Nov 19, 2012
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Fashion scares me. I am very glad I have a uniform at work. White shirt, tie, dark pant and a lab coat. No decisions. Even Barrets quip last week about me being comfortable with my hair style, bald, wasnt a decision. It just kinda happened. My daughter Emily loves fashion. She is even telling me how to dress. Last Wednesday she told me to change my tie. Dad, you have to wear a blue tie. It is World Diabetes Day.
Diabetes is very common in Manitoba. A couple of years ago, I went on a fishing trip with some high school friends. In the year before the trip, one of the fisherman had developed diabetes. Our trip organizer sent out an email telling us all to not make any food with sugar in it. The newly diabetic fisherman sent another email telling the rest of us not to panic. We could prepare any food we wanted. He could eat anything he wanted, in moderation, as long as he kept taking his meds. I had forgotten about this story until I heard an interview on World Diabetes Day. It was with a twelve year old girl with type 1 diabetes. A friends parent wouldnt let her come over to the house any more. The parent said her diabetes made her too much work. Then one of this twelve year old diabetics classmates told her she couldnt eat anything or play any sports because of her diabetes. She has even had well meaning adults snatch Halloween candy out of her hand. Despite being a common disease, it seems like we need some more information out there.
What is diabetes? Diabetes is when your body has trouble using sugar. There are 3 main types of diabetes: type 1, type 2, and gestational diabetes. Type 1 diabetes is when your pancreas doesnt produce insulin. You must inject insulin or you will die. Type 1 diabetes accounts for about 10% of diabetics. In Type 2 diabetes, your body may produce normal, or even above normal amounts of insulin. However, other parts of the body like your muscle and fat cells arent listening to the insulin signal. Type 2 diabetes can be treated with diet, exercise, pills or insulin. Type 2 diabetes accounts for about 90% of diabetics. Gestational diabetes is a temporary condition that occurs during pregnancy. It affects approximately 2 to 4 per cent of all pregnancies. Gestational diabetes increases the risk of developing diabetes later in life for both mother and child.
Lets start with a person without diabetes. They eat something. The carbohydrates in their food get broken down into sugar. That sugar goes into the blood. The pancreas produces insulin in response to the sugar. The insulin is a signal to all the cells in the body. I think of insulin like a key. It goes into locks in the cells. When the insulin key goes into the lock, little doors open in the cell. These open doors let the sugar leave the blood and get into the cell. The cell then burns the sugar to produce energy.
What is happening in diabetes? In Type 1 diabetes, the body cant produce any insulin keys. So there is no way to open the doors in the cells. The sugar stays in the blood stream. That means the blood sugar level stays high, but the cells have no energy to use. Type 2 diabetes is a little different. The pancreas produces insulin. It may even produce higher than normal amounts of insulin. The problem seems to be with the little locks on the sugar doors in the cells. The little locks seem to have gotten rusty. Even if insulin keys go into the locks, the keys cant turn and the doors wont open. We call this insulin resistance, and we think this is the main problem in Type 2 diabetes.
It should make sense why we inject insulin for Type 1 diabetics. The pancreas doesnt produce any insulin so we inject it. In Type 2 diabetes it is not as straight forward. We can inject insulin. With enough insulin keys, we can force those rusty lock open. We can give pills that force the pancreas to produce more insulin. They have names like glyburide. They work well, but eventually the pancreas will get tired and stop producing insulin. Or we can give medications like metformin which act like WD-40. This makes the locks easier to turn.
What can a diabetic eat? Can a diabetic, type 1 or type 2 eat chocolate bars, regular pop, honey, jam and fruit juice? Yes, of course they can. Should they eat just candy, pop and fruit juice? No, of course not. In general, a diabetic should be eating according to the Canada Food Guide just like the rest of us. So yes a diabetic child can have Halloween candy as a treat. A diabetic can and should play sports and exercise like everyone else. A doctor or dietician may prescribe certain dietary changes to a diabetic, but they wont be too far off from the Canada Food Guide. In general, we want a diabetic to have a healthy diet, to exercise and to take their pills