Learning & Support 2017-04-02T08:21:22+00:00

Diabetes in the World and Blood Glucose Monitoring

Diabetes is a chronic disease which affects millions of persons worldwide. Many diabetic patients are Insulin Dependent Diabetes Mellitus (IDDM) who remains alive today thanks to insulin. Many insulin dependent diabetic patients are treated with human insulin however a significant percentage are immunogenic to this treatment and require treatment with animal insulin to remain alive. Many patients are undiagnosed leading to complications and healthcare disorders in later life.

Many patients, especially children, regularly have to undergo emergency hospitalisation to overcome hypoglycaemia and hyperglycaemia.

In 2000-2001 about 82,000 lower-limb amputations were performed annually in the USA among people with diabetes. Statistics show that every hour, nine people with diabetes must have a toe, foot or leg amputated to save their lives.

These are just some gruesome aspects of diabetes. Diabetes has not been cured and insulin is actually highly dangerous, so there is no shortage of motive in searching for a primal precipitating cause that might suggest more effective and safer treatment protocols.

Diabetes is the major cause of lower limb amputations, excluding trauma, and the leading cause of blindness caused by diabetic retinopathy in many countries.

The statistics of the diabetic population place a large burden on healthcare providers worldwide.

To set the clock back, on 11 January 1922 Banting and Best first injected animal insulin made from pancreatic extract into a diabetic patient in Toronto, Canada. The first injections were not successful however on 23 January 1922 a new series of injections on the boy patient resulted in a drop of the patients’ blood glucose levels to near normal. This medical scientific breakthrough marked the end of the sentence of death for diabetic patients who before 1922 were forced to eat sparingly as their bodies had lost the ability to metabolise food properly and at best their life expectancy was one to two years following diagnosis.
By the end of 1923 animal produced insulin was being used safely to treat diabetic patients in the Western world and purified versions of animal insulin were developed in forthcoming years.

In 1925 six year old Patricia Cheeseman was the first person to be treated successfully with insulin in the UK at Guy’s Hospital, London.

understanding of DNA by Watson and Crick in the 1950’s led to the development of genetic engineering techniques which led to the biosynthesis of what is now called genetically engineered or ‘Human Insulin.’

The 1980’s with the explosion of scientific technology clinicians became aware that many diabetic patients suffered from long term side effects of diabetes including diabetic retinopathy, neuropathy, nephropathy and other side effect disorders including hypoglycaemia and hyperglycaemia. It became noticeable that diabetic patients are more likely to suffer heart disease and stroke. It is now recognised that good glucose control within normal ranges can prevent many of these side and long term complications of diabetes.

Urine testing using visual urine test strips became widely available in the 1970’s to diabetic patients and enabled a broad and general patient management of diabetic patients. Clinicians then recognised in the 1980’s that blood glucose monitoring of diabetic patients could lead to a reduction in short and long term side effects and improve control.

In the last 20 years many self-monitoring blood glucose sensors have been developed and marketed which require a drop of blood to perform a blood test. Blood is drawn invasively by pricking the patient’s finger with a needle. The blood sample is then placed on a specially treated paper strip and the colour change that takes place is correlated by visual observation, or by placing the strip in a glucose meter for analysis. The meter displays a readout of the blood glucose level expressed in mmol/l or mg/dL.

Today many meters are convenient and easy to use but can be prone to error caused by the patient’s testing technique. Unusually high results (greater than 16.7 mmol/l, 300 mg/dL) or low results (less than 2.8 mmol/l, 50 mg/dL) may indicate hyperglycaemia and ketoacidosis (high) or hypoglycaemia (low) and require immediate remedial treatment action by the patient and carer with possible third party support and hospitalisation to stabilise the condition.

In order to prevent long term complications it is important to test blood glucose levels regularly throughout the day and many diabetics, especially children, hate having to perform this task due to the pain and inconvenience. Obtaining a blood sample (with a lancet or automatic figure puncture device) is the greatest barrier to measuring blood glucose and is more feared by the diabetic patient than injecting insulin. It is however essential to prevent long term complications and patient compliance is important.

