Diabetes Mellitus: A Complete Overview for Patients and Family

Diabetes mellitus is the root cause of many diseases – some that prove to be fatal. Yet, there is a perceivable lack of seriousness around diabetes mellitus. Most people think it is merely a ‘high blood sugar problem’ that they need to keep ‘under control’ by avoiding sugar and/or taking insulin medication. However, the fact is that high blood sugar is an ‘effect’ of diabetes and not the cause. The ‘root cause’ is insulin resistance which develops in our cells due to mitochondria dysfunction or depletion and or inflammation, infection and other underlying imbalances in the body. 

This callous approach towards diabetes coupled with unhealthy lifestyles and eating habits has given this disease a strong foothold in the modern day society. In sense, diabetes is an under-discussed global pandemic, perhaps because it does not have the shock value that some recent viral outbreaks have had.  But nevertheless, it is a ruthless silent killer.

The number of Type 2 diabetics has tripled since the 1980s. As of now, in India alone there are 77 million diabetics. What makes matters worse, is that the number is projected to double in the coming decade. To put it succinctly, the elephant is already in the room. And the best possible way to address it is by creating awareness.

Definition of diabetes mellitus: 

Diabetes mellitus is a problem caused by unregulated insulin level in the blood which results in elevated blood sugar levels.

Insulin is a hormone that is produced in the pancreas. It helps in the passage of blood glucose into the cells. However, in a diabetic person, the pancreas do not produce enough insulin or the cells become insulin resistant. As a result, the blood glucose does not pass into the cells. This causes high blood sugar and other symptoms of diabetes to occur.

Criteria for diagnosis: 

A person is normally said to be diabetic if his fasting Blood Sugar (FBS) is above 126 mg/dL and Post-Prandial Blood Sugar (PPBS) is above 180 mg/dL. However, blood sugar range should not be treated as the ultimate indicator of diabetes mellitus as it is likely to fluctuate throughout the day. Instead, we can check our fasting insulin level which should be around 2-6. After eating, insulin level depends on a lot of factors and can shoot up to 80.

HbA1c is a more reliable indicator as it is the average blood sugar of the last 2-3 months. In a normal person, the HbA1c is below 5.7%. An HbA1c above 6.5% indicates diabetes. If the HbA1c is between 5.7% and 6.5% it means the person has pre-diabetes. Thus, anyone with HbA1c of more than 5.2% should start his diabetes reversal journey to avoid further damage to the body which will happen when diabetes mellitus sets in.

Importance of glucose for the body:

Glucose is the primary fuel for the body. When we eat food (carbs), it is broken down through the process of metabolism and absorbed into our blood as glucose. Once this blood glucose (also called blood sugars) has been absorbed into the cells, it gets converted into energy that is used for the proper functioning of the cellular and biological systems.

It is noteworthy here that this blood glucose does not get absorbed into the cells on its own. Insulin is the factor that acts as a key that opens the doors of the cells for blood glucose to enter.

Consequences of excess sugar in the blood:

Mitochondria is the engine that drives our cells. Each cell has about 500-1500 mitochondria. In a diabetic person, the quality and quantity of mitochondria has deteriorates due to his internal or external environment. Consequently, the ability of his cells to absorb the blood sugars is reduced. This phenomenon is called ‘insulin resistance’. As a result of insulin resistance, there is more unabsorbed sugar in the blood which elevates the blood sugar level.

When the glucose level in the blood crosses 180 mg/dL it becomes toxic for our entire system down to the cellular level. The body experiences increased oxidative stress, activation of the sorbitol pathway and osmotic damage. All of these primarily impact the nerves, kidney, brain and vision. Diabetes is also known as a vascular disease as increased blood glucose (sugar) levels can affect orangs and tissues from head to toe. In the long-term, it could cause irreversible damage to the organs involved and increases the chances of strokes, cardiovascular and heart complications and peripheral vascular diseases. 

Some of the symptoms or signs of high blood sugar are:

• Increased thirst and a dry mouth.
• Frequent urination
• Headache
• Tiredness and fatigue
• Blurred vision
• Weight loss
• Recurrent infections
• Slow healing cuts and wounds

Types of Diabetes

Diabetes can be broadly divided into 2 types depending upon its duration. 

Chronic diabetes conditions: These conditions are that which last longer. In fact, earlier it was considered that the condition will last the lifetime of a diabetic. But that has changed with time, increased medical knowhow and advancement in treatment procedures.  Today, Type 1 diabetes can be better managed and dependency on insulin can be reduced. On the other hand, Type 2 diabetes can be completely reversed with suitable changes in diet and lifestyle along with correction of imbalances through an integrative and functional medicine approach.

