Fundamentals Of Diabetes Mellitus

To understand the definition of diabetes mellitus and how to reverse it's impact, an appreciation of the stages of insulin resistance will prove invaluable.

The take home message is this - you don't just suddenly "get" diabetes. Not type 2 anyway.

It develops over years or decades as insulin becomes more and more resistant. That is what Metabolic Syndrome is all about. That gradual slippery slope to ill health - unless you decide to take charge!!

So what is a diabetes definition?

Diabetes mellitus is a disease that means the blood sugar levels are too high. Too high is usually held to mean that the fasting blood sugars are greater than 125mg/dL (6.9mmol/L)

All of us need some blood sugar in our blood; that's how our brain gets fuel, gets energy.

But too much means two things for a person with diabetes: one is the body doesn't get the energy it needs, and second, that high blood sugar level starts causing damage and over time it damages the eyes, the kidneys, the nerves, and can cause really serious complications. Treating diabetes mellitus means lowering the blood sugar levels and then keeping them normal.

How common is diabetes?

Short answer - very. Here are the statistics to illustrate just how prevalent it is becoming.

For an overview on how diabetes 2 develops here is a page detailing the symptoms of diabetes.

There are two kinds of diabetes and it's very important that people know the difference and what the risks are.

What is the difference between "type 1" diabetes and "type 2" diabetes ?

Essentially in type 1 the pancreas has shut down and ceased to make insulin whereas in type 2 the body has become resistant to it's own insulin and cannot deal with the sugar in the blood stream. For more detail follow the links above.

Back in the days before the agricutural revolution we didn't have food available on demand like we do now. We went through periods of eating and then fasting: literally not having food for weeks. Therefore we needed to store fat very efficiently. The place that our bodies store fat the best is right in the centre, and that's called central obesity.

That form of fat storage is right next to your liver, your pancreas and your stomach, and it's very efficient. It can immediately put sugar back into your blood if you're starving.

However, in our modern societies, where food isn't an issue for most people, that central fat just grows and grows, and now instead of being a good thing it is decidedly unhealthy.

All that fat next to your liver causes it to make abnormal cholesterol particles and causes inflammation. Things start happening that cause diabetes but also increases the risk for heart attack and stroke. So people with type 2 diabetes mellitus and central obesity (that's most people with type 2 diabetes) have a risk for heart attack and stroke.

So, you can have type 1 diabetes, meaning your pancreas doesn't work anymore because it was attacked by antibodies, and you can come from a family where your parents had type 2 diabetes; you can have central fat, high blood pressure, abnormal cholesterol levels and it means you have both type 1 and type 2.

However, what's really important is not the names 'type 1' and 'type 2', but if you have abdominal fat, it is even more important to be proactive in managing your health in order to avoid becoming a heart attack or stroke candidate.

Is one type of diabetes worse than the other?

Diabetes mellitus is a very serious disease and, contrary to what many people think, being "a bit diabetic" is akin to being "a little bit pregnant". You either are or you are not.

Diabetes is diabetes is diabetes. It is deadly, and if you don't treat it, it is like cancer. People have died from it in their 20s and 30s. Others have become blind or had limbs amputated.

So, untreated diabetes is very bad. To say one type is worse than the other would be disingenuous.

If you treat diabetes, you can avoid most of the complications. This is a treatable disease. It isn't cancer. It is not invariably fatal and type 2 is even reversible in some people.

Ignoring it is the worst thing of all.

What tests detect diabetes mellitus?

There's a test called the Haemoglobin A1c that tells you what your blood sugar level is. Perhaps even more importantly it tells you what your levels have been for the past 3 months.

We know that a normal blood sugar is 100 or less. If it's between 100 and 125, it means you have pre-diabetes, or you're someone who's on the way to get diabetes.

If your blood sugar is 126 or more, it means you have diabetes mellitus. Now, in medicine, they never do anything once, so if your number's abnormal, you need to go back in and have it rechecked to make sure of the diagnosis. What is more important though, is that you are aware if you are a person with a high risk.

Say your blood sugar's 112 this year and then it becomes 126 next year. What's happening is that your helth is slowly, silently deteriorating. What you want to do as an individual is to change whatever you can change, or take medication, so that the disease doesn't get worse.

Unfortunately doctors are resigned to the reality that MOST people will find it really hard to change their habits. They therefore take the path of least resistance and prescribe medications as the first solution rather than as the last resort. This BBC news story illustrates the concern with this approach.

The downside of medications, of course, is that they can have serious complications and side effects. To my mind, taking responsibilty and assisting the body in healing itself by making some lifestyle changes and ensuring that the cells are receiving optimal levels of nutrition is far and away the safest and most satisfactory solution.

For further information about what we mean by this please check out our solutions page

How often should I see my doctor if I have diabetes?

When you have diabetes mellitus, you need to not only go to your health advisor more frequently, but you actually need to really take charge of your healthcare. No one else has as much to gain from a reversal of your situation and an improvement in your overall health.

If your heart isn't in it then you can't really expect others to get excited.

One good thing about diabetes is it's numeric. Your doctor tells you what your blood sugar level needs to be and also what your average blood sugar over three months should be. Simply monitoring the levels as you implement lifestyle changes and improve nutrition will give you a clear indication of their impacts.

You also need to manage your cholesterol levels, your triglycerides, your good (HDL) and bad (LDL) cholesterol levels and your blood pressure. Most people worldwide don't get the kind of medical care they should for their diabetes mellitus and that's in part because diabetes doesn't hurt. You go to your doctor because your back hurts and you focus on that in the eight minutes your doctor has to spend with you. At the end of the consultation, issues like blood pressure, blood sugars and all these other things you need to be aware of to live long and healthy with diabetes, have not been addressed.

So what is recommended is that you routinely go every three months to have your diabetes checked out. And this really needs to be a visit that is not an acute visit for something else. This needs to be a visit to specifically ask "Hey, how's my blood sugar? How's my blood pressure?"

You need to really keep track of it and that is fairly easy because there are such clear targets and guidelines. You need to know what your blood pressure was last month and what should it be three months from now?

And if it's not normal, ask, "How can I get it better"?

Because people who take a proactive approach to their diabetes mellitus can actually reverse type 2 and minimise the damaging effects of type 1.

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