Diabetes mellitus is a disorder in which the pancreas fails to secrete sufficient insulin or the body’s decreased ability to use insulin. Diabetes mellitus is Greek for ‘a passing through of sweetness’ which refers to the passing of sugar rich urine, a characteristic of the disease. It is a very serious disorder, sometimes fatal and is the leading cause of death in Western society because of its damage to the cardiovascular system.

In a healthy body food is digested to release glucose into the blood. This causes beta cells in the pancreas to release insulin into the bloodstream. Insulin helps in the transportation of glucose from the blood to the liver and muscle cells. This can then be released later into the blood for metabolism. If the pancreas fails to produce sufficient amounts of insulin or if there is insulin resistance then diabetes will set in.

There are two types of diabetes, Insulin-dependent diabetes mellitus (IDDM) also known as juvenile-onset diabetes, type 1 diabetes and Non-insulin-dependent diabetes mellitus (NIDDM) also known as maturity-onset diabetes, type 2 diabetes. Both environmental and genetic factors contribute to both forms of diabetes mellitus but the exact cause of diabetes mellitus is unknown. In both types, excess sugar in the blood known as hyperglycemia needs to be removed by the kidneys. Excessive thirst, frequent urination, weight loss and hunger are the symptoms.

In type 1 diabetes the body’s immune system destroys the pancreas beta cells resulting in low insulin levels. To prevent death insulin injections are needed this is why it is called insulin-dependent diabetes mellitus (IDDM). It is most common in people under 20 years old and then persists throughout life; this is why it is also know as juvenile-onset diabetes. IDDM is most common in Northern Europe especially in Finland where 1% of the population develops IDDM before the age of 15 years.

In untreated IDDM the cellular metabolism is similar to that of a starving person. This is because the insulin is not present to help the glucose into the body cells, to produce Adenosine triphosphate (energy currency) most cells use fatty acids. Triglycerides are stored in adipose tissues which are catabolized to yield fatty acids and glycerol. The breakdown of fatty acids cause a byproduct of organic fatty acids called ketones or ketone bodies. The buildup of ketones causes a fall in blood pH which is known as ketoacidosis, if this is left untreated it can cause diabetic coma and death.

Weight loss is also caused by the breakdown of stored triglycerides. Lipids are deposited on the walls of blood vessels as they are transported by the blood from cells storage depots. This leads to atherosclerosis and cardiovascular problems such as cerebrovascular insufficiency, ischemic heart disease, peripheral vascular disease and gangrene. Sever kidney problems may also arise from damage to renal blood vessels. Loss of vision due to cataracts (excess glucose attaches itself to lens proteins) and damage to the retina’s blood vessels.

To treat type 1 diabetes a regime of self-monitoring the blood glucose level (up to seven times a day), insulin injection (up to 3 times a day), exercise and regular meals containing 45-50% carbohydrates and less than 30% fats. This regime will keep the levels of insulin and sugar in the blood normal. It is also possible to have a pancreas transplant but immunosuppressive drugs must be taken for life. Eating foods containing carbohydrates such as rice, potatoes, bread and cereals will raise blood sugar and insulin levels. This sugar raising effect of a food is called ‘the glycaemic index’ and it measure how quickly the carbohydrate is absorbed by the body. Studies have found that people with type 1 diabetes have better control over their blood sugar levels by following a low-glycaemic-index diet.