Friday, October 21, 2005

So what exactly is diabetes?

Despite the fact that diabetes mellitus is sharply on the upswing, particularly amongst younger kids, it seems a lot of people dont know what the disease is about. Diabetes comes from a Greek word that means to siphon. The most obvious sign of diabetes is excessive urination. Water passes through the body of a person with diabetes as if it were being siphoned from the mouth through the urinary system out of the body. Mellitus comes from a Latin word that means sweet like honey. The urine of a person with diabetes contains extra sugar (glucose. In 1679, a physician tasted the urine of a person with diabetes and described it as sweet like honey. Diabetes mellitus starts with the inability of the pancreas to produce insulin, the hormone which regulates sugar. It is a multifactorial disease, Type 1 diabetics(15% of cases) dont produce ANY insulin, so they need to inject themselves with it. Type 2(85% of cases)diabetes produce decreased insulin, this can be managed by diet and/or medication. Poorly managed type 2 diabetics cease the ability to produce any insulin and become type 1 diabetics.
High sugar levels and the inability of the body to keep it in check damages blood vessels, thereby limiting circulation starting with the vessels furthest away from the heart. Oppotunistic infections also thrive in this environment of poorly managed diabetes. Bored yet? Basically the onset of gangrene and the threat of sepsis will lead to surgical intervention eg. amputation. Depressing aint it? Well it doesnt end there. Eventually the heart and kidneys are affected as well. Heres a few facts :

Most common cause of death amongst diabetics : Kidney failure
Most common cause of blindness in the US : diabetes
Most common candidates who undergo amputation : diabetics

You can look up more details by googling it. While theres a great selection of medication available, it is ultimetely change in lifestyle which turns the tide.
Like regular soda? Too bad, you're going to have to go diet(despite the controversy over aspartame, its better to switch). Got a pot belly? You're almost guarenteed DM2 in the future. Get active. Dont go renting the Taebo collection yet. Start walking, or better yet, get a treadmill, watch TV while walking. No fast food, period. Footcare is an absolute must for diabetics. Wash your feet every night and apply lotion, or some olive oil, make sure the skin is hydrated. So is there a cure for diabetes. NOPE. There is positive buzz that stomach stapling is an excellent way to lose weight and control blood sugar. I think they are smoking crack. Dont get me wrong, there are certain individuals who need gastric bypass surgery like the poor dude who didnt leave his house in seventeen years, but its not a good idea for most people. This method has unfortunetly been glamorized by Hollywood(tHey should have stapled Roseanne's mouth along with her stomach IMHO) Keep in mind that different parts of the stomach have different functions, and doctors will, in the future have to deal with long term complications of such a radical procedure. This leads to(drum roll) the DrM plan which is the next blog entry.....


JD said...

Dr. M wrote: "The most obvious sign of diabetes is excessive urination."

I wish I had known this prior to my being diagnosed with diabetes. This was *exactly* my most obvious symptom.

"Footcare is an absolute must for diabetics. Wash your feet every night and apply lotion, or some olive oil, make sure the skin is hydrated."

I had been applying lotion more recently on an "as needed" basis, but I think now I'll put the lotion on on a more regular basis.

If I may make one other comment/suggestion: recommend to your patients that they wear sandals instead of enclosed shoes as much as possible. Yes, I know that climate often dictates that shoes be worn; however, an uncle of mine and I have both noticed that since we both switched to sandals, the diabetes-related fungal and bacterial infections that we both used to get have completely disappeared. Shoes are just too hot and humid, and provide the ideal environment for fungi and bacterium. Wearing sandals (with socks) have kept my feet drier and cooler.

"There is positive buzz that stomach stapling is an excellent way to lose weight and control blood sugar. I think they are smoking crack."

It's interesting you should mention this because my doctor has made this suggestion. I wasn't terribly fond of the idea when she brought it up. In my own case, I don't think my problem necessarily is that I overeat (in terms of quantity) - exercise and quality of food, I think, are bigger problems for me.

"This leads to(drum roll) the DrM plan which is the next blog entry....."

Insha'allah! ;)

DrMaxtor said...

Asalam Aliakum JD,
Thanks for your comment, very true about the sandals. I dont think stomach stapling is a good idea unless all other options have been completely exhausted, and I think you have plenty of those left. Will be putting up the plan soon, inshallah.

Leena said...

Thanks for the info. I think I am a little confused, though.

Does being overweight "cause" diabetes? Is there a relation between the two, other than that bad eating habits aggravate the disease?

Was the picture of the child in this post already named "fatty" or was that your choice? :-)

My grandmother's death was diabetes-related, so I am concerned about it and I appreciate your posts.

DrMaxtor said...

Being overweight, specifically abdominal obesity promotes insulin resistance, in effect significantly contributing to the development of diabetes.
Abdominal obesity is a recommended protocol for catching people who are at risk of developing metabolic syndrome and subsequent diabetes. Measurment of the waist line will become a mandatory protocol for patients in the near future. Its difficult getting rid of abdominal fat due to the relatively poor blood supply to the gut. More to follow in the next blog entry.

DrMaxtor said...

BTW Lenna, I didnt pick the name of the kid's picture. Just pulled it off google image search.

Aaminah said...

Asalaamu alaikum Dr. M.

This probably sounds like a silly question, but here goes: I use Vaseline (well, actually a cheap off-brand) on my feet regularly. Is this problemmatic (not the same as lotion or olive oil) or is it okay to continue to do so? I only do so about twice a month. Yeah, I'm with JD, I gotta start doing the lotion more regularly.

DrMaxtor said...

Waliakum Asalam Aaminah,
Theres no such thing as a silly question when it comes to health. Vaseline is ok, but it isnt absorbed. I think lotion is better.

alienbea said...

My husband's nephew was recently diagnosed with diabetes - he's six! Subhana'Allah. :(

That picture, btw, is deeply disturbing. That's what my son looked like when he was six months old. Not anymore, alhumdillah -- he's a normal-sized four year old, and lost all the rolls when he started walking. But if your child looks like that, why are you feeding him McD's? Some things just defy all logic and reason.

DrMaxtor said...

Actually B, thats just a picture I yanked off google.