed when exposed to stress in life will manifest fullfledged disease. Sometimes, when you are undergoing investigation for some other disease like Chronic Diarrhoea, longstanding infection or extreme weakness, tests will reveal that you are having high Blood Sugar levels.

Types of Diabetes Mellitus

Types of Diabetes depends upon the status ofInsulin Hormone in the body. They are Type I or Type II.

A. Type I or IDDM

If there is no Insulin or very less amount of Insulin then one has to be given Insulin injections regularly and this is called as 'Insulin Dependent Diabetes Mellitus' or IDDM or Type I Diabetes. These patients are young with rapid onset. If Insulin injections are not given to them they develop ketones in urine - and develops Ketoacidosis and coma. They can lead normal life with regular injections of Insulin. It usually manifest from the age of 4-5 years and these children would require daily Injections ofInsulin to survive.

B. Type II DM or NIDDM

In these patients either there is deficiency of Insulin or resistance to the normal insulin action in the body. Usually there is family history of Diabetes in these patients. This is again of two types:

• (a) Obese NIDDM - those who are over weight
• (b) Non-Obese NIDPM

This type of Diabetes is usually seen in the people who are above the age of 40, it is also called as 'Maturity onset Diabetes'. More than 2/3rd of all Diabetic patients are suffering from Type II Diabetes. In this group of patients Diabetes can be controlled by Diet Restriction, Regular Exercise, and Oral Hypoglycaemic Agents, i.e. Tablets. Insulin injections are usually not required, initially, but later they may also require Insulin injection.