High Fructose Corn Syrup - Metabolism of Fructose

Metabolism of Fructose:

Sucrose, a disaccharide, is composed of equal amounts of fructose and glucose. High fructose corn syrup, as the name implies, is higher in fructose than glucose. Fructose and glucose are both monosaccharides.

Now the question is the ability of the human body cells to metabolize fructose in comparison to glucose. The name High fructose corn syrup that gives the impression that it contains a large amount of fructose. The content of fructose is only 55% versus 50% in sucrose. Sucrose is pure disaccharide of only glucose and fructose. The reason HFCS has more than 50% fructose is because the glucose extracted from corn starch is enzymatically treated ( Man is entering the picture) to convert some of the glucose to fructose. This treatment of the corn starch is done to make the sugar sweeter which is why it is so popular in the food industry. The enzymatically treatment is not done by the body but is artificially administered to increase the level of fructose. Any disorder and/or dysfunction attributed to the consumption of fructose can manifest whether one consumes cane sugar or beet sugar or HFCS. Plain old sucrose is the enemy.

Glucose metabolism is subject to a negative feedback system. When the hypothalamus metabolizes glucose a signaling pathway is initiated that results in the suppression of food intake and the ultimate release of glucose in the process of digestion. This feedback system prevents you from eating too much food. Changes in neuropeptide expression results in suppressed food intake while simultaneously increasing overall energy expenditure for the many very active cells that comprise muscle and neural tissue, for example. This is normal since an energy supply is necessary for active cells.

This is in contrast to fructose metabolism. The brain and the liver possess a unique set of transporters and enzymes that enable fructose to bypass a very important reaction that controls the rate limiting step in glycolysis that is critical in the regulation of ATP production and consumption. Glycogen is a stored sugar chemical in the liver that, when broken down, releases glucose into the bloodstream from the liver. If there is nothing ready to use the excess glucose it is converted to fat. You don't want that!

When the hypothalamus fructose metabolism bypasses the above regulatory step its metabolism rapidly depletes ATP in the hypothalamus. This leads to a series of chemical reactions that make the effects of glucose metabolism and fructose metabolism very different even though they utilize the same signaling pathway to control food intake. Keep this in mind. It is important to understand why fructose can lead to diabetes and obesity.

Fructose is highly correlated with the development of diabetes, obesity and a metabolic syndrome. Fructose metabolism differs from glucose metabolism in that fructose  causes the formation of uric acid. A chemical is acted upon by uric acid that causes a very rapid depletion of ATP, the main source of chemical energy for body cells. When the body senses the loss of stored ATP it signals for food intake to manufacture the ATP it senses it, the body , needs. This chemical is not subject to feedback inhibition such as is the case  for glucose metabolism. This results in a very large ATP depletion. This cycle repeats itself and more food is taken in and the breakdown product are stored as fat. You, in other words, get fatter and fatter. Since the liver is the source for the majority of fructose metabolism the depletion of ATP, in the liver, has a direct effect on other liver metabolic procedures. An increase in uric acid formation takes place after a series of chemical changes in the liver.

This increase in the level of serum uric acid is directly associated with the prediction for the development of obesity and hypertension. Gout is another disorder that is associated with the excess production of uric acid. Increased consumption of HFCS can lead to an increase in the symptoms of gout. 

The metabolic syndrome results in laboratory test animals resulted in increases in obesity, visceral fat accumulation, fatty liver and elevated insulin levels. Changes in other chemicals after fructose consumption may account for increased food intake that could result in weight gain. 

Keep in mind the consumption of any of the basic sources of sugar from sugar cane, sugar beets and corn starch all contain fructose. Abuse of sugar, any sugar, intake has serious effects on your health.

Jim

Symptoms of Diabetes show Partial Remission

Diabetic patients, in a study in the Journal of the American Medical Association, reported that 11% of those patients who undertook an intensive diet and exercise program showed a partial disease remission at the end of one year. This compares with only 2% that didn't follow the intensive program.

Patients reported shorter symptoms of diabetes effects, a greater weight loss and better physical fitness gains form the intensive program. The above results saw improvements in blood glucose levels, the researchers said.

Please refer to other posts in this blog for follow up information related to exercise and diet in glucose level control in diabetics. 

Enjoy the blessings associated with the birth of the Christ Child. 

