Curated Paper 1- Colton Koch

    While reading the page on metabolic pathways, it interesting to see the visual of how interconnected and delicate that these metabolic pathways truly are. During my time as a biology student, I have had the opportunity to study many of the different reactions independently of each other. Unfortunately, due to this style of learning during this time I did not see how interwoven these pathways are with each other. This interconnectedness of various metabolic pathways makes sense when you think of diseases being caused by a seemingly unrelated hormone or chemical that is too high or too low in another part of the body. It shows how a tiny imbalance in one system can cascade into a serious problem for another system.

    Diabetes is one of the most prevalent and common illness in the United States that is caused by an imbalance in the metabolic pathways of our body. I do not think there is anyone in the class or country that does not personally know an individual who has either Type I or Type II diabetes. From previous knowledge, I know that Type I is a genetic defect where the body is unable to produce insulin, and that Type II happens after the body is unable to effectively take up glucose. It is interesting to look at how different organ systems play roles in controlling blood sugar and hyper or hypoglycemia. The major hormones that are involved in this is the pathway are insulin and glucagon. They are antagonists of each other meaning they have opposite effects when secreted. While reading the slide about how insulin is used to properly uptake glucose, it talks about when the body does not have the proper amount of insulin it is unable to use the glucose. The slide says, “cells essentially starve in the midst of plenty of sugars.” While reading this I could only think of the people who are unfortunately apart of a shipwreck and while stranded at sea they pass away from dehydration. Even though they are surrounded by water, they are unable to drink it because their bodies and especially the kidneys cannot filter that high salt level. This is the same way our bodies reacts when we have had a diet high in sugar for extended periods of time. Our receptors to insulin become worn out and our bodies are unable to breakdown and use glucose. The cells starve in an environment that has all it needs to sustain life they are just unable to use it.

            Diabetes can also cause damage to many different systems. Many healthcare providers are aware of the different forms that diabetic damage can manifest in the body. While shadowing at an ophthalmology clinic, I saw how when a patient came in for their check up the ophthalmologist would be significantly more thorough with their checkups if the patient had a history of diabetes. This is because diabetes would increase their chance of getting cataracts early in life or could severely damage the blood vessels in the retina or the back of the eye. This is called diabetic retinopathy and is one of the leading causes for blindness in the developed world among adults. The damage to these blood vessels in many cases are permanent. Early diagnosis and treatment of diabetic retinopathy are the only way to prevent blindness. Many patients would come into the clinic and have none to mild symptoms of diabetic retinopathy because they were good at controlling their A1C and blood sugar levels. Others had serious complications because they were unable to make the needed changes to their lifestyle and diet to control their diabetes.

            While reviewing diabetes, I was shocked to find that diabetes was among the top ten leading cause of death in 2013. I decided to find some more recent data because we have seen obesity rates climb in recent years and obesity has a strong correlation with diabetes. According to the Centers for Disease Control, or CDC, in 2022 diabetes was the eighth leading cause of death in the United States with just over a hundred thousand deaths. This fell from the seventh place that it was in not because of better life decisions and dieting but because of COVID-19. Many of the highest listed diseases could all be simplified down to inactive lifestyle and poor diets. As Americans, we love to use our cars and drive wherever we want to go even if it is just down the street. This means that we are missing out on simple exercises that many other countries are gaining. The United States has a car ownership of 900 cars per thousand people. Japan on the other hand has only 800 per thousand individuals. In 2021, Japan also had only fourteen thousand deaths due to diabetes. Diabetes as a cause of death is not even in the top 20 causes of death but is ranked at 25. It is presumptuous to say that one element like driving cars all the time is the primary cause of diabetic deaths, but it is fair to say that many different things are coming together to cause an epidemic in the United States. This is impacting our economy in a major way. In 2012, the cost of diabetes and the strain it puts on the United States was estimated at $245 billion but according to the National Institutes of Health in 2022 it was up to $413 billion. This is $4 billion more than the GDP of Vietnam, a country that is home to almost 100 million people. This is a serious strain on our government who pays for a lot of Medicare and Medicaid. Diabetic ailments also crowd the hospital system with patients who could have avoided many of the issues if they changed their lifestyle. There needs to be a more cost effective treatment and it starts with proper education on individuals’ health.

Diabetes also does not affect individuals in varying socioeconomic levels equally also. Many who come from poor areas of the country have the highest risk of obesity and diabetes. If you overlay the maps of average income and levels of obesity it almost mirrors each other. This is because the more affluent individuals have the ability to buy fresh produce and have disposable income to spend on gyms and trainers. These factors help reduce their risks of developing type II diabetes. But the individuals who are poor often can only afford to eat fast food or prepared and highly processed snacks. These individuals live in areas called food deserts. This means that making it to a store to buy fresh produce is unobtainable due to how far of travel it is to the grocery store. We can see that in the stores it is cheaper to buy soda than it is to buy real fruit juices and healthy option drinks. Many families choose the unhealthy options and increase their risk of diabetes and other obesity linked diseases.

            Sugar in these unhealthy options is also an incredibly addictive substance that can elicit the same response in your brain as cocaine. In my life, I have seen the difficulties that those who have diabetes face. As a kid I would eat copious amounts of sugary desserts and drinks. It hit the point where if I did not stop my habits, I would be looking at becoming diabetic. Cutting the amount of sugar in my diet was hard because somedays it would feel like I was going through withdrawals. As a society, we need to work together to create a lifestyle to limit the prevalence of disease and other obesity-linked diseases in our country. While watching a documentary, a physician was interviewed and said that we need to change the name of our healthcare system to the “sickcare” system. This is because we only treat and help those individuals who are sick, and we do not think about how to keep the healthy patients healthy. This brings us to the solution of ayurveda. Instead of treating only certain parts of the diabetes, we need to focus on the patient as a whole. Proper diet and exercise can be much more effective at treating sicknesses than prescribed medications. To make the needed changes we need to look into their mind and soul and find out why the patient does the things that they do. This will allow us to provide specialized treatment which in turn will hopefully bring better health to the patient. I look forward to the day where diabetes and other lifestyle linked preventable deaths are significantly decreased. This will lessen the strain on our economy and together we will benefit.