Today diabetes therapy is geared towards controlling high blood glucose levels (hyperglycaemia), preventing low blood glucose levels (hypoglycaemia), and preventing diabetes complications. Type 1 IDDM treatment consists of a daily routine of insulin injections combined with diet and exercise therapy. Type 2 NIDDM treatments may include insulin injections or oral agents to lower blood glucose, as well as diet therapy and a weight reduction programme for overweight patients.

The monitoring of blood glucose in both Type 1 IDDM and Type 2 NIDDM is seen by physicians as being paramount to the care of both forms of diabetes. Tight glucose control leads to the risk of increase in hypoglycaemia. Individual patients encounter low glucose levels and hypoglycaemia at different glucose levels however a combination of sensible insulin intake, diet and exercise not only reduces the risk of hypoglycaemia but also enhances the quality of life for diabetic patients, not only for themselves but also for their families and carers.

It is now generally accepted that animal insulin (porcine and beef insulin) yield physiological warning signs of hypoglycaemia such as tremor, sweating and hunger, and in most patients will be experienced with blood glucose levels of 2 – 4 mmol/l. When treated with human or synthetic genetically engineered insulin an IDDM patient is likely to perceive the warning signs of hypoglycaemia with blood glucose levels of 1.5 – 2.5 mmol/l and these warning signs are likely to be neurological such as confusion, sensory disturbance, behaviour change and seizure.

If not corrected hypoglycaemia can lead to diabetic coma, hospitalisation and even death.

Insulin can kill in an instant, hyperglycaemia usually will not. Insulin is a high alert drug because of its ability to throw people into dangerously low blood sugars, and the new insulin analogs are not even insulin but only insulin-like. Diabetics want and need a cure.

Sadly something is not quite right about how doctors conceptualize and treat diabetes. For the children the need to revisit diabetes is vital for there is an alarming rate of low blood sugars occurring in children at night. There are alarming reports of doctors now saying that diabetes is a “seizure disorder” because children are having so many seizures from low blood sugars, the kinds of seizures that cause cognitive changes in the brain of developing children. Doctors are telling parents to expect these seizures, and that they are part and parcel of diabetes. This is not quite true, but often results in putting children on anti-seizure medicine instead of doing something more fundamental to address the low blood sugar.

Blood glucose levels should be measured as frequently as the patient wishes, simply, painlessly, accurately and quickly. It is generally accepted that blood glucose monitoring reduces the risk of complications such as retinopathy leading to blindness; neuropathy or nerve complications; nephropathy or kidney disease and cardiac disease amongst insulin dependent diabetics.

Diabetes is disabling, deadly and on the rise. If the number of heart related deaths caused by diabetes is added to the diabetes statistics diabetes is the biggest killer in the United States.

Diabetes is a fundamental disease that affects the entire colony of cells in a person because it has to do with energy metabolism and the vastly important hormone insulin and its receptor sites. All life is dependent upon basic metabolism, the input of nutrients and removal of wastes. Insulin allows blood sugar (glucose) to be transported into cells so that they can produce energy or store the glucose until it is needed. Insulin binds with receptors on cells like a key would fit into a lock. Once the key insulin has unlocked the door, the glucose can pass from the blood into the cell. Inside the cell, glucose is either used for energy or stored for future use in the form of glycogen in liver or muscle cells. Most of the food we eat is turned into glucose, which serves as our main source of energy. Insulin is the key for the body’s trillions of cells, without it glucose can’t get into the cells, so the cells begin to starve. This is all part of a vast network where cells communicate with the intercellular environment through thousands of receptor sites on cell surfaces that respond to thousands of specific molecules (ligands) that bind to these receptors. A receptor that is bound to its activating ligand causes biochemical changes to occur inside the cell. Any problem in this constant communication dynamic between ligands and receptor sites result in disease.

Diabetes is often conceptualized as a severe imbalance of part of endocrine system that destroys our ability to metabolize food. The unbalance results in elevated levels of insulin, a lack of insulin, or the cell insulin receptor sites becoming insensitive to insulin. Though we are going to present a non-nutritional and non-lifestyle trigger that sparks a decline into diabetes, the fact remains that the disease has to do with cell nutrition. The essential elements of nutrition will always be important for any lack will make it more difficult for the body to compensate for and correct any systemic problem no matter what the cause.