Merry Christmas and Happy New Year to all!

Jim

Insulin - Methods for Administering Insulin

Different Methods for Taking Insulin

Needle and Syringe

With good blood glucose control a syringe and needle is the most common way to administer insulin. Knowing your normal dosage and the activities you plan to enjoy you can approximate your insulin amount to inject just under the skin.

Insulin Pens

The insulin Pen is similar to a regular writing pen with a cartridge. Insulin pen users screw a short, fine disposable needle on the tip of the pen before an injection. You dial in the amount of insulin you need, insert the needle under the skin and press the plunger on the end to deliver the insulin. The insulin pen is used more often in other countries than in the United States.

External Insulin Pumps

About the size and shape of an iPhone and weighs about three ounces or less. You can wear them on a belt or carry them in your pocket or purse. They use a disposable plastic cartilage as an insulin reservoir. A needle and plunger are temporarily attached to the cartridge to allow you to fill the cartridge with insulin from a vial. You then remove the needle and plunger and load the cartridge into the pump. Insulin pumps contain enough insulin for several days. An infusion set carries the insulin from the pump to the body through flexible plastic tubing and a soft tube or needle inserted under the skin.

Disposable infusion sets deliver insulin to a site on your body like the abdomen. Devices are available to assist you to insert a cannula beneath the skin. An infuse set consists of a cannula needle or a soft tube. The cannula needle or soft tube is held in place by an adhesive patch or dressing. You replace the infusion set every few days.

The insulin pumps supply insulin in a steady constant stream. The pump supplies a one-time larger dose of insulin at meal times and when faulty programming by you, sometimes, causes the blood glucose level to increase above what you planned. You must frequently monitor your blood glucose levels to determine the proper dose of insulin to deliver and program accordingly.

Injection Ports

The ports look similar to injection sets without the long plastic tubing. They do have a cannula that you insert into the tissue beneath the skin. An adhesive patch holds the port in place. You insert the insulin into the port with a syringe and needle or a pen. Reducing the number of skin punctures is the main advantage of an injection port.

Injection Aids

Spring loaded syringe holders make the injection under the skin quickly. Some of these devices have a button that activates a plunger to inject the insulin.

High Pressure Insulin Jet Injectors

These apply a fine spray of insulin, under high pressure, onto the skin that penetrates without a needle or cannula.

Exercise? Great for Diabetics

Why Exercise?

Exercise is beneficial for diabetics by helping you manage blood  glucose levels. Blood capillary beds are increased and that increases the efficiency of your body cells. This makes the cells use of insulin better.

Activity, through exercise, helps you "burn"' calories. This requires you to provide glucose that eventually creates products that muscles use for movement. It also lowers your blood glucose that aids in glucose management.

Exercise distributes your blood into the increased blood capillary beds. This lowers your blood pressure and reduces your chance of stroke. 

Your heart is a wonderful muscle and, it too, increases its' capillary beds. This lessens the chance for heart related problems tied to oxygen deprivation.  The effects of a heart attack are minimized and recovery is quicker,

On a chemical basis, exercise raises good cholesterol (HDL) and lowers bad cholesterol (LDL) and triglycerides. Keep in mind fat is necessary to provide insulation to myelinated nerves. Your body produces cholesterol naturally for this purpose. Too much fat in your diet is the problem. Anytime you can exercise is good for heart health.

Insulin need is reduced through exercise by reducing the amount of blood glucose. The pancreas produces less insulin because of exercise.

Weight control is better through exercise. Losing fat, a source of stored glucose in the form of glycogen, prevents the body from turning to this potential source of glucose. That, in turn, lowers blood glucose.

Exercise leads to quicker working energy by supplying glucose, needed for normal activities, faster. It also converts chemicals that make muscles "sore" faster. Your recovery time from good exercise is shorter.

Weight bearing exercise is excellent for other systems in your body. Blood flow back to the heart from lower extremities, like your legs, is enhanced by the "milking action" of muscles contracting in your lower legs and thighs. Bone health is enhanced by better blood circulation and repair of tissues in better and more efficient.

Swimming, a form of low-impact exercise, is very effective for increasing cardiovascular health without the risk of join damage associated with walking, jogging and running. The older you get the chance of damage or injury is greater with impact exercise.

