How does diabetes affect the blood sugar levels?

In order to understand the pathogenesis behind diabetes mellitus, it is important to know how the pancreas regulates the blood sugar levels by the action of insulin. The pancreas is a gland located in the upper abdomen and secretes several hormones, including insulin. Absorption of glucose from the digestive tract and production in the liver elevates the blood glucose levels.

The pancreas responds by secreting insulin which promotes the uptake of glucose by the cells of the body as well as slowing down absorption from the gut and release of glucose by the liver. This lowers the blood glucose levels. In diabetes mellitus there is either deficiency of insulin or the body becomes unresponsive to insulin. This allows the blood glucose levels to remain elevated which causes damage to cells throughout the body.

Types of Diabetes Mellitus

There are broadly three types of diabetes mellitus known as type 1, type 2 and gestational diabetes.

Type 1 Diabetes

The onset of type 1 diabetes is early in life, more commonly in adolescence, is a result of destruction of the beta cells of the pancreas produces insulin. It was previously known as juvenile diabetes. Gradually the insulin levels drop until the pancreas is almost completely unable to produce any insulin. Therefore patients require insulin injections and it is referred to as insulin-dependent diabetes mellitus (IDDM).

Types 2 Diabetes

This type of diabetes typically occurs later in life, after the age of 40 years, although it frequently seen these days in younger individuals. This may be associated with the prevalence of obesity in younger age groups. In type 2 diabetes, the body’s cells do not respond to insulin as it normally would. Medication promotes the uptake of glucose by the cells but may reach a stage where insulin has to be administered. It is also known as non-insulin dependent diabetes mellitus (NIDDM).

Gestational Diabetes

As the name suggests, gestational diabetes develops in expectant mothers during pregnancy. It should not be confused with type 1 or type 2 diabetes which may have been pre-existing prior to pregnancy. The exact cause of gestational diabetes is not conclusively known. It is believed that hormones associated with pregnancy disrupts the cell’s responsiveness to insulin. Glucose tolerance may restore to normal after childbirth, however, the mother is at a greater risk of developing type 2 diabetes later in life.

Prediabetes

Prediabetes or impaired glucose tolerance (IGT) is similar to type 2 diabetes and often precedes type 2 diabetes but is reversible. The degree of insulin unresponsiveness in prediabetes is not to the same extent as in diabetes mellitus and patients will not record elevated blood glucose levels as high as in diabetes mellitus. Exercise, dietary change and weight loss can reverse prediabetes. However, once it reaches the stage of diabetes mellitus, it is irreversible.

“You can easily get health benefits of 7 to 8 minute vigorous exercise in a week if you don’t find the time to perform regular exertion. However, it is against the established perspective of the physical exertion.” Dr. James A. Timmons said.

Researchers find out those inactive young men who do only 15 min intense exercise in two weeks, develop the ability to metabolize blood glucose more efficiently. Conventional aerobic exercises may also increase insulin sensitivity in the body. The heavy exercise did the same but also directly causes reduction in the men’s bloog sugar level, this is the edge of the heavy physical work out.

The approved guidelines for physical workout are 30 minutes a day persistently at least five days a week, but in this busy and hectic life, people are hardly finding any time to exercise. So the researchers present the hypothesis that high intensity physical work out may cause better insulin sensitivity and efficiency.

For the experiment, researchers’ selected 16 men aged 20 to 25 to perform six equivalent sessions of physical workout for less than half an hour, with 30 second quick sprinters then four minute rest period.

After the two weeks of activity, men’s blood sugar and insulin levels above optimal range after drinking a sugary solution of seventy-five grams.

“When we drink or eat something our blood sugar level get raised very quickly, in healthy and active persons it comes down quickly and in the sedentary person the time get prolonged to reach at normal level this long duration, over times, lead to diabetes and heart diseases.

In this study more than 22,000 adults (including 517 diabetics) were included and fish consumption of the participants was determined by using dietary and lifestyle questionnaires. The researchers found that those diabetics who took less than one serving of fish per week were 18 percent more likely to have protein in their urine than the people who took at least two serving of fish per week.

Study co-author Dr. Amanda Adler pointed out that: “One of the earliest signs of kidney disease is to have protein in the urine.”

The study has been published in the November issue of the American Journal of Kidney Diseases.

Adler and team suggested that kidney function may be benefited by the unique nutrient composition of fish, as it can improve blood glucose control and improve plasma lipid profiles.

There can be some other lifestyle factors that may reduce people’s risk of having protein in the urine, but the design of our study accounted for that possibility, Adler added.

Keeping blood pressure under control, tight control of glucose, quitting smoking and strictly following a diabetic diet are some other measures that can prove helpful to lower the risk of albuminuria (aside from eating fish).

Writing in a research article in the most recent edition of the journal “Lancet”, Drs. Oliver Jones and Julian Griffin highlighted the need to research the possible link between the ‘Persistent Organic Pollutants (POPs), a group which includes many pesticides, and insulin resistance. A most probable relationship between the two could possibly lead to adult onset diabetes.

The researchers made special mentioning of their peer based reviewed research and  on the basis of the results obtained they demonstrated that there exists a very linear bond type relationship between the levels of POPs in blood, particularly the ‘organo-chlorine compounds’, and the risk of ‘Type-2 Diabetes’.

Scientists do not have any satisfying evidence supporting any possible correlation implying any kind of causation effect. However if any kind of link is discovered, it does mean disastrous implications on human health. Since the information about the same is very confined, no solid ground has been achieved to draw such conclusions, explained the researchers.

