Diabesity

Definition of diabetes:

• When insulin is unable to play its proper role and no longer has the ability to process sugar causing glucose to accumulate in the blood.

• Type I: immune system destroys beta cells in pancreas, disabling it to produce insulin, can be treated but not cured.

• Type II: body’s cells don’t respond normally to insulin but it is still able to produce insulin, 90% of diabetes cases are this type. Strongly associated with excess weight, can be cured at its early stages if a normal weight is achieved and maintained.

• The blood of a person with type I will have islet cell antibodies whereas a person with type II will not.

Characteristics/symptoms of Type I and Type II:

• Type I usually begins abruptly. Suddenly a person will experience symptoms such as dehydration, excessive urination, and weight loss. If it goes untreated after a month more severe symptoms follow that include significant malaise, vomiting, and even loss of consciousness.

• Type II begins with quieter symptoms that may go on longer without being detected. Risk factors increasing the chances of developing type II include being overweight or obese, having a family history of diabetes, showing insulin resistance such as high blood pressure, high cholesterol, or other abnormal blood fats, or being a member of an ethnic or racial minority known to have an above average risk.

• Symptoms include fatigue, frequent urination, slower healing of sores, recurrent infections, blurred vision, heart attack, stroke, kidney failure leading to severe headaches and water retention, abdominal bloating, constipation, or explosive diarrhea.

Why are we seeing a rise of diabetes and more cases of Type II in children?

• Increased obesity = elevated risk for diabetes

• Obesity has been escalating in our youth; In 1970s only 4% of children/6% adults were considered to be obese. In the 2000s both have increased to approximately 16%.

Health care costs of diabetes:

• In 2002, diabetes related costs in the US were an astonishing $92 billion.

• When you include indirect costs associated such as lost wages and lost work productivity, it amounts to $137.7 billion.

Regulation of blood glucose:

• The pancreas-more specifically the islets of Langerhans- is responsible for maintaining normal sugar metabolism. In a healthy body, when food is eaten causing blood glucose levels rise, sensors in the pancreas detect the change. The pancreas then releases a corresponding amount of insulin which goes to receptors on cells throughout the body. When these receptors are triggered by the insulin the cells allow glucose to enter them. As the glucose moves into the cells, the glucose level in our bloodstream drops. The pancreas senses the change and stops releasing insulin, keeping blood sugar levels steady and enables our body to function properly.

How is this regulation disrupted in Type I and II?

• Type I: an autoimmune disorder – beta cells are destroyed by body’s own immune system. When someone’s immune system has certain genetic alterations they’re exposed to a series of triggers causing their immune system to attack its own body.

• Type II: the body’s cells become insulin resistant – they can’t use the insulin properly. Even though the pancreas is producing insulin, the cells are not receptive to the insulin that is circulating. At first the body produces greater amounts of it to compensate, but at some point the pancreas falters and diabetes develops.

Visceral vs. Subcutaneous fat and the consequences:

• Visceral fat is invisible fat found inside the abdominal cavity. This type of fat is more metabolically active and more dangerous. It churns out more potentially dangerous chemicals that are produced by adipocytes and its location adds to risk. If fat cells are overstuffed and are close to bursting they spill over into nearby organs such as the liver and pancreas. When fat gets inside muscle cells they can’t respond properly to insulin. Muscle doesn’t take up sugar normally or metabolize as efficiently as it should. Fat in the pancreas shortens the lives of beta cells, and in the liver it alters its response to the insulin.

• Subcutaneous fat is the layer of fat under skin and acts as insulation and