Sleep, of course, is very important to your health. Exercise helps you achieve deep sleep which is necessary for psychological recovery. 

Stress, anxiety and depression recovery are alleviated through exercise and proper sleep habits.

The local gym, personal coach and, especially good, a physician trained in exercise programs for diabetics is a great place to begin your exercise program.

Diabetes and Pregnancy

Diabetes and Pregnancy

Several normal physiological changes occur in pregnancy. Increased hormonal secretions influence blood glucose levels.  Remember, hormones are "global" since they are carried by the blood stream to all parts of your body. 

One effect is a "glucose drain" from your system through the placenta to the fetus. The emptying of your stomach is slowed, an increased excretion of glucose by the kidneys occurs and there is a resistance of cells to insulin.

The risks to a developing fetus from a diabetic mother include:

• Miscarriage
• Growth restriction
• Fetal obesity
• Mild neurological deficits
• Birth defects

Building on the above risks, mild neurological and cognitive deficits in offspring include increased symptoms of ADHD, impaired fine and gross motor skills and impaired explicit memory performance are linked to Diabetic Type 1 mothers. A mechanism for the above deficits may involve prenatal iron deficiency. 

High blood sugar is harmful to both the mother and her fetus. If you plan on a pregnancy try and maintain the blood sugar level close to a normal range two to three months in advance of becoming pregnant.

Type II diabetics need insulin instead of oral diabetes medication. Type I diabetics need extra insulin during pregnancy. You need more frequent blood glucose checks to carefully manage your glucose levels in pregnancy.

Tips for diabetics before and during pregnancy.

• Coordinate with your health care team to monitor and achieve blood glucose normal levels
• See a physician experienced in diabetic pregnancies
• Monitor your eyes and kidneys - pregnancy may increase damage to them
• Stop smoking, drinking alcohol or the use of harmful drugs
• Follow the dietary plan of an experienced dietician

If you are already pregnant consult a physician right away. It is not too late to bring blood glucose levels to a normal range so you and your fetus stay healthy during the rest of your pregnancy.

Screening for Glaucoma - Preventive Medicine

Glaucoma

Glaucoma is silent and early detection is essential. Permanent loss of vision is the end result. Yearly examinations by a vision specialist, of your choice, will screen for the early onset of glaucoma.

Your body keeps you in balance without your knowledge. This is called homeostasis. In the eye a fluid keeps the shape of the eye perfect for you to see well. Fluid balance maintenance is very important. 

In your eye, fluid enters the internal chamber from small blood vessels called capillaries. These capillaries are found at the arterial end of blood vessels that supply fluid to your body systems. These small tubes are only one cell layer thick. At the same time, fluid is reabsorbed back into the circulatory system through venous capillary beds that return blood to the heart. 

This inflow and outflow of fluid from the chamber of the eye is perfectly balanced. Why is this important? Liquids are not compressible. This is why early detection is essential. If the rate of fluid formation, in the eye chamber, is greater than the rate of reabsorption internal pressure in the eye increases. This slowly increasing pressure destroys the optic nerve of the eye if it is allowed to continue undetected. Glaucoma is abnormal pressure buildup in the internal chamber of the eye. 

This is not temporary. It results in permanent blindness. A vision specialist will prescribe a liquid medication that prevents the pressure buildup. You have to take the medication for the rest of your life.

There are non-profit groups that routinely test people with a machine called a tonometer. It measures internal eye pressure. They screen for values that may indicate you need to see a vision specialist for further tests.

Glaucoma may indicate a capillary condition that results from diabetes. Diabetes is controllable but there is not a cure for diabetes. If you are diabetic your chance of suffering from glaucoma is high.

A Different Way to Look at Oxidation and Reducton

Oxidation and Reduction

Glucose is a simple sugar that provides, in small steps, a way to produce energy (ATP) . Cellular Oxidation or Cellular Respiration is:  Oxygen + Glucose breaks down into Carbon Dioxide and Water and Energy. The reverse of this equation is Photosynthesis where the Energy is supplied by the Sun that raises an Electron to a Higher Energy Level.

Oxidation is a gain of Oxygen
Reduction is a loss of Oxygen

That explains Oxidation and Reduction. It also means, in an Equation, if something is Oxidized then something else is Reduced. There are Cycles in our cells that make this possible by rearranging atoms and molecules to make  it all possible.