‘Persistent Organic Pollutants (POPs) ‘are chemical substances that persist in the environment, bio-accumulate through the food web, and pose a risk of causing adverse effects to human health and the environment. They were profusely used with the introduction of DDT in the 1940s. As the compounds biodegrade slowly, they continue to find their way into the food chain and ultimately into the blood streams of individuals even though many of these toxins were banned many years ago. Additionally, these compounds can persist in body fat for very long periods of time following exposure.

Obesity and genetic factors are already the well proclaimed factors which trigger the onset of the diabetes among the adult population. No clue has been achieved to find the environmental factors such as pollution to contribute for the same.

During the process of the research, an interesting factor which came into light was that obesity and diabetes was absent in people with low concentrations of POPs in their blood. Meaning thereby, such individuals were more likely to bear risk of diabetes if they were thin with high levels of POPs in their blood. Such a relationship was however, in reverse order if they were overweight but with low levels of POPs.

Scientists are of the view that it requires further exploration. This emphasis has been impressed upon with more stress just because the hypothesis that the POPs exposure could cause diabetes is at present focus. This can be base upon the development of specified cell of tissue cultures. This would lead to the development of an effective method to combat the side effects of POPs on the human health.

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CKD, as defined by a ‘Glomerular Filtration Rate (GFR)’ lower than 60 ml/min/1.73m2, is an independent risk factor for major CV events and death in diabetic patients, say Christian Schneider of the University of Cologne, Germany.

Christian Schneider and team at the University of Cologne ,analyzed data from the Prospective ‘Pioglitazone’ clinical trial in proactive macro-vascular events , which compared the effect of ‘Pioglitazone’ and ‘placebo’ in 5154 patients with Type 2 diabetes and macro-vascular disease.

Baseline analysis of the research findings show that out of the total 5154 patients nearly 597 participants, making a ratio of 11.6% , had ‘chronic kidney diseases’. These patients were older in age and had longer duration of diabetes with a higher prevalence of hypertension than those without chronic kidney diseases.

The study also pointed out that in comparison to those patients who did not have any chronic kidney diseases the patients with chronic kidney diseases were more likely to reach the primary composite end point of all related health problems. These could include mortality, myocardial infarction (MI), stroke, acute coronary syndrome, coronary and carotid arterial intervention, leg revascularization, or amputation above the ankle. The difference between the ratios of both the patients’ types was 27.5% to 19.6%.

Results obtained in the study do indicate similar trends on analysis in the way that the patients with chronic kidney diseases were also more likely to reach the secondary end point of all cause of mortality, MI, and stroke when compared to the patients with no chronic kidney diseases. In this case the difference existed with a ratio of 18.3% to the 11.5%.

Researchers observed that after treatment with ‘Pioglitazone’, only 23.7% and 14.6% of chronic kidney diseases patients met the primary and secondary end points, respectively. This is in comparison to the 30.7% and 21.4% of the patients who were treated with placebo.

It was observed by the researchers that the patients who were treated with ‘Pioglitazone’ showed considerable improvements in kidney functions. The results with these patients showed a reduction in estimated GFR of 0.8 ml/min/1.73m2/year, compared with the placebo group.

Christian Schneider and co-researchers concluded in their study report,”Patients who had CKD and were treated with pioglitazone were less likely to reach the composite end point of all-cause death, MI, and stroke, independent of the severity of renal impairment.”

CKD, as defined by a ‘Glomerular Filtration Rate (GFR)’ lower than 60 ml/min/1.73m2, is an independent risk factor for major CV events and death in diabetic patients, say Christian Schneider of the University of Cologne, Germany.

Christian Schneider and team at the University of Cologne ,analyzed data from the Prospective ‘Pioglitazone’ clinical trial in proactive macro-vascular events , which compared the effect of ‘Pioglitazone’ and ‘placebo’ in 5154 patients with Type 2 diabetes and macro-vascular disease.

Baseline analysis of the research findings show that out of the total 5154 patients nearly 597 participants, making a ratio of 11.6% , had ‘chronic kidney diseases’. These patients were older in age and had longer duration of diabetes with a higher prevalence of hypertension than those without chronic kidney diseases.

The study also pointed out that in comparison to those patients who did not have any chronic kidney diseases the patients with chronic kidney diseases were more likely to reach the primary composite end point of all related health problems. These could include mortality, myocardial infarction (MI), stroke, acute coronary syndrome, coronary and carotid arterial intervention, leg revascularization, or amputation above the ankle. The difference between the ratios of both the patients’ types was 27.5% to 19.6%.

Results obtained in the study do indicate similar trends on analysis in the way that the patients with chronic kidney diseases were also more likely to reach the secondary end point of all cause of mortality, MI, and stroke when compared to the patients with no chronic kidney diseases. In this case the difference existed with a ratio of 18.3% to the 11.5%.

Researchers observed that after treatment with ‘Pioglitazone’, only 23.7% and 14.6% of chronic kidney diseases patients met the primary and secondary end points, respectively. This is in comparison to the 30.7% and 21.4% of the patients who were treated with placebo.

It was observed by the researchers that the patients who were treated with ‘Pioglitazone’ showed considerable improvements in kidney functions. The results with these patients showed a reduction in estimated GFR of 0.8 ml/min/1.73m2/year, compared with the placebo group.

Christian Schneider and co-researchers concluded in their study report,”Patients who had CKD and were treated with pioglitazone were less likely to reach the composite end point of all-cause death, MI, and stroke, independent of the severity of renal impairment.”