By Riva Preil
November marks American Diabetes Month, and is therefore an appropriate time to discuss Diabetes Mellitus (DM). DM was first described in an Egyptian manuscript in 1500 BCE as a disease associated with increased urination (polyuria), and in fact the very name “diabetes,” which means “to pass through” was first used by the Greek Appollonius of Memphis in 230 BCE due to this trademark of the disease. The other two primary symptoms of DM are increased thirst (polydipsia) and increased hunger (polyphagia).
Normally, when a person eats carbohydrates, complex sugars are consumed, digested, and broken down into simple sugars (ex. glucose) which are sent to the bloodstream. Glucose is transported to the body cells where it is absorbed and metabolically broken down through cellular respiration in the mitochondria of the cell. This process produces ATP, or energy, and enables us to function. Insulin, produced in the pancreas, is vital in this process- it allows for normal transport of glucose into the cell. However, with DM, a person experiences hyperglycemia, increased blood sugar levels due to interference of glucose transport into the cells (to be discussed further- stay tuned for next blog).
There are generally two reasons for this abnormality: either the beta cells of the islets of Langerhans in the pancreas are not properly producing insulin (Type 1 or Insulin Dependent DM) OR the insulin is being produced, however the person has developed an insulin resistance (Type 2 or Non-Insulin Dependent DM), thus preventing glucose from entering the cells. In addition, a third type of diabetes known as gestational diabetes may develop in some pregnant women. It is associated with decreased insulin secretion thereby interrupting with glucose transport into the cells. The prevalence of gestational diabetes is 2-5% of all pregnancies, and it usually spontaneously resolves after childbirth. There is a correlation between gestational diabetes and future development of Type 2 DM. In fact, approximately 20-50% of women who experienced gestational diabetes while pregnant eventually develop Type 2 DM.