This means there is another way to state what happens to a atom or molecule in an Oxidation and Reduction reaction.

Here is a summary of the different ways to view Oxidation and Reduction.

Oxidation is:

A Gain of Oxygen
A Loss of Electrons
A Loss of Hydrogen

Reduction is:

A Loss of Oxygen
A Gain of Electrons
A Gain of Hydrogen

Household Cleaner, like Chlorine Bleach, is a good way to see Oxidation and Reduction in action. Chlorine, by itself, likes to steal electrons from whatever it touches. If it grabs an electron form something else, the Chlorine atom is reduced. The substance that losses its electron is oxidized. That why they say Chlorine Bleach is a great oxidizing agent used in cleaning.

To the Chemists, well, it is a little simple.

If you look at The Periodic Table that lists all the Elements you find an arrangement of particles found in each element. These particles make up the nucleus of each and every atom and contribute to a hazy electron cloud that surrounds each atom.

The nucleus is comprised of Protons (+) and Neutrons (No Charge) while the Cloud contains Electrons ( - ). In elemental form each atom of an element is neutral as far as a electrical charge.

Chlorine is placed in a group of elements that are very reactive. (They all like to steal electrons)
Why? In nature we all try to achieve an equilibrium of comfort. Thats life! Atoms have a different way to achieve comfort.

In an atom, when it is "neutral" as far as charge is concerned,  the number of Protons (+) in the nucleus is the same as the number of Electrons ( -)  zipping about in the electron Cloud. The overall charge is Zero on the Chlorine Atom. Why can't Chlorine just behave itself?

For an Element, like Chlorine, the Electrons whirl about the Chlorine Nucleus in several different rings or Energy Levels. To achieve stability, hence peace and quiet, an atom needs just 8 electrons in that outermost ring. Chlorine only has 7 electrons in its outermost ring. It is so reactive it steals another electron from some other element.

Keep in mind, the  number of Protons in the Nucleus doesn't change. Forget the Neutrons for this discussion.

When Chlorine "steals" an Electron from some other Element it now has 8 Electrons in its outermost Energy Level. It now has achieved electronic stability. Now,the overall Charge on the Chlorine Atom, before stealing, was Zero. What is it now? Remember, originally the number of Protons and Electrons were the same. If you add one electron the overall charge on the Chlorine is a negative ( - ) 1.  Due to stealing the electron the Chlorine Oxidizing Agent (used in disinfecting or cleaning) is Reduced (gained an electron) and become a negatively charged Ion! Therefore, all Elements or Molecules with an overall Charge are ions. Some simple and some Complex!

A Sodium Atom is the opposite of a Chlorine Atom. Sodium, using a line of reasoning like for Chlorine, needs to lose an Electron for stability. Guess where Chlorine got its Electron it needed. You are right! From Sodium. Sodium now has an overall Positive charge and become a positive charged Ion. When Table Salt is formed a Chlorine ion and a Sodium Ion unite in what is an Electrostatic Bond that forms a molecule of Sodium Chloride.

Isn't this fun! Since Chlorine was reduced by gaining an electron the Sodium is the Reducing Agent and Sodium was Oxidized (lost its electron) to Chlorine. Hence Chlorine is the Oxidizing Agent.

Whew! See how easy this was? I will leave the discussion now. The above is an Oxidation - Reduction Reaction. One of many that occur in the Oxidation of Glucose to eventually form ATP, a source of storable chemical energy.

Pre-diabetic - Several Screening Tests to Take

Diabetes or Pre diabetes or Normal - Screening Tests

If you belong to a group of people that have a higher than normal risk for developing diabetes you need to consult with a Diabetologist for screening. African Americans, Latinos, Native Americans and Asian Americans are groups that are at risk.

As one ages you are susceptible for developing pre diabetes as the groups above.

All of these blood glucose tests, mentioned below,determine whether you are normal, pre diabetic or diabetic.

One test is the A1C. If your percent value is less than 5.7% you are normal. If your percent value is equal to or greater than 5.7% but less than 6.5% you are pre diabetic. If the percent value is equal to or above 6.5% you are diabetic.

