Monday, December 15, 2008

Insulin is not a cure

What is insulin and why do Type 1 diabetics need to inject it to stay alive?

Our bodies are made up of cells. Each cell requires a constant supply of fuel (sugar) in order to do what it is supposed to do (it's role in the body). Without sugar the cell will die. This "sugar" comes mainly from carbohydrates that we consume. These carbohydrates are converted to sugar by our digestive system and absorbed into our bloodstream. Our blood then carries this sugar to all cells throughout our body.

Once the sugar reaches a cell, insulin is required for the sugar to enter the cell. Insulin is the vehicle that moves sugar from the bloodstream into each and every cell. Without insulin, this sugar cannot enter the cell and simply accumulates in the bloodstream. The starving cell sends out a signal that it needs sugar and the body reacts by dumping even more sugar in the bloodstream. This is the process that causes a Type 1 diabetic's blood sugar to go high. And until there is insulin there to enable the sugar to enter the cell, blood sugar will continue to rise because of this vicious cycle and the cells will continue to starve.

If a Type 1 diabetic injects too much insulin, the sugar from food consumed will be moved into cells very quickly (like if you changed a 2 lane busy road into a 10 lane highway, traffic would move much, much faster). The problem with this is that once all the sugar is gone (no more food in the stomach and all blood sugar absorbed by cells) the cell will be starving because the sugar supply has run out. The body will try it's best to adapt - a limited amount of sugar stored in liver will be released for example, but until more sugar is consumed blood sugar will continue to drop and the cells will continue to starve and could eventually die.

In a non-diabetic these 2 scenarios are avoided because our bodies are very, very efficient at monitoring insulin production and release from the pancreas, sugar absorption into bloodstream and blood sugar levels. For the Type 1 diabetic, not only does the pancreas no longer produce insulin, but all of this monitoring is gone also. Injecting insulin is the easy part of managing Type 1, the challenging part is all of this monitoring that non-diabetics take for granted...

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