Metabolic stress in Diabetes Mellitus

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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Basic metabolic changes in Diabetes Mellitus

Previously on Wellness and I the disorder of Diabetes Mellitus or DM was explained. But as mentioned earlier DM is the metabolic disorder and it largely determines how your body will function there after. Today I will share how to understand DM by knowing about its metabolic changes in the body.
DM as mentioned earlier occurs due to inadequate or complete lack of insulin hormone from the pancreas. This in turn leads to accumulation of glucose molecules in the blood as duely explained previously. This alone changes the original metabolism of our body, but forcing the cells to look out for other sources of energy already stored or easily available in the blood. There are 3 major energy producing biomolecules our body can utilize, viz carbohydrates or sugars, protein or protein molecules and fats. So now due to the unavailability of glucose for the cell it is forced to burn either the fat or the protein whichever is easier. Our body is also a smart piece of engineering designed to save itself first and burn out for the last and that is why it will go for fat deposits in the body before it can burn protein molecules as they are vital for basic functioning of the organs and tissues. However burning up fats doesn't seem to happen completely in the body and it leaves behind at the end of the metabolic cycle keto acids or by products that are not metabolised properly to be ridden from the body. If they start accumulating it can go on to be fatal for the brain and liver. There comes this time where the body can choose to metabolise protein molecules if there isn't enough fatty deposits in the body, this causes rapid increase in the blood acidity and muscle wasting which then weakens the already energy depleted body. As muscle and bone protein form the basic structure of the body if they get utilised to run the body energy station can you imagine how weak our basic structre would become?

You must now wonder if all this is a natural option chosen by our body if it becomes diabetic or doesn't secrete insulin enough how is it that people suffering from it before being diagnosed appear and live so normally without having problems? Let me throw some light on that one again as I mentioned earlier the body doesn't let it all go untill it can't handle the situation anymore, so its obvious why the symptoms aren't out there for all to see at first. But yes if ignored all hell can easily break loose to the outside. Another part of the metabolic change is the blood content that changes with the growing sugar content and rapid increase in the acidity. The requirement for the water content due to increased solutes in blood shoots up leading to increase in thirst constantly. Due to the breakdown of fats and some protein in the body with the lack of sugar content the body constantly craves for nutrients and hunger pangs increase in rapid succession. The depletion of energy deposits lead to loss of body weight. The idea to keep the metabolism in control is to first get a calculated diet plan and follow it to the TEE as there isn't any other choice and get your medication on time. Controlling the hunger and the wastage of the body can go a long way in dealing with the basics of metabolic changes in diabetes.
There is more on metabolism that we need to understand in diabetes which will follow in the next post.

Wish you wellness,
Neha Wasnik
R.D

Diabetes Mellitus : Bitter sweet tale

This new series of my blog is dedicated to the reason of my being, my grandma who passed away yesterday due to heart failure secondary to diabetes.

Everybody in this world has a story to tell with the subject of Diabetes in one way or the other. We all somehow have been intertwined into this bitter sweet symphony of life called Diabetes whether its in a childhood form or adult form. Some more unlucky of us have lost the dearest parts of our life to it and some are awaiting to face that dreadful moment. I have unfortunately lived through it recently. I am about to share with you through this new series on Diabetes the various obvious things to prevent if A) you or your dear one is diagnosed with Diabetes Mellitus (DM) or B) you would want to prevent lifestyle developed DM.

Diabetes Mellitus or DM as I would refer to it often ahead is an adult onset metabolic disorder of the hormone insulin secreted by the endocrine cells of the pancreas. Insulin to put it in simplest of metaphorical terms acts as a visa for every glucose molecule in our blood to enter any cell. The passport being the sodium molecule which acts as active transporter of the glucose into the cells of the body from the blood stream. To understand how it all occurs or even how it all goes wrong in the case of DM imagine our body cells to be a foreign land and the blood stream to be the airports, glucose molecules as people and sodium channels being airplanes while sodium being the passport carried while boarding the plane, insulin is the visa that needs to be validated before entering the airplane to go abroad. Now imagine what happens if you have the passport but don't get your visa validated at the immigration desk? What happens if there is no visa validation at all for anybody at the airports across the country? What happens to the airports' premises if people are stamping over the other but get no visa to board the plane? Can you see the chaos at all airports bursting out at the seams with people? This is what happens outside every cell in our body when there is lack of insulin secreted or too inadequate to help glucose enter the cell. The glucose molecules start accumulating outside in the blood stream unable to enter the cells to generate energy and hence fuel for the body. This increases the viscosity of the blood and hence the blood pressure over a period of time. Due to the increased pressure there is an increased demand on the heart. Our body is engineered to absorb as much stress to a certain extent without disturbing the outside environment of the body and it is this ability of the body that prevents the diagnosis of DM too soon untill of course the body starts letting out symptoms.

DM like AIDS is not the threatening reason people die but because these disorders easily bring in the diseases that cause death. It is never the immediate cause of death but it sure is the easiest way to introduce it to the body. DM is known to have secondary complications the primary being ophthalmic, kidney failure, heart disease, stroke, skin disease, diabetic foot. All these secondary to DM ailments are the reason for death due to DM not DM alone. Its only when the body goes into ketoacidosis due to extreme acidity of the blood raised by the incomplete breakdown of fat instead of glucose in the body, does it lead to death.

Diabetes alone can be easily kept under control with lifestyle adaptation however it is the general myth that it can be ridden out of our body that needs to be clarified. Insulin secretion stops from pancreas naturally or due to obesity where the fat deposition exceeds on the cells making them resistant to insulin uptake. If insulin secretion stops or is inadequate it will result into diabetes mellitus and that is permanent. However, if that is the diagnosis it should not be necessarily taken as if you were handed your death certificate but instead as a chance to survive keeping your life as normal as it were with some mandatory changes in lifestyle. In the next part I shall reveal more obvious truths about DM and busts some myths too.

Wish you wellness,

Neha Wasnik
R.D