The second test is the fasting plasma glucose test (FPG.) Less than 100 mg/dl is normal. If it is equal to or greater than 100 mg/dl but below 126 mg/dl you are pre diabetic. If it is equal to or greater than 126 mg/dl you are diabetic.

The third test is the oral glucose tolerant test ( OGTT. ) If your blood glucose is less than 140 mg/dl you are normal. If greater than 140 mg/dl but less than 200 mg/dl you are pre diabetic. If you are equal to or greater than 20 mg/dl you are diabetic.

A Diabetologist can interpret these results, from your specific test results and history, to determine whether you are normal, pre diabetic or diabetic.  

Please check with the American Diabetes Association if a Diabetologist is not available in your area.

Step Out for Diabetes - Help Raise Funds for Diabetes Research

Stepout for Diabetes

ADA

Register, Join, Check Locations in your State or Country and have a Great Time Raising Funds for Diabetes Research!

Click the Link Below!

Stepout

With you always in Diabetes Education and Fund Raising,

Jim

Diabetic Foot Problem - Charcot Joint Disease

A Serious Diabetic Foot Problem

Charcot Joint Disease

Charcot Foot is the degeneration of a weight bearing joint in the foot. It is a process of bone destruction, bone resorption and eventual deformity.

If it is left unchecked it could lead to ulceration, superinfection, loss of function of the foot , possible amputation and death.

Diabetes mellitus neuropathy (the most common in the U.S. today, resulting in destruction of foot and ankle joints), with Charcot joints in 1/600-700 diabetics. The neuropathy is related to long-term poor glucose control.

One mechanism is the loss of peripheral sensations where you can't sense touching on the ankle surface. This can lead to minute further damage to the joint called microtrauma.

The damage to the ankle is unnoticed by a diabetic. This results in inflammatory resorption of traumatized bone that causes weakness in the effected weight-bearing joint that, in turn, makes the joint susceptible to further trauma. It is a vicious cycle.

It results, from the decline in fine motor control of the joint and unnatural pressure on some joints. This leads to more microtrauma. Desensitized nerves in the ankle joint cause an increase in the blood flow to the joint. This leads to hyperimia which leads to further resorption of bone tissue. The bone resorption along with mechanical stress will cause destruction of the ankle.

If untreated or unrecognized the final result may be amputation. In the serious states infection could set in and result in death.

Please continue to consult with a Diabetologist and ask questions if you suspect numbness in the foot and ankle could lead to complications.

Pituitary Gland and Diabetes Insipidus

Diabetes Insipidus

When the Pituitary Gland is involved there are three types of diabetes insipidus: 

Central Diabetes Insipidus a deficiency of the hormone ADH (Anti-Diuretic Hormone) in the Posterior Pituitary Gland. The urine is very dilute but without the sugar taste of the urine associated with diabetes mellitus.

Neurogenic Diabetes Insipidus is an insensitivity of the kidneys to ADH that controls excretion of body fluid. The urine is very diluted sense the inability of the hormone ADH to restrict water loss. Again, like in Central Diabetes Insipidus, no glucose is present in the urine.

Iatrogenic Diabetes Insipidus - an artifact of medical drug use that causes the kidneys to excrete large amounts of urine. There is no glucose in the urine.

Diabetes Insipidus is characterized by excessive thirst and the excretion of large amounts of severely diluted urine, that, with a reduction of fluid intake, that has no effect on the concentration of the urine. This means the patient needs to continually take fluids into their body to prevent dehydration from the fluid loss excreted from the body. You need reserve water if you are exposed to conditions where excess water is lost normally.

Diabetes Mellitus and Diabetes Insipidus are two entirely separate conditions with unrelated mechanisms. Both cause the production of large amounts of urine (Polyuria). Diabetes Mellitus causes polyuria by a process called osmotic diuresis due to high blood sugar leaking into the urine and  carrying excess water with it. 

Osmosis is the process where water moves through a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration. When leakage of blood glucose from the blood capillaries into the tubular ducts takes place it increases the solute concentration in the tube above that in the blood capillaries. Water, therefore, flows into the tubule by osmosis. Since this causes diuresis excretion from the kidneys along with the sugar the taste of urine in diabetes mellitus is sweet to the taste.

Diabetic Retinopathy

Diabetic Retinopathy

It is damage to the retina coat of the eye caused by complications from diabetes. It can lead to blindness. It affects approximately 80% of diabetics with a history of diabetes for at least ten years.

