Reply #11: That is Type I diabetes (Diabetes primer for those who are interested) [View All]

[TechBear_Seattle]

Diabetes mellitus is where glucose accumilates in the bloodstream, causing a lot of problems. Complications of diabetes includes: slow wound healing, greatly increased chance of bacterial infection, suceptibility to viral infections, kidney failure, blindness, degeneration of nerve cells and a nearly 200% increase in the risk of heart attack, stroke and other cardio-vascular problems. Between slow wound healing, nerve damage and the increased risk of infection, it is not uncommon for a person with severe diabetes to get an injury (typically on the foot) and not be able to feel the pain. Without that warning, the wound goes untreated, and the increased threat of infection can lead to gangrene so advanced that by the time the person realizes something is wrong, amputation is the only possible treatment.

Diabetes is actually a symptom, not the cause. Nearly all causes of diabetes falls into one of two categories: Type I and Type II.

When a person eats, all carbohydrates eventually get turned into a sugar called glucose. It is a very energetic molecule, which is why most animal life on the planet has evolved to use it. A percentage of this glucose is released immediately into the blood stream; the rest gets bound together with fat to create a molecule called glycogen. When the level of glucose in the blood gets too low, the liver unravels glycogen and releases more glucose, keeping up a steady supply during the day.

As glucose levels in the blood rise, cells called the islets of Langerhans (ioL) in the pancreas begin to secrete insulin. Insulin is a carrier hormone. One end of the molecule is bent into a shape that "grabs on" to a glucose molecule when the two meet in the blood stream. When insulin "catches" a glucose, it gets bent into a slightly different shape; now, the other end is triggered to "grab on" to a cell receptor. When a cell wants more glucose, it will put out these receptors and basically fish for glucose. When a filled insulin molecule hits one of these receptors it will latch on and the cell drags everything in. The insulin is broken down into amino acids and recycled while the glucose is used for fuel.

Type I diabetes is where the islets of Langerhans are damaged or destroyed, resulting in too little insulin being produced. Usually this damage is caused by the body's own immune system destroying the ioL, typically in early childhood. Most of the remaining cases occur in old age, as a result of the body's general deterioration. The remaining cases of Type I diabetes can be blamed on some other condition which has affected the ioL or to a very rare genetic condition where the islets never develop or are improperly formed. Type I is typically treated by injecting insulin shortly before every meal as well as by food management. Type I diabetes accounts for about 5% of all cases of diabetes in the United States.

Type II diabetes is where the body does not use the insulin that is present. Typically, a person with Type II produces too much insulin and cells have stopped "fishing" for it. While obesity has been strongly linked to Type II there are many people with this type of diabetes who have been lean their entire life, and many people who are obese and never develop Type II. There is evidence that Type II and some kinds of obesity may be co-symptoms of a common cause; several studies have shown this cause to be a high glycemic diet (ie a diet with lots of foods which cause a sharp, sudden spike in blood sugar with a parallel sharp, sudden spike in insulin levels.) Usually, Type II is treated with food management, exercize, weight loss and medications which either impede the production of insulin or encourage cells to take up more insulin. Most of the 95% of all cases of diabetes in the United States which are not Type I are Type II. (There are some very rare forms of diabetes mellitus which are neither Type I nor Type III.)

So called "gestational diabetes" is a sub-type of Type II. It is caused by hormonal changes in some pregnant women which lead to insulin resistance. When these changes reverse after giving birth, the diabetes fades as well and the metabolism returns to normal.

If this study pans out, it marks the first time we have observed the mechanism -- or at least one of the mechanisms -- which cause insulin resistance. That is what makes this such a significant breakthrough. The first possibility is for medications which reduce insulin resistance itself; the second (and much hoped for) is an actual cure for Type II.