It is a well known fact that Diabetes Mellitus otherwise known as DM is a metabolic disorder caused due to the inadequacy of insulin hormone. Metabolic disorders like this one brings in metabolic stress along with it needless to say. However it takes a real long time before the body starts giving out symptoms of this built up stress. What we need to understand is what are the implications of this metabolic stress caused due to DM and how does it all begin? This dual question takes us back to the previous posts of understanding Diabetes Mellitus.
Now lets understand the stress caused in our metabolism due to DM. Stress is caused due to accumulation of reactive oxygen molecules or free radicals in the body. In diabetes this is usually caused by the metabolic impairment of fat and protein metabolism. Due to the resistance to insulin especially in the muscles, liver and fat cells or adipocytes there is increase in free fatty acid deposition in the skeletal muscle cells, this impairs the cellular or mitochondrial energy molecule formation in muscles leading to anaerobic energy formation. Due to the release of free fatty acids on improper fat metabolism to generate energy, there is increase in reactive oxygen molecules forming reactive lipoproteins in the blood or oxidated VLDL or LDL (low density lipoprotein a.k.a bad cholestrol). Oxidated LDL and is the key to the formation of arterial plaques leading to the much infamous atherosclerosis or blockage in the coronary arteries.
Free radicals aren't so easily removed from the body as they tend to engage other molecules with them to cause major damage to the tissues in a matter of time. Fat metabolism impairment due to resistance to insulin and lack of readily available glucose molecules to enter the Kreb's Cycle which eventually generates energy in our body leads to the overall metabolic stress caused by the reactive oxygen molecules attached to fatty acids or even protein molecules. Now there is another metabolic stress built up on the side while the free fatty acids and protein molecules are on play and this is due to ketoacidosis. I had earlier mentioned about diabetic ketoacidsis when due to the incomplete breakdown of fats to generate energy there is a formation of ketone bodies or molecules which are the end products of the incomplete fat decomposition cycle. This cycle palys fatal to the liver, kidneys and brain as the level of ketone directly harmful to kidney and brain rises. Primarily this cycle comes to play if the body is thoroughly malnourished and is left with no option but to enter the fat decomposition cycle. Now I have witnessed people fall prey to this and with adequate insulin therapy and nourishment being monitored on an hourly basis this can be reversed. However the danger of this stage is something you don't want to see. The metabolic stress developed with ketone bodies causes disorientation, high acidity in the blood and kidney failure too which inturn is sufficient for the entire body collapse including heart and lungs.
Metabolic stress in DM has major and direct implications on vital organs like kidney, liver, heart and the lungs too. Due to the increasing free radical formation there is an obvious enagagement of visceral or central organs and tissues causing them regular and consistent damage. If the levels of these free radicals isn't controlled physically and biochemically there is no doubt that a major secondary complication will arise soon. I will discuss about the acute complications of Diabetes in my next post. Till then if you have anything about diabetes you want me to write on please leave a comment.
Wish you wellness,
Neha Wasnik
R.D
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