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Diane Chapman, age 15, ofMonroe, La., for her question:

WHAT CAUSES DIABETES MELLITUS?

Diabetes mellitus is a disease that impairs the ability of the body to use sugar and causes sugar to appear abnormally in the urine. The disease is caused by defective carbohydrate metabolism.

Diabetes is actually considered a group of disorders withmultiple causes, rather than a single disorder. The human

pancreas secretes a hormone called insulin that facilitates the entry of the sugar glucose into all tissues of the body, providing energy for bodily activities. In a person with diabetes, however, the entry of glucose is impaired, a resultof either a deficiency in the amount of insulin produced or of a blocking of its action.

About 10 million people in the United States and Canada are diabetics and perhaps about 4 million of them do not even know they have the disease. Diabetes contributes to about 300,000   deaths each year but with effective treatment, most symptoms and consequences of the condition can be controlled.

Diabetes mellitus is usually classified into two types: juvenile onset diabetes, which occurs in children and young adults, and maturity onset diabetes which is found in persons over 40 years old. Juvenile onset diabetes accounts for only about 10 percent of all cases.

Signs and symptoms, besides the presence of too much sugar and other products in the blood and urine, may include great thirst, passing large amounts of urine, loss of weight and loss of strength. Untreated diabetics have a tendency toward attacks of boils, carbuncles and other infections. The disease also causes decreased blood circulation in the limbs.

Diabetes cannot be cured. But the disease can be controlled by injections of insulin and careful attention to diet. Most diabetics live just as long as people of normal health. But every diabetic should be under a doctor's care. The patient must learn to test his blood for sugar and keep a record of his diet, weight and blood sugar.

Doctors usually tell the patient with diabetes that it is best to distribute meals and snacks throughout the day so that the insulin supply of the body is not overwhelmed at only a few times daily when large meals are eaten.

Also, the diet should contain food that contains polysaccharides rather than simple sugars. Polysaccharides must first be broken down in the stomach, therefore producing a much slower rise in blood sugar.

Elevated blood sugar levels for many years can eventually cause kidney disease; impairment of sight due to rupture of blood vessels in the eyes; reduction of blood flow to the limbs which can cause numbness and sometimes necessitate amputation; and alterations in nervous sensation. For these reasons, it is important to detect diabetes and to obtain treatment.

Detection of diabetes in the absence of symptoms can start with the measurement by a doctor of the glucose level in the blood. If a high level is detected, the amount of blood sugar is again measured after an overnight fast.

 

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