In ancient Greece, diabetes was known to exist, but it was a rare disease. Today, that has dramatically changed as diabetes now affects some 18.2 million Americans. Diabetes costs our nation $132 billion yearly as of 2002, a cost of $13,243 per affected person. The insulin-producing cells in the pancreas are connected by connexin 36. Changes in Cx36 alter the insulin content and glucose-induced release of insulin in these pancreatic cells. Based upon scientific studies, it is thought that the insulin secreting cell (beta cell) anomalies in both type 1 and type 2 diabetes are related to connexin dysfunction. In addition, many of the side effects of diabetes such as diabetic cardiomyopathy, arrhythmias, diabetic retinopathy, diabetic peripheral neuropathy, diabetic cataracts, and diabetic microangiopathy may be related to connexin dysfunction.
We will focus on type 2 diabetes since medicine has more success in reversing this condition through lifestyle changes.
Type 2 diabetes is the most common form of diabetes. In type 2 diabetes, the body does not produce enough insulin or the cells do not respond to the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells.
Type 2 diabetes impairs the ability to get glucose (sugar) into cells and is is due to insulin resistance or reduced insulin sensitivity, combined with reduced insulin secretion. The defective responsiveness of body tissues to insulin almost certainly involves the insulin receptor in cell membranes.
Causes of Type 2 Diabetes (Pathophysiology)
There are numerous thoughts as to the exact cause and mechanism in type 2 diabetes. Central obesity (fat concentrated around the waist in relation to abdominal organs, but not subcutaneous fat) is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones that may possibly impair glucose tolerance. Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes. Other factors include aging (about 20% of elderly patients in North America have diabetes) and family history (type 2 is much more common in those with close relatives who have had it). In the last decade, type 2 diabetes has increasingly begun to affect children and adolescents, likely in connection with the increased prevalence of childhood obesity seen in recent decades in some places.
Treatment of Type 2 Diabetes
Type 2 diabetes is usually first treated by increasing physical activity, decreasing carbohydrate intake, and losing weight. It is sometimes possible to achieve long-term, glucose control with these measures alone. However, insulin resistance can be recovered by attention to diet, exercise, and weight loss.
A connexin-enhancing lifestyle may help you to lose weight and restore some of the necessary physiological components of insulin secretion and receptor internalization. Chromium supplementation has been shown to help restore more normal glucose levels in type 2 diabetics.
The usual next step, if lifestyle modification fails, is treatment with oral antidiabetic drugs. Insulin production is initially only moderately impaired in type 2 diabetes, so oral medication (often used in various combinations) can be used to improve insulin production, to regulate inappropriate release of glucose by the liver and attenuate insulin resistance to some extent, and to substantially attenuate insulin resistance.
Diabetes occurs in people of all ages and races, but some groups have a higher risk for developing type 2 diabetes. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the aged population.
Conditions associated with type 2 diabetes can become serious. They may include hyperglycemia and hypoglycemia (high or low blood sugar, respectively). However, other diagnostic tests including the hemoglobin A1c test, managing and checking your blood glucose, and tips on what to expect should be obtained from your health care provider.
Complications
Having type 2 diabetes increases your risk for many serious complications. Some complications of type 2 diabetes include: heart disease (cardiovascular disease), blindness (retinopathy), nerve damage (neuropathy), and kidney damage (nephropathy).