A spoonful of sugar

So, you hit 55, and your company decides that you and your family deserve a full body health check-up. "It's on the house," they say. So, you get those tests. The full package. The sugars, the lipids, the electrolytes, the scans, and the never-ending run on that treadmill. The next day, however, the reports couldn't be any less amusing. Your doctor folds his sleeves, puts his teeth down, ruffles his hair, and says, “Sir, your sugar profile doesn't look so good." He reconducts the entire panel of sugar tests, fasting sugar, premeal random, and post-meal sugar. Alas! Just as your waistline would have it, "The numbers don't look so good."

Diabetes, as we all know it, is the sugar problem. "He has sugar!" they all say while depriving the middle-aged-white-eyed-office-going uncle of the one piece of confectionary that had his name on it. Let's dig this problem out and take it from the top. In this article, I would like to describe the "Mellitus" kind of Diabetes. Diabetes mellitus is the body's inability to effectively ABSORB sugar. All the food we eat every day is broken down into a million or more, smaller molecules, small enough for them to squeeze out through cells and enter your bloodstream. For this sugar to be absorbed effectively, you must have heard of INSULIN.

This is where the problem starts. In human beings who can adequately absorb sugar, Insulin binds to its receptor and allows sugar to enter the cells. In Diabetes mellitus, Insulin effectively retires from its job. The guy just refuses to put in the hours. So, insulin is present and the receptor is there. They just put up "The Resistance." Ironical that retirement hits everyone at a similar time. Diabetes, the "Mellitus" kind has been known to show a pattern. Middle-aged men, with a more or less sedentary job and a formidable waistline are under attack. We live in a world today that thrives on everything that tastes nice. Effectively today, we are "Slaves of the Tongue."

With your insulin unwilling to comply, there's just too much sugar in your body for it to function effectively. So much sugar that there is an "osmotic imbalance." Simply put, there's a war of waterworks. Water follows sugar at its command, dehydrating body cells of their required water content. The infamous “Polyuria, Polydipsia, Polyphagia” are consequences of the same. An undying thirst, an unfaithful bladder, and a noisy grumbling stomach, all because the sugar in your body decides to misbehave. Despite the bounding supply of sugar in the bloodstream around your cells, since sugar (glucose) is not absorbed into your cells via insulin, it creates a façade of starvation. Your cells are deprived of the nutrition they require at a cellular level to create energy.

Your body, however, works tirelessly to stay alive. The will to stay alive creates opportunities. While glucose aka sugar can be burnt to create energy, the next best option is to burn protein and fat. In the measly process of burning protein, you eventually reduce muscle mass. Further, burning fat is not rewarding either. When you burn fat, you make smaller molecules of fat called fatty acids eventually paving way for high lipid levels in the bloodstream. If that wasn’t enough, these fatty acid molecules are converted to ketone bodies, an easy, convenient method of generating fast energy. Ketone bodies are basically 2-carbon compounds that can be interlinked into the metabolism and burnt, at the cost of producing acidosis (low pH) in the body. A deranged pH does no good for the body’s systems eventually causing the whole show to crash.

At a microscopic level, this excess sugar has already started accumulating in your arteries. Smaller ones first, then the larger ones too. However, it’s the smaller arteries that cry the loudest because arteries in the retinal layer of your eye, in your nervous system, and in the smallest confines of your kidney can get plugged so badly that the damage done may be beyond repair. Uncontrolled diabetes may result in retinopathy leading to blindness, nephropathy causing irreparable kidney damage often leading to high blood pressure, gangrene due to microvascular deposits in the ends of your feet, neuropathy causing difficulty to sense and feel, and other such complications. In the large arteries sector, Diabetes has an evidence-confirmed increased risk of causing coronary artery disease and hypertension, both sinners of the same troupe.

In this manner, Diabetes Mellitus can have a catastrophic effect on the quality of life of any human being. Worst of all, once you’re on the pills, there’s no getting off them. My best advice? Try to stay away from them as much as possible. There is enough hue and cry about diabetes becoming a part of your life by the time you’re 50. It’s become so common, that we believe it’s a part of our life, just something we have to deal with. The deal is to stay away from it. Lifestyle change made in proportion to your current living style is enough to make a difference. There is no need for elaborate diet charts and a heavy workout schedule.

The key is to live a balanced life. Try to live at your age and pace. While aging is a real thing, the change must be subtle and your body needs to be prepared for it. Regular gentle exercises and nutritious food are starters for a good lifestyle. While everyday life can be stressful, it is important to find your own way to deal with the stress.

For those already on pills, all is not lost. Despite being a chronic disease, Diabetes can be managed very well in order to lead a good life. Monitor your sugar levels periodically. A balanced lifestyle combined with elegant sugar control can keep most problems at bay.

Diabetes is the new age epidemic. It's in the air and we all know it. The problem is, it's been around so long, the sugar is now no longer as sweet.