Doc Barb’s Health Corner January – February 2017

Diabetes

There are two categories of Diabetes in medicine: Diabetes Insipidus and Diabetes Mellitus. If one hears, “that person has diabetes,” one usually understands that the person has diabetes mellitus and is not confusing it with the illness of diabetes insipidus because diabetes insipidus incidence in the general population, as per the Mayo Clinic is 3 people in 100 thousand. Hardly anyone knows another person with this illness. The person with diabetes insipidus has excessive thirst and urination. The most frequent cause of this illness is the person does not make anti diuretic hormone (ADH), also known as vasopressin. ADH is made in the supra optic nucleus of the brain, passed on to the hypothalamus and from there is released into the bloodstream by the pituitary gland. There are several reasons, all involving some sort of brain tissue damage as to why a person can quit releasing this hormone into the bloodstream. For example, one nay quit making this hormone because of a tumor or tiny stroke in the supra optic nucleus. Another example, a tumor could block the pathway to the pituitary gland. The pharmaceutical companies have produced an analog for ADH, vasopressin, and this solved the problems of excessive thirst and urination symptoms but not the underlying cause.

Diabetes mellitus is a problem with the insulin/ glucose /fat storage regulation system. Insulin is a hormone produced in the beta islet cells of the pancreas. Sometimes under special circumstances, the liver can produce some insulin but this is not the major source of production of insulin. What kind of problem within this system depends on which type of diabetes mellitus a person is experiencing? Glucose must be tightly controlled; it is needed as a fuel source by all cells of the body but can be at high levels in the bloodstream, it can damage blood vessels. Pure glucose poured through a vein will dissolve the vein much like hot water poured through a gelatin tube. A damaged blood vessel is why individuals with diabetes mellitus are more likely to have strokes.

Diabetes mellitus breaks down into type I and type II. Type I has been called juvenile diabetes because it affects younger people in greater numbers than adults. It also should be noted that type II diabetes mellitus before 1980 was uncommon in children. Type I diabetes mellitus is caused by a virus that attacks the pancreas. It wipes out the beta islet cells which produce the insulin. Interestingly, it most often does not harm the other pancreatic cells that produce the digestive enzymes. This is not true 100 percent of the time and so the person that is infected with a strain of virus that totally damages the pancreas will have type I diabetes mellitus and enzyme deficiency; without sufficient digestive enzymes, a person will experience gas, bloating, abdominal pain, nausea, and heartburn. Some adults do become afflicted with this family of viruses. They do develop type I diabetes mellitus and an afflicted person may develop the enzyme deficiency as well.

Type II diabetes mellitus is the result of developing the metabolic syndrome. The individual continues to make insulin in their pancreas but the fat cell receptors have become resistant to the insulin and do not facilitate storing the excess glucose as fat in the fat cell. How one suspects one has developed the metabolic syndrome is by noticing one is overweight and one’s body shape has gained fat around one’s middle between the rib cage and the hips. If the belly fat is protruding beyond the chest, it would be a good idea to have a blood test called hemoglobin A1c (HbA1c) drawn for analysis. If the HbA1c is above 5, it is out of range and it is abnormal indicating diabetes mellitus is beginning. Medical science does not know exactly why the metabolic syndrome makes the fat cells less receptive to glucose storage. The metabolic syndrome also involves imbalances of the cholesterols and increases of their levels. Since glucose is running at high levels and doing damage to the cardiovascular system, some of the cholesterols are being stuck in the blood vessels. This causes atherosclerosis (hardening of the arteries). If blood pressure rises, this process increases faster. This also makes it likely the individual will develop conditions for stroke or a heart attack. As a side note, a common bacterium is found in the mouth which normally is controlled by the immune system. This species has an affinity for the heart and if the mouth’s blood vessels do not remain intact, this species will have access to the heart. That species weakens the heart and it becomes more likely to have a heart attack.

The first treatment of diabetes mellitus is to lose weight and to increase exercise. Non-exercise affects the bowel; it will slow the peristaltic movements of the bowel. The bowel works best if the lower body has enough physical movement. Alternative medicine has been leading the way in looking at the gut issues and only recently is the AMA following.

The National Institute of Health finally gave into studying the gut’s environment, the microbiome, 6 years ago. A wealth of information has been learned and it is backing up alternative medicine’s claims regarding yeast, bacteria and parasites must be in balance. Often poor digestion is a cause of weight gain; therefore, dietary changes alone do not change weight.

Digestion relies on more than just digestive enzymes; the gut needs a functioning, balanced microbiome. The organisms of the microbiome finish digestion and produce some vital byproducts the body absorbs. The AMA-FDA complex had previously held the view that all parasites and yeast must die; however, the evidence for a balance in the microbiome is overwhelming. Slowly, the medical establishment is changing; therefore, one’s AMA doctor might recommend adding probiotics to one’s diet. Many physicians are beginning to encourage people to prepare their foods from scratch and not use processed foods.

Mentioned above is since 1980, children have been developing diabetes mellitus. This seems to be in association with the use of corn syrup in foods and soft drinks. Corn syrup is fructose. Whether the human be a child or adult, too much unopposed fructose is poisonous to the body because it throws off metabolism. The liver has a complex system to handle fructose which involves eating the whole fruit. A liver can process about 4 oz. of fruit juice in 24 hours without problems. So, putting fructose into other foods and drink is excessively much and there are consequences such as the liver producing insulin and extra cholesterols (especially the undesirable very low density variety). It is a good guess that the great increase in the use of fructose has contributed to the problem of the people the United States having issues with being overweight including diabetes mellitus. This is another reason to prepare meals with whole foods from scratch.

If dietary/exercise changes do not bring the HbA1c back to 5, then the second line of treatment is added to the diet and exercise. These are medications to encourage the body to produce more insulin to force the fat cells to store the glucose as fats. If this strategy fails, then the person is placed on insulin along with dietary requirements. Exercise is always encouraged.

**Barbara J. Houk, MD, Psychiatrist (board eligible), Fellow American Psychotherapy Association. Dr. Houk has retired from clinical practice of Psychiatry. Her chief residency was in Consultation-Liaison Psychiatry (today known as Psychosomatic Illness Psychiatry) and retains the medical approach to the whole body through integrated medicine.

Email questions for Doc Barb’s Corner in future newsletters to Susan revsp19@gmail.com

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