The necessity for an early eye examination schedule by an ophthalmologist is essential. The earlier the detection, in a diabetic patient, the possibility to reduce the effects of diabetic retinopathy increases.

The detection of diabetic retinopathy is difficult. A diabetic experiences no early warning signs. The presence of blood capillaries in the eye are especially sensitive to poor blood glucose control. High blood  glucose damages the capillaries in the retina of the eye. This is the beginning of the non-proliferative  diabetic retinopathy. Detection of this stage of the disease is one reason for the very early schedule of visits to an ophthalmologist. You can't detect the early changes. Early changes, that are reversible, and do not threaten central vision is called background retinopathy.

If you didn't see an ophthalmologist and schedule a series of  examinations to detect the early start of the disease you may detect vision changes. Blurring vision makes driving and reading difficult. Blurred vision is minor the first time you experience it. The blood capillaries, in the retina, begin to leak. This is called ocular hemorrhage and blurs vision. Proliferative diabetic retinopathy is the proliferation of new blood capillaries at the back of the eye that leak. A second, more severe leaking of blood from the capillaries, begins soon after. The onset may occur in several days to several weeks later.

Your eye has the ability to reabsorb the few red blood cells that leak the first time from the capillaries. The next phase a much greater amount of blood leaks. The reabsorption of the blood may take  from only a few days to as much as years to clear. These hemorrhages usually take place at night during sleep. The blurring of the vision deepens. Your activities that require clear vision decline.

The elevation of blood glucose that causes the blood capillaries to leak also cause a swelling of the crystalline lens of your eyes. Edema, or swelling, is the result of sugar alcohol accumulating in the lens. You experience the thickening of the lens as blurred distance  vision. Your near vision is not affected or the changes are slight.

Hyperglycemia causes the death and thickening of the basement membranes of the capillary cells. The capillary begins to leak. Holes begin to open that allow the contents of the capillary spill into the chamber of the eye that contains the retina. Some diabetics develop macular edema. When fluid from the capillary moves into the macula your vision blurs even more. The macular portion of the retina is responsible for the detailed portion of our vision.

As the proliferative diabetic retinopathy progresses severe non-proliferative diabetic retinopathy enters an advanced, or proliferative stage when blood vessels grow. Without treatment these new capillaries can bleed, cloud vision and destroy the retina.

Glaucoma can result as the capillaries grow and prevent the proper reabsorption of the fluid in the eye. The build up of pressure can damage the optic nerve. The blindness is now permanent.

Islets of Langerhans Transplantation

Goal of Transplantation

When you agree to have a transplantation, from a donor of their Islets of Langerhans from the Pancreas, the goal is to infuse enough islets to control your blood glucose level thus removing the need for insulin injections.

A successful transplant can slow or prevent the progression of complications like nerve, blood vessel and eye changes associated with diabetes. It should help with good control of blood glucose levels.

Unless you are receiving a transplant from an identical twin that contains cells with exactly the same DNA your immune system will think the transplanted cells are foreign bodies and produce anti-bodies to kill them.

This requires the administration of drugs that supress your immune system. You must continue to use some of the drugs for the rest of your life.

For different diabetes events these mugs are great participant gifts.

Procedure

Transplanted islets come from the pancreas of a deceased donor. The  pancreas is subjected to a mixture of purified enzymes called collagenases that isolate islets from the other pancreatic tissue. The researchers inject the enzyme solution into the pancreatic duct that runs the length of the pancreas. This causes the pancreas to swell. The donor pancreas is then cut up into little chunks, transferred to a Ricordi's Chamber where digestion takes place until the islets are separated out from the exocrine gland tissue. 

The pancreas has both endocrine products and exocrine products. 

For our sake, we are interested in the endocrine products,  insulin and glucagon. They are hormones that are secreted into the blood circulatory system directly when called upon to control blood glucose levels. They are found in the islets.

The products that digest our food in the small intestine are enzymes. They enter the small intestine through ducts. When tissue does that the products are referred to as exocrine. (Pass into a duct system - not the circulatory system)

The islets are separated from the exocrine debris in a purification process. During the transplant procedure a catheter (tube) is carefully guided through the upper portion of your abdomen and into the hepatic portal vein of the liver. This provides the way the islets are placed into the body where they can begin to function.

