We are talking about the epidemic of the third millennium, at least until we
live seated, at work, stressed, without ever moving, proceeding with cars and
eating fast and bad. Only the robots, which will work for us, can solve the
problem of our diabetes. In the past time, when the work was carried out by hand, people ate
little food, many country foods, many vegetables and healthy foods, without fats and
fried oils; they moved on foot, they hoed the earth, they always worked with the
strength of their arms, they tune in with nature and creation and respected the
environment; diabetes did not exist among the poor who ate only one poor meal a
day. Only the well-to-do classes suffered from diabetes, gout and vascular
diseases; the women suffered from scoliosis, because fashion required them to
dress with tight clothes that covered the whole body, up to the neck. Then
someone understood that the sun was important for the calcification of the bones
and the life in the open air reinforces the body and the spirit. Hence the motto
that says: "where the sun comes in, do not enter the doctor!".
Over the last century the picture of the most common diseases in the developed
world has changed significantly. Until the middle of the last century, the most
widespread, fearsome diseases were those caused by infectious agents:
tuberculosis, pneumonia, intestinal typhus, polio. Acute illnesses that the
discovery of penicillin, and then other large antibiotics, and vaccines have in
fact solved with a consequent lengthening of the average life. In the 50s-70s,
heart attacks and tumors have become the leading causes of death for both men
and women, and they are still, even if in ways and in quantities very different
from before. In this case too, the progress of medical science has changed the
lives of patients. New drugs, increasingly advanced surgical procedures and
increasingly sophisticated diagnostic and organizational tools have
significantly reduced mortality for acute cardiovascular diseases and cancer.
The history of medical and scientific progress, however, should not mislead us:
all these improvements have led us today to know how to treat a great number of
diseases better and better. But treating does not mean healing. And this is the
main reason why today we are facing a growing number of chronic diseases.
Chronic means that they do not heal, that they last for a lifetime, that
accompany the person every day. And, as we now know, that can cause the episodes
of sharpness that we fight so well, but that it would be even better to be able
to prevent.
The disease called "diabetes" is a defect of our engine to burn its gasoline. "I'm glad that this concept of" the engine and the gasoline "I listened to it in a conference, when a speaker, who liked this My observation, took up this my practical concept that I, in my turn, had learned from my great Prof. Macaione of biochemistry It may seem a paradoxical concept but if we assume that our organism works like a car, that in order to move it needs fuel, or rather glucose instead of burnt gas, and produces energy.
Our fuel is the food and the
engine are the cells of the whole body, where the glucose
enters and it's burned.
The foods that we eat contain basically three elements that can produce energy: proteins,
fats and carbohydrates. But the body considers the carbohydrates as "a super petrol" and in particular
the glucose such as the only fuel, which is absorbed through the intestine and
carried in the blood. From the blood, the glucose to be "burned" and produce energy
must enter every cell and it burns according to highly
energetic chemical processes, with production of heat and energy for our
body.
The process, of course, is not as explosive as in the case of the petrol engine!
When the glucose is lowered in the blood, the body also tends to turn off and there are some people who suffer
from the decline in sugar, late in the morning, especially if they have made a
poor and hurried breakfast.
The entry of glucose into cells is not a simple mechanism: there is a kind of obligatory "door" through which it must pass, a
door that also has a name, is called Glut 4, and which has a sort of "lock"
which can only be opened in the presence of a substance, a hormone, insulin,
which functions as an "access key" to open the Glut 4 port. Insulin is a large
protein produced by a special gland, the pancreas, made of specific
cells that "feel" the amount of glucose that runs in the blood and, in the
presence of increased quantities, as after a meal, increase their ability to
produce the hormone.
Diabetes is precisely the condition in which this mechanism does not work: the patient becomes like the rich man who has lost the
key to his strongboxt. He has too much glucose available and inability to assimilate it
into the cells.
Diabetes care consists, in fact, in making this access key work inside the
keyhole, that is the insulin, to trigger the mechanism that conducts the
fuel (glucose) inside the cells. Sometimes we lost the key due to the exhaustion of the beta
cell that does not produce the insulin key and we have to introduce it from
the outside with insulin injections; at other times the lock works poorly
(insulin resistance phenomenon) and it is necessary to unblock the keyhole (to use insulin-sensitizing
drugs, eg metformin and pioglitazone).
Now there is a new class that eliminates excess blood glucose (SGLT2 receptor inhibitor drugs) in urine. It has been
demonstrated by all the clinical and scientific research that the presence of
chronic hyperglycemia over time causes damage to circulation: in fact, diabetes
is considered the "vascular disease with elevated blood sugar". The walls of the
blood vessels, in particular of the arteries, small or large, and of the
capillaries are damaged. The damage consists in a slow and progressive hardening
of the vessel walls, further increased by hypertension (high blood pressure) and
by the excess of circulating fats (cholesterol, triglycerides). They form on the
walls of the "plaques", whose scientific name is "atheroma", which not only
reduce the possibility of passing through the blood, but which often create real
internal "wounds", which can be subject to inflammation and to " thrombosis ",
ie complete occlusion. A thrombosis in a coronary artery causes a stroke, in a
brain artery causes a stroke, in an artery of the legs can also lead to
amputation of a limb.
Type 1 diabetes is the condition in which an important inflammation of the pancreas cells occurs, which progressively die as they fail to produce more insulin. In type 1 diabetes, the only treatment option is to replace the hormone deficiency with the insulin injections needed to maintain the vital function of the body's cells from the outside. This form of diabetes that in fact creates an "insulin-addiction" is also known as "juvenile diabetes", because it is much more frequent in the developmental, or even infantile, even if today we know that it can present itself, although to a much lesser extent , even in adulthood. From a scientific point of view, the cause of the severe pancreatic inflammation that causes the death of insulin-producing cells is singular: it is a genetically determined "mistake" of the organism, which does not recognize those cells as its own and implements a species of "rejection" against them. It is what in medicine is called "autoimmunity process" and that, in reality, is the mechanism of many other diseases. The inheritance of this form of diabetes consists precisely in the genetic predisposition to develop autoimmunity: the disease is not inherited, but the tendency to form antibodies against oneself.
Type 1
diabetes accounts for around 10% of all diabetes cases. Type 2 diabetes is the
most widespread form in the world, in developed countries but also in developing
countries, and it is progressively growing everywhere. In this case insulin is
produced by the pancreas, to a slightly lower extent than normal.
The insulin produced in these people, however, fails to perform all its tasks
giving rise to what is called: "insulin resistance". In this case, a particular
genetic condition, inherited, tends to accumulate a lot of fat in the abdomen
and this excess of fat causes the insulin does not work as it should. The result
is once again the difficulty of the glucose to pass inside the cells to be
burned and an excessive amount of glucose that stagnates inside the bloodstream.
The body then tries to produce more insulin, and for a while it succeeds, but at
a certain point the capacity of the "pancreatic insula" is no longer able to
respond to the needs. This type of diabetes, also called "adult diabetes" or "non-insulin-dependent",
does not require the replacement of the missing hormone from the outside and
usually appears only after age 40, or very often only in the last years decades
of life of people. In countries where there has been a growing presence of
obesity for an incongruous diet even in childhood or adolescence for many years,
type 2 diabetes is starting to show up even in the younger age groups, with
significant health problems importance. Gestational diabetes is a form that
appears during pregnancy, almost always without any symptoms on the part of the
woman, but that is discovered during the normal examinations that are performed
during the gestation. It is very important that a diabe diagnosis test is
performed