• Type 1 diabetes: The function of our immune system is to protect our body from infections by fighting off bacteria, viruses, etc. But sometimes, the immune system attacks and destroys our own cells that make insulin. This is called the autoimmune destruction of beta cells of the pancreas. Consequently, the pancreas produce little or no insulin. This condition is called Type 1 diabetes. It usually occurs in toddlers and teenagers, but can happen at any age. Type 1 diabetics are dependent on regular insulin injections for the management of diabetes. However, with correct protocols the need for insulin can be reduced as better control of blood sugar metabolism is developed.
• Type 2 diabetes: This type of diabetes is typically characterized by high blood sugar and high to normal insulin levels. In a person without diabetes, the appropriate insulin levels would rapidly reduce the blood sugar to normal. But in Type-2 Diabetes, the cells become insulin resistant due to lipotoxicity of liver, muscles, pancreas and viscera. This makes blood sugar hard to control with insulin or any other medication. 90-95% of all Diabetes cases are of Type-2. As discussed earlier, the reversal of Type 2 diabetes is possible with suitable changes to diet and lifestyle along with integrative and functional medicine approach.

Type 1 diabetes is due to the insufficiency of insulin, whereas Type 2 diabetes is due to the inefficiency of insulin.

• Type 1.5 diabetes: This is a lesser known type of Diabetes falls that between Type 1 and Type 2. It is also called LADA or Latent Autoimmune Diabetes in Adults. Type 1.5 shares some characteristics with both Type 1 and Type 2. Just like Type 1, in this case also the Pancreas doesn’t produce enough insulin and the body becomes dependent on exogenous insulin for its functioning. But unlike Type 1 the damage to the pancreas is not very high and can be stopped with proper care and treatment and the dependency on insulin can be minimised. Like Type 2, Type 1.5 diabetes can also be reversed with changes in diet and lifestyle and an integrative functional approach. 

Short duration diabetes conditions: These conditions last for a shorter duration and can be reversed easily. Pre-diabetes and gestational diabetes come under this category.

• Pre-diabetes: This is an early stage of insulin resistance where the blood sugar is elevated above normal, but not high enough to be called Type-2 Diabetes. For a normal person, the HbA1c level is below 5.7% and for a diabetic it is above 6.5%. If the HbA1c reading falls between 5.7% and 6.5%, the person is said to be pre-diabetic. The fasting blood sugar (FBS) for a pre-diabetic is usually between 101-125 mg/dL and the post-prandial blood sugar (PPBS) is between 140-199 mg/dL.
• Gestational Diabetes: As the name suggests, this type of diabetes occurs during pregnancy – usually between the 24th and the 28th week. It is caused due to the deficiency of vitamin B6 and can be easily reversed by supplementing vitamin B6 (100 mg) taken once daily for 2-3 weeks, along with dietary and lifestyle modifications.

Symptoms of diabetes:

Both Type 1 and Type 2 diabetes are typified by high blood sugar. Therefore, they have overlapping diabetes symptoms. However, in Type 1 the symptoms of diabetes appear more quickly than in Type 2.

Some of the common Type 1 and Type 2 diabetes symptoms are:

• Attention deficit 
• Tiredness or fatigue 
• Lack of proper  sleep
• Blurred vision
• Constant feeling of thirst and dryness of the mouth 
• Slow healing of wounds and frequent infections
• Constant feeling of hunger leading to weight gain
• Numbness and tingling sensation in the hands and feet 
• Frequent urination
• Infection of the genitals, vagina or urinary tract 
• Erectile dysfunction

Apart from the above, Type 2 diabetics may show the following symptoms of diabetes as well:

• Nausea
• Vomiting
• Abdominal pain
• Recurring yeast infection or Candidiasis

It is noteworthy here that because Type 1 diabetes occurs mostly in children, the above listed diabetes symptoms can be difficult to notice. However, there will be other signs of diabetes that should not be missed. These are:

• Bedwetting
• Changes in appetite
• Changes in behaviour more severe than regular mood changes
• Diaper rashes that won’t go away

Onset and severity of diabetes symptoms and age factor: 

Type 1 diabetes is usually seen in children whereas Type 2 is a lifestyle disease and can occur at any age. However, there has been an alarming increase in the incidence of Type 2 diabetes in children of late. In fact, nearly 1/3rd of the diabetes cases in children are of Type 2 and can be easily reversed.