It takes a little time for the islets to attach to the new blood capillaries and to produce insulin. As the new islets ramp up for production of insulin the physician may order many tests to check blood glucose levels after the transplant. You may need to continue injections of insulin to help you bridge the gap until the new cells take over.

Immune System Depression

Like everything else there is no free lunch. If you have to suppress the immune system, to prevent the immune system from destroying the islet cell from an unrelated donor, you leave your  body more susceptible to other diseases that may enter you body. Your physician can inform you of those possibilities.

Three drugs currently used to suppress the immune system are Daclizumab (Zenapax), Sirolimus (Rapamune) and Tacrolimus (Prograf). Two of the drugs, Sirolimus and Tacrolimus, you must take for life. In conclusion, immune system suppressant drugs are not a cure. They provide a comfort level to allow a transplant to do its thing. The alternative is the destruction of the transplanted cells.

Mis--diagnosis of Type II Diabetes

Type II Diagnosis and Type I Diagnosis - Cause for Concern?

The population in the U.S. is bordering on obesity. Obesity and lack of exercise are contributing factors in the onset of Adult Onset Type II diabetes.

Physicians routinely see patients with high blood glucose that are obese and inactive. They make a diagnosis of Type II diabetes that results in a program of treatment that doesn't make the patient feel better.

The reason the patients don't feel better is, in many cases, because they suffer from Type I diabetes. The protocol for treating Type I diabetes is different from Type II diabetes.

When the correct diagnosis is finally made the patient begins to feel much better.

Here is a link to an excellent article, published in todays Wall Street Journal, that is well written that addresses the problem that exists today.

Damage to Blood Capillaries in Diabetes

Capillary Problems and Blood Glucose

When a capillary narrows the flow decreases dramatically. If you halve the radius of a blood capillary the blood flow through the capillary decreases to one-sixteenth of its normal rate. 

This will cause an increase in blood pressure (think hypertension) which can lead to ruptured blood vessels. In the brain region, a stroke is possible. Heart attacks can occur with lessened blood flow to the arteries that supply the heart muscle.

Blood vessels capillary networks in diabetics are unable to relax well. Researchers believe  altered proteins involved in relaxation are affected by a glucose-derived molecule. The net result is possible hypertension, chance of strokes and increased obesity.

When insulin is not present in the circulatory system the level of glucose remains high in our circulatory system. It begins to decrease the level of nitric oxide, a chemical that increases the diameter of blood vessels. The continual exposure to high blood glucose levels leads to the eventual narrowing of the blood vessel system.

I  have not read this book. If you do read the book tell others the pros and cons.

Unfortunately, in diabetes, when a person has their diabetes under control, a small percentage of the glucose is converted to a sugar type that can modify the proteins.

In your blood vessels this modified glucose competes with a mechanism called phosphorylation that modifies an enzyme that makes possible the formation of  nitric oxide. Its name tells you what it does. Its called a nitric oxide synthase. It catalyzes the formation of nitric oxide, a blood vessel dialator. The modified-glucose wins out in the competition with phosphorylation and negates the formation of nitric oxide. Net result is constricted blood vessels that increase a diabetics chance for developing high blood pressure, strokes and heart attacks.

Researchers are focusing on blocking the mechanism that prevents the formation of the modified-glucose molecule. If that is successful the effect on nitric oxide production will cease and become normal and the danger from hypertension, stroke and heart attacks will diminish.

Interesting point to remember about nitric oxide is the nitro glycerine tablet a person takes to dilate their heart blood vessels in a heart attack. 

Glucose - Enzymes - Food for Thought

Glucose and Enzymes

All chemical reactions require enzymes to catalyze the reactions. How are enzymes produced?

In cells the nucleus, an organelle, contains DNA that contains our genome. The genome contains all the information that constitutes you. It is unique.





All of us basically share a likeness (physical, chemical, psychological, etc.)  to all that we are. Very small differences make us unique.

When a cell receives a message, from somewhere in our body ,that glucose is on its way to supply a basic ingredient for energy production our cells prepare to receive the glucose.

It seems simple. Glucose appears outside the cell, enters the cell, and produces energy that is immediately used or is stored for future use. There are two ways glucose can enter the cell. Both work when a person doesn't have diabetes.

