The Outstretching Reaches of Diabetes

            Diabetes is a very complex disorder that is made up of several linking components stretching across a wide variety of systems. These systems cover everything from physiological components, to psychosocial behavioral issues, and even a significant effect on the economy. These diverse topics when seen at a glance may seem completely unrelated, but when we get down to the specifics it all traces back to one root cause, diabetes. If we take a closer look, it boils down to the abuse of one single molecule, glucose. In today’s world it’s all about connections, diabetes exemplifies this need to great extent.

            Before we can discuss diabetes’ connections, we must first understand the basic mechanism behind how it works. Diabetes is caused from having high blood sugar for long periods of time. The root pathway behind this all ruminates from insulin intolerance; where the body loses its capacity to make insulin. Without insulin glucose cannot be transported to your cells efficiently and tends to build up in your blood stream. This buildup of glucose is what connects diabetes to the diverse topics we will be discussing today.

            Diabetes has many connections with physiological components and disorders within the human body. The main items I want to talk about is how diabetes connects to cancer, blindness, and, kidney failure.  The mechanism for how cancer comes from diabetes is all in the sugar and insulin. The excess of the two aid in tumor growth: sugar as a source of energy fuel source and insulin as a growth factor. Cancer cells practically run off of glucose so having excess sugars in your blood is like adding oxygen to fire. Cancer cells also have insulin receptors on their surfaces. This is the key to the cancers success! When cancer cells captures insulin it gains three benefits. Insulin encourages cell growth and discourages cell death, bolstering the proliferation of cancer cells. At the same time, studies suggest that insulin makes cancer cells more invasive and more likely to spread. This invasiveness is why our body can’t stop it effectively. The cancer cells spread so quickly that our immune system cannot fight them off at the same rate that they spread. Forms of retinopathy (blindness) follows a similar physiological pathway in which high glucose levels cause changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. How this happens in a nutshell is you develop high blood glucose levels (from diabetes); this escalated blood glucose levels cause glycation to your RBC’s and thus make it harder to push blood through your arteries, veins, and capillaries. Over time the capillaries in and near the retina began to expand and weaken (microaneurysms) from the excess blood glucose and glycation. The microaneurysms allow RBC’s to leak into the retina (usually on the outside) and cause blurred or a narrower field of vision and without treatment blindness. Nephropathy (kidney failure) can be induced by diabetes. Basically high levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters and after many years, they start to leak and useful protein is lost in the urine. So why is this important (other than you need your kidneys to survive without extensive dialysis treatments). The proteins lost in your urine (micro or macroalbuminuria) are obviously not getting to your cells to carry out their many vital functions for day to day life.

            Diabetes has its connections with psychosocial and behavioral issues. Diabetes has major effects on the brain and its functions. The main thing that diabetes effects is hormone imbalance; primarily dealing with dopamine and norepinephrine. My main focus on diabetes effects on the brain deals more with behavioral disorders; in specific, schizophrenia and ADHD.  In schizophrenia again it’s the insulin regulation that is messing everything up. See insulin doesn’t just regulate glucose it also regulates dopamine to the brain. The insulin overabundance restricts the dopamine regulation and free flow of norepinephrine in the prefrontal cortex of the brain (responsible for cognitive functions). This lack of dopamine and too much norepinephrine allows for an overabundance of the NET transmitter protein. What NET does is it sucks away all of the dopamine and converts it to norepinephrine. So in a nutshell the insulin causes an overabundance in the NET transmitter protein and results in hormone imbalance causing schizophrenic behavior. With ADHD it is almost exactly the same problem. People with Type 2 Diabetes show ADHD like behaviors depending on their blood glucose levels (too high or too low). Low blood glucose can cause inattention and impulsivity, and high blood glucose can cause restlessness and irritability. This irritability is caused by malfunctions of neurotransmitters that control both dopamine and norepinephrine.

            We have talked about both the physiological and behavioral associations of diabetes and now we are going to talk about its effects on society and the economy. A study was conducted to update the previous estimates of the costs and burdens diabetes puts on the U.S. population. To more adequately estimate these costs they used the current U.S. Census Bureau (for the population) and a diabetes prevalence approach by sampling the population by different categories to include: age, ethnicity, sex, insurance status, and home of residence (whether or not it is in a nursing home or not). Throughout the study they were able to break down the cost burdens to show that diabetes costs the nation $245 billion dollars annually; of that $176 billion is from direct healthcare while the other $69 billion results from loss of productivity of the American people. This shows that diabetes prevalence in the U.S. is rising about 5.2% annually (specifically a 27% rise from 2007-2012) and that people with diabetes pay 2.3 times more annually for healthcare than people without.

            In today’s world it’s all about connections. As we have seen diabetes is a very complex disorder that is made up of several linking components stretching across a wide variety of systems. It has vast effects on physiological components, psychosocial behavioral issues, and even the economy. At a glance they may seem completely unrelated, but when we get down to the specifics it all traces back to one root cause, diabetes. If we take a closer look, it boils down to the abuse of one single molecule, glucose. Diabetes exemplifies this need and power to connect at a great extent.