Moreover, a less severe form of Type 1 diabetes can also occur in adults. This is called Latent Onset Diabetes of Adults or LADA. It is less severe because the destruction of beta cells of the pancreas occurs at a much slower pace when compared to children, in adults who are 35-40 years of age.

When to See a Doctor: 

Any of the above listed diabetes symptoms should alarm us enough to get a simple blood test done and to consult a doctor. If we are found to be diabetic, we would need to ensure our organs have not been affected. We will need to follow this up with regular blood glucose level tests along with lipid profile, liver function and renal function tests. More importantly, we should keep track of our fasting insulin levels and TGL/HDL ratios which are better indicators of diabetes, as stated earlier.

What causes diabetes:

Type 2 diabetes is also called a lifestyle disease because it develops basically due to poor lifestyle. There are several contributing factors to what causes diabetes such as consumption of ultra-processed foods, sedentary, increased stress, sleep disturbances, dehydration, environmental toxins & non-native EMF exposure and micronutrient deficiency.

When we consume a highly refined carb diet, it adds a lot of sugar to our blood. In order to pass this sugar into the cells, more insulin is needed. So the pancreas produce more insulin. If this continues over a long period of time, the cells become resistant to the effect of insulin. Since the blood sugar is still not passing into the cells, the pancreas produce even more insulin and the vicious cycle is complete. 

Under the given circumstances, taking insulin exogenously will not fix the problem. Instead, we will end up with the double-trouble of high blood sugar and high insulin. Moreover, taking exogenous insulin over a long period of time will overburden the pancreas and lead to pancreatic and kidney degeneration.

 It is noteworthy here that the process of insulin resistance starts many years before a person is actually diagnosed with Diabetes or even Pre-diabetes. Some of the early signs of increased insulin levels or early signs of diabetes are increase in appetite, weight gain around the belly, darkening of skin around the neck and underarms, skin tags, inability to lose weight, brain fog, inability to skip a meal, fatigue and tiredness, post-meal fatigue, inflammation and oxidative stress etc.

Risk Factors:

There are several facts and myths revolving around the risk factors that affect that causation of Type 2 diabetes. Some of them are clarified as follows:

• Family history: It is often said that Type 2 diabetes is a genetic disorder. But the fact is that Type 2 diabetes is a non-communicable disease – that is, it cannot be transferred from one person to another even through our genes. Type 2 diabetes is in fact a problem of epigenetics, or the impact of our external and internal environment on our genes. In other words, it is not our genes that are responsible for Type 2 diabetes, but our poor lifestyle choices.
• Environmental factors: Our surroundings affect our cells down to the genetic level. Toxins from polluted air, water, soil or from the chemical and pesticide laden food we eat, can all have an adverse impact our cells and mitochondria functioning and cause insulin resistance and even lead to heavy metal toxicity.
• Autoantibodies: For any patient suffering from Type 1 diabetes and LADA, the panel of autoantibodies should be taken into account before starting treatment. Autoantibodies are antibodies that are made against substances formed by our own body. These antibodies either directly destroy cells that have that substance on them or make it easier for white blood cells to do so. Disease caused by autoantibodies such as Type 1 diabetes and LADA, are called autoimmune diseases.
• Race or ethnicity: Western countries usually have temperate climate. Therefore, the people living in those countries though not immune to metabolic disorders, have an increased Personal Fat Threshold. Thus, they develop diabetes at a later age compared to South Asians who have a lesser Personal Fat Threshold.
• Weight and obesity: Obesity is often considered as a primary risk factor for diabetes. However, for both obesity and diabetes, the basic underlying pathology is the same – that is, insulin resistance and inflammation. Even normal weight or thin individuals are at risk of developing diabetes. Hence body weight or BMI is a crude index for assessing the risk for developing diabetes.

Conclusion:

Diabetes is no longer a death sentence. Neither are we doomed to be diabetic forever. It is not an age-related disease, nor is it genetic disorder and neither is it a result of consuming too much sugar, as popularly believed. It is in fact, a lifestyle disorder that can be sustainably reversed with a holistic change in lifestyle. 

Now that you have an overview of Diabetes Mellitus, you should be in a position to ask yourself, whether you would want to carry on ‘managing’ and living with the disease forever? Or would you want to reverse the disorder completely and sustainably, and live a disease and medicine-free life?

Conventional methods offer you the first option – that is, a diseased life forever. On the contrary, Wellfinity.in adopts an integrative, holistic, functional medicine approach that ensures disease reversal and simultaneously improves overall wellness. It is the obvious choice if you are looking for a better quality of life, but that choice is yours to make.