Type I Diabetes occurs early in life and the cause is lack of insulin.

Type II Diabetes occurs later in life and insulin production is available. The factor that transports insulin into the cell is missing. 

The cell needs a factor present for glucose to enter the cell. In the nucleus of a cell there are two important molecules. DNA and RNA. Like a blueprint, the DNA has a code for the manufacture of the enzyme. It replicates the code for RNA. RNA receives the information and forms a complementary code. It begins the manufacture of a faulty trigger that doesn't insulin to enter the cell interior.

All this takes place in the nucleus and inner cell machinery. Here is where trouble can begin for a Type II diabetic. What if the DNA message has changed? What caused the message to change? How does the body compensate for the inability of insulin to function? Lots of questions.

If the cell manufactures a faulty factor, from information received from the nucleus, it won't catalyze the reaction that makes it possible for glucose to enter the cell. The result is the loss or ability to activate the factor that facilitates the cell membrane to ferry the glucose into the cell interior.

It doesn't matter if the levels of insulin are normal. Glucose that doesn't enter a cell means the glucose in the blood begins to rise. There is a solution from the kidneys. The second way glucose can enter a cell, and out of the bloodstream, is based on the sodium/potassium pump. The Sodium+/Potassium+ active transport Pump allows glucose, that is reabsorbed from the kidneys, to piggy-back with the Sodium with its transporter. The Sodium Transporter helps glucose enter the cell. Even though normal amounts of insulin are available but can't function to lower blood glucose the secondary active transport system is available.

To make the removal of glucose easier diet plays a role in the Type II diabetic. That helps control blood glucose and allows normal levels of glucose in the bloodstream.

With you always in understanding the confusing relationship of glucose, insulin and secondary active transport systems in the kidneys. 

Enzymes - Necessity?

Enzymes

They increase the rate of chemical reactions in living systems. Molecules at the beginning of a chemical reaction, called substrates, converted into different molecules called products.

All living cells need specific enzymes to occur at rates sufficient for life and at low temperatures (body heat) than inorganic catalyst temperatures(very high temperatures).

Enzymes determine the metabolic pathways that take place in a living cell.

Enzymes are not consumed by the reaction. They are used to catalyze the same reaction over and over until they are replaced from wearing out. The enzymes are highly specific for their substrate they catalyze.

Enzymes are affected by other molecules. Inhibitors are molecules that decrease enzyme activity. Activators increase their activity. They are, of course, part of negative feedback systems we discussed earlier, and help maintain homeostasis. 

Remember the perfect environment for living cells? Drugs and poisons are enzyme inhibitors. Temperature, pressure, chemical environments, like pH and concentration of substrate molecules, affect enzymes.

Continue to focus on how slight changes in any of the above factors can results in a change in the enzyme. Once changed the enzyme no longer catalyzes their specific chemical reaction.

Life is very fragile.

This is a "reminder" post about the significance of enzymes and how they play a very crucial role in human homeostasis.

Food Pecking Order and Storage - Danger?

Carbohydrates, Fat and Proteins - Pecking Order

In Diabetes the emphasis is the breakdown product of polysaccharides to disaccharides to glucose, a monosaccharide.

What if, for a variety of reasons, glucose stays lower than normal. If you went to a diabetic camp, where your time exercising is high, you know what happens.

First line of supply is the storage of Glycogen in the liver. It is broken down to release glucose until the hypoglycemia returns to normal values of glucose.

If you are unable to ingest carbohydrates your body begins to call upon other sources to use as fuel.

The second line of defense is your fat storage centers. In the production of energy fat enters the energy cycle and is a great source of energy. Danger exists if you continue to use fat because carbohydrates are unavailable. The body has many uses for fat other than providing a source of energy.

Starvation is near. The final source of energy is protein. The major source of protein that comprises your muscle tissue. In  severe loss of protein a very important organ can deteriorate. Your heart. Several important singers (Karen Carpenter for one) died from heart failure when the heart "muscle" was used as a food source.

Again, the glucose energy pathway has an entrance point for proteins to enter.

The body has to protect a means to seek food. The muscular system is of paramount importance. When muscle tissue is depleted to severe levels you can't move about to find food.

It is wise, in diabetes education to consider the pathways our bodies work to protect essential organs like the heart and brain.