Clearly diabetes is disabling, deadly and on the rise. The incidence of diabetes is skyrocketing not only in adults but in the juvenile population as well. Healthcare experts have called the alarming rise in diabetes and its related complications “an epidemic” that threatens to spiral out of control. In 1997 15.7 millions adults in the United States were reported to have diabetes. By the year 2002, this number had already swelled to 18.0 million or 8.7% of all adults. Diabetes and its complications now claim hundreds of thousands of lives in the U.S. each year, incurring total expenses of over $130 billion in direct and indirect costs to the healthcare system. Worldwide, the number of people with adult-onset diabetes is predicted to explode in the next 10 years, doubling to an estimated 221 million people. By contrast, only 43,171 people in the United States were diagnosed with AIDS and only 18,017 died.

If we add the number of heart related deaths caused by diabetes to the diabetes statistics we actually find that diabetes is the biggest killer in the United States. This means that the above statistics understate the problem. Thus it would help a lot of people if we could isolate a basic cause for this disease. Though there are several important causes/factors contributing to the dramatic rise in diabetes, the core cause has eluded scientists and doctors – meaning a cure to diabetes has not been found. This medical review sifts the focus away from typical diabetic etiologies and suggests we concentrate on causes that can quickly bring on diabetes through intense chemical exposure or slowly through decades of low level chronic exposure.

A growing number of children are visiting paediatric cardiologists to treat their high cholesterol, or seeing endocrinologists to keep their diabetes in check. In short, kids are “catching” the diseases that kill most adults,” wrote Krista Ramsey of the Cincinnati Enquirer. “The picture has been on the wall, but we’ve just refused to see it,” said Dr. Larry Fox, medical director of the Northeast Florida Paediatric Diabetes Centre in Jacksonville. “We have to realize that the kidney disease and heart disease we used to see in people in their 50s and 60s – who developed Type II diabetes in their 40s – we’re now going to see in people in their late 20s and 30s. If we don’t do something about it, our grandchildren are going to go blind in their 20s.”

Diabetes is a fundamental disease that affects the entire colony of cells in a person because it has to do with energy metabolism and the vastly important hormone insulin and its receptor sites. All life is dependent upon basic metabolism, the input of nutrients and removal of wastes. Insulin allows blood sugar (glucose) to be transported into cells so that they can produce energy or store the glucose until it is needed. Insulin binds with receptors on cells like a key would fit into a lock. Once the key insulin has unlocked the door, the glucose can pass from the blood into the cell. Inside the cell, glucose is either used for energy or stored for future use in the form of glycogen in liver or muscle cells. Most of the food we eat is turned into glucose, which serves as our main source of energy. Insulin is the key for the body’s trillions of cells, without it glucose can’t get into the cells, so the cells begin to starve. This is all part of a vast network where cells communicate with the intercellular environment through thousands of receptor sites on cell surfaces that respond to thousands of specific molecules (ligands) that bind to these receptors. A receptor that is bound to its activating ligand causes biochemical changes to occur inside the cell. Any problem in this constant communication dynamic between ligand
Diabetes is often conceptualized as a severe imbalance of part of endocrine system that destroys our ability to metabolize food. The unbalance results in elevated levels of insulin, a lack of insulin, or the cell insulin receptor sites becoming insensitive to insulin. Though we are going to present a non-nutritional and non-lifestyle trigger that sparks a decline into diabetes, the fact remains that the disease has to do with cell nutrition. The essential elements of nutrition will always be important for any lack will make it more difficult for the body to compensate for and correct any systemic problem no matter what the cause.

Children and adults have been consuming about 80% of their energy intake in the form of highly processed refined carbohydrates which are devoid of minerals and vitamins. Scientists know that cells cannot convert this caloric energy into cellular energy without nutritional cofactors and this has been a recipe for disaster for a long time.

Type 1 diabetes: which usually starts in childhood, is a process where the pancreas stops making insulin altogether. It is often called insulin-dependent diabetes. In Type 1 diabetes the cells in the pancreas that make insulin are somehow destroyed, causing a severe lack of insulin. This is thought to be the result of an autoimmune reaction of the body that attacks and destroys the cells in the pancreas. Normal medical explanations for what causes this include infection; exposure to food-borne chemical toxins; and exposure as a very young infant to cow’s milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body. The autoimmune process results in the circulation of antibodies that cause beta-cell destruction (the body fighting what it now considers foreign to itself). It is known that certain drugs, such as alloxan, streptozocin, and thiazide diuretics, are toxic to the beta cells of the pancreas and can cause diabetes, but toxic causes have until now been generally ignored. Vaccines have also been implicated in this scenario.

Type 2 diabetes: In 1933 Joslyn, Dublin and Marks published in the American Journal of Medicine a paper titled, “Studies on Diabetes Mellitus” discussing a major epidemic of a disease that looked very much like the Diabetes of the early 1920’s only it does not respond to the wonder drug, Insulin. Even worse, sometimes Insulin treatment killed the patient. This disease became known as Insulin Resistant Diabetes because it had the symptoms of Diabetes, but did not respond well to Insulin therapy. Until recently, type 2 diabetes starts in adulthood (and in some teenagers); the body still makes insulin but not enough, or the body can’t use what is made with reasonable efficiency. It is often called non-insulin-dependent diabetes. Type 2 diabetes is believed to develop when the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it – this is known as insulin resistance. In response to this more insulin is produced and this over-production exhausts the insulin-manufacturing cells. The problem can be one of three: there is simply insufficient insulin available; the insulin that is available may be abnormal and doesn’t work properly, or a defect in the insulin receptor sites does not allow insulin to function.

The official take on the causes of diabetes is that it is a response to obesity or unhealthy patterns of food intake and energy metabolism. A diet high in refined carbohydrates and sugars, nutrient deficiencies (such as chromium and omega-3 fatty acids), genetic factors, sedentary lifestyle, chronic immune reactivity to dietary antigens and inborn errors of metabolism all are thought to play roles. None of this tells us much about the underlying cause, nothing about how to halt this dramatic rise in human suffering for even with dietary control diabetes is not cured. Though more than 97 million Americans are overweight or obese, diet alone does not explain obesity nor diabetes.

Every cell in the body depends on an adequate supply of glucose for the energy it requires to function properly. For type-2 diabetes mellitus doctors believe that the breakdown in blood sugar regulation results from a sedentary lifestyle, poor diet, and genetic predispositions which all combine to gradually desensitize the body to the actions of insulin, the hormone that transports glucose from the bloodstream into cells. Eventually, it is thought, this malfunction may trigger a vicious cycle of imbalances that promotes further obesity and metabolic imbalances.

Health officials acknowledge that the inability to maintain normal glucose control can itself lead to obesity, heart disease, hypertension, diabetes, chronic fatigue, accelerated aging, as well as numerous mental and emotional disorders. Doctors routinely tell us that people are developing diabetes because they are fat and that if they fight obesity, they will help prevent diabetes. Yet the opposite could be true and some people do suspect that people are obese because they are diabetic – not the other way around. The fact that the pancreas secretes excess insulin, the liver manufactures fat from the excess sugar and the adipose cells store excess fat are parts of the diabetic profile suggests obesity is a result not a cause.

It has long been thought that a diet rich in “empty” sugars will catch our pancreas and adrenal glands in a biochemical see-saw, overworking them and this could weaken the pancreas and result in diabetes. In general though the medical establishment does not recognize the link between sugar consumption and diabetes for if it did there would be warnings against most of the foods found in the supermarket today. Prudence would have us say that sugar over-consumption does not explain the recent rapid rise in diabetes yet it is foolish not to consider it as a background factor. No factor alone can explain anything when it comes to life and health and in a hunt for principle causes this is an important point to retain in mind. We are going to be surprised at what the principle cause actually is, and how other causes tie into the principle one, but there is no denying the facts.