Many North Americans have Diabetes. It sometimes runs in families. Or it may be caused by infection. But often we simply don't know what brings it on. In order for fat people to better handle this situation it is important to understand what we are dealing with.

The food we eat must be used or stored. Unlike sharks, we can't have food just sitting in our stomachs indefinitely. Instead, we break it down into basic energy bundles like sugar through the process of digestion. We don't need all the energy right away so we store it in warehouses of fat.
Insulin is a special hormone that acts as the "shipping and receiving" agent for sugar. It helps store some sugar in our livers and other places, and later helps transport it to various parts of the body that need the energy. Insulin is named for the little "island-like" cells living in a "sea" of tissue known as the pancreas, a small gland near our stomach. In some people the pancreas doesn't function properly and if there's no insulin then sugar just wanders aimlessly about the body-it can't be stored, and it can't get into the body's cells to act as fuel. This causes a number of problems.

Firstly, sugar floating in the bloodstream acts like a sponge, sopping up fluid from our cells all over the body. The body tries to get rid of all this excess sugary fluid by dumping it out the kidneys. That's why diabetics go to the bathroom so often and also why they get so dry and thirsty. That thirst is usually for sugary drinks and there's a hunger for sweets. You see, without insulin, even though there's lots of sugar around, none of it can be used by the body's cells, and no matter how much diabetics crave sugar it keeps right on flowing uselessly out the system.

Thirst, excessive urination, and hunger for sweets aren't the only symptoms. Because the body can't use the sugar for energy, people lose a lot of weight and get very fatigued. So if you notice that your clothes are loser fitting or non-fat admirers are complimenting you on your weight loss even though you haven't altered your intake, diabetes is a possibility.

Why are health care professionals constantly pointing fingers at fat folks as easy targets for diabetes? Some of this castigation is unfair if you understand the process. As all humans get older they don't use as much energy and tend to have more fat and sugar on board. The pancreas works overtime, somewhat more so in fat people, to store and transport the excess sugar until, in some individuals, it finally "poops out" and stops supplying insulin.

However, this process is not exclusive to fat people, nor to older adults. Some children and thinner people have what used to be known as juvenile diabetes in reference to the age group most severely affected. It has recently been postulated that cow's milk, when introduced to some susceptible infants, causes the immune system to "go crazy," attacking its own pancreas. There are also genetic and infectious causes of pancreatic failure, and alcohol, being a kind of liquid sugar, is a major culprit as well.

Because almost every system in the body is dependent on sugar for energy, diabetics are prone to other problems. The blood vessels need energy too and without insulin to help them get that fuel, they may become fragile, damaged, and clogged with fatty deposits. Heart disease, stroke, blindness, and serious infections used to be the result. But today, meticulous care to prevent infections and proper control of sugar levels by medicines means a fairly normal life for most.
In the milder form that usually affects older people, weight loss, exercise, and proper diet give the exhausted pancreas a chance to recover. Most doctors say that fat people have to lose lots of weight. This is not true. The body usually responds favorably to an appropriate diet even if little or no weight loss occurs. Sometimes pills must be taken that lower the blood sugar levels. They work by pushing the remaining pancreatic cells to work harder in order to keep insulin at reasonable levels. But these medicines alone are not always enough.

The discovery of injectable insulin has been a lifesaver for millions. It used to be extracted from pigs and cattle which caused some allergy problems when injected into humans. Medical advances allow scientists today to take the same bacteria that cause traveler's diarrhea and alter their genetic make-up so that they produce insulin almost identical to the natural substance in humans.

And now for some closing good news. Advances in diabetes treatment are being made every day (continuous insulin pumps, portable sugar level monitors, pancreas transplants etc.) and it is now possible for diabetics to live long and happy lives. Research just published does indicate, however, that keeping the blood sugar level as normal as possible is the key. Keep a diary of your sugar levels in order to assess the circumstances under which your particular sugar gets out of sync. Then sit down with your enlightened physician and discuss the best way to adjust your medicines to suit you, not vice versa. ß

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Heretic Physician