The True Meaning of Alternative Medicine |
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WHAT CAUSES DIABETES?Diabetes may take many forms, but, broadly speaking, falls into two main groups. The first type of diabetes is more striking, but less common, than the second. It often leads to diabetic coma if untreated. A sixteen-year-old schoolgirl started to complain of fatigue and loss of energy, and her parents noticed that she seemed to have lost weight. A few days later she became intensely thirsty, and her sleep was disturbed by the need to pass large amounts of urine. When she started to vomit and became drowsy she was brought to hospital; the casualty officer suspected diabetes and this was quickly confirmed by blood and urine tests. Not only was the amount of glucose in her blood very high, but there was a great excess of fat in her plasma. She was given insulin by injection, and put on a carefully controlled diet. Within two weeks she felt entirely well. The treatment for this type of diabetes includes a special diet and, usually, two injections of insulin each day. The condition is itself due to lack of insulin, the vitally important hormone secreted by cells in the pancreas, which we need in order to use sugars and fats normally; so it is usually known as insulin-dependent diabetes. Why do the insulin-producing cells of the pancreas fail? Three current theories concern inheritance, virus infections and destruction of the cells by antibodies. This type of diabetes is only weakly inherited. For example, Dr David Руке has found that if one identical twin has the condition, there is only a 50 per cent chance that the other twin will also be affected. The chance of a parent with this form of diabetes producing a similarly affected diabetic child is quite small. The role of inheritance has become clearer. Drs Nerup and Cudworth have looked at a group of simply inherited substances present on the surface of cells. These go by the name of ‘histocompatibility antigens’, or HLA (they are important in transplantation of kidneys and other organs). People with some types of HLA have an increased chance of developing this form of diabetes; this emphasizes the role of genetic factors. The evidence for virus infection is weaker and based mainly on animal studies. Diabetes is an occasional sequel to mumps, and to a German-measles infection during pregnancy. The story is rather circumstantial. The evidence that insulin-producing cells are damaged by antibodies is also very incomplete. We know that some diabetics do have such antibodies. In someone with an inherited susceptibility to this type of diabetes, it is possible that certain viruses may stimulate the production of an antibody. This antibody would gradually damage the insulin-secreting cells, and overt diabetes would appear after a year or more. The second type of diabetes is commoner, but less dramatic. It can start at any age, but most often it appears in middle age or in the elderly. Patients are often obese. The diagnosis is made by routine blood or urine tests, or following the complaint of thirst and excessive urine flow or itching or, regrettably, because of complications such as heart disease. There is some argument about whether this form of diabetes (sometimes called maturity-onset diabetes) is also due to insulin deficiency. On average, patients have less insulin in their blood than non-diabetics of similar weight and age. Another feature (studied by Dr Reaven at Stanford University in California) appears to be that they are resistant to certain of the effects of insulin. This resistance is linked with obesity. It seems that both insulin lack and insulin resistance may be present. This type of diabetes is more clearly inherited, as is clear from Dr Pyke’s twin studies. Obesity is certainly an important cause. The mainstay of treatment is diet. Correction of obesity is most valuable, and often abolishes the symptoms and most of the abnormal chemistry. The diabetic has to avoid sugar, to control the amount of carbohydrates and to limit the intake of saturated fat. Lately we have learned that the level of glucose in the blood can be kept lower if extra fibre (roughage) is added to the diet. Hence the rewards of successful dieting are very considerable. The more effective the dieting the less chance that it will be necessary to use drugs or other treatments; but when necessary the latter can be very useful in helping achieve normal levels of glucose, cholesterol and fat in the blood. *2/202/5* THE G.I. FACTOR: WHAT IS DIABETES?Diabetes is a chronic condition in which there is too much sugar (glucose) in the blood. Keeping the sugar level normal in the blood needs the right amount of a hormone called insulin. Insulin gets the sugar out of the blood and into the body’s muscles where it is used to provide energy for the body. If there is not enough insulin or if the insulin does not do its job properly, diabetes develops. In general, children and young adults develop diabetes because they cannot make enough insulin (type 1 diabetes). People over the age of 40 usually develop diabetes because their insulin does not work properly (type 2 diabetes). At first the body struggles to make extra insulin because what is there is not working properly, but later these people also develop a shortage of insulin. The aim of treatment for people with type 2 diabetes is to help them make the best use of the insulin they have and to try to make it last as long as possible. Diabetes is on its way to becoming one of the most common health problems in the world. Currently, in many developing and newly industrialised nations, there is an epidemic of diabetes. Already in some countries half of the adult population has diabetes. In Australia it is the seventh leading cause of death. It is very common in Australia’s Aboriginal people in whom up to one in four has diabetes. *122\42\4* |
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