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Thursday, December 5, 2013
How Diabetes Occurs in The Body
Since I'm new to this ailment, what does it mean (besides I`ve got lots of sugar in my blood) when my teststrip shows blood sugar at 320?
Glucose (the sugar we follow most commonly in the blood) is a form of fuel for many tissues in the body. It generally enters the body as food although in some instances it can be given through a tube (intravenous catheter or IV) into the blood. It then gets distributed to the various tissues which rely on glucose for fuel, or which are storage depots for glucose converted into either a large sugar-like molecule called glycogen (in liver, muscle, kidney, brain) or to fat molecules (as in fat cells).
The blood is the compartment in the body through which the glucose has to pass to get from one location to another - there is no direct connection from the intestine to muscle or brain, for example. When the sugar in the blood is too high, that occurs either because one of the sources is putting too much sugar in to the system, or one of the targets which takes up sugar can`t do so correctly. When we eat, most of our food is digested and turned into sugar. Our cells have to use sugar to stay alive.
Insulin is a hormone that allows certain cells (liver, muscle, fat cells) to receive sugar. If we do not have enough insulin, those cells are not able to use sugar, the sugar gets trapped in the blood, and the blood sugar is high. That is important because it has consequences in both the short-term and in the long-term. In the short-term, it may force the sugar to go out in the urine and take fluid and key salts from the body with it. The lack of insulin also causes the break down of fats into molecules called ketones which result in overproduction of acid in the body. If this goes too far, primarily in people with type 1 diabetes, it can cause an emergency called diabetic ketoacidosis which is dangerous and can kill people.
Type 1 diabetes is the situation where people have lost virtually all ability to produce insulin themselves. It is important in that situation to test your urine for ketones when your blood sugar is high - ketones are produced when the body is critically low on insulin. You should contact your diabetes health care provider immediately if you:
- have thirst which you can’t control
- feel severely dried out (dehydration with extreme urine loss)
- are breathing very heavily
- have positive urine ketones
If you are unable to reach them, you should seek emergency care immediately.
Most people have type 2 diabetes in which the pancreatic cells can make some insulin but it is not enough to meet the demand caused by resistance of the insulin-sensitive cells to insulin. Most people with type 2 diabetes can have extreme urine loss and risky situations can result from dehydration. However, they usually do not develop ketoacidosis although some can if they have another severe sudden illness like pneumonia or a heart attack, or if they have had diabetes for a very long time.
In the long-term, high blood sugar causes an increase in chemical reactions which lead slowly and progressively to damage to the body over the course of many years. This affects primarily blood vessels and nerves and the consequence can be damage to
- eyes (blindness)
- kidneys (kidney failure requiring dialysis or transplant)
- legs (infections and amputations)
- heart (heart attacks)
- brain (strokes)
We`ve learned that controlling the blood sugar to near normal levels dramatically reduces the chance of some of these consequences. We are studying whether controlling blood sugars has an effect on the other complications. Currently, we don’t have an answer. The National Institutes of Health is supporting a study called the ACCORD Trial (Action to Control Cardiovascular Risk in Diabetes) which will be starting in January-February of 2003 to recruit people in high-risk groups to answer this question.
If your blood sugar is 320, it means you probably do not have enough insulin and some cells are not getting enough sugar and others are getting too much. Temporarily your body can adjust to this situation, but over time you can become sick if your blood sugar stays high. If your blood sugar tests are high, you should contact your diabetes health care provider. For more information on blood sugar and diabetes, link to the following websites:
Nancy J Morwessel, CNP, MSN, CDE
Pediatric Nurse Practitioner
College of Medicine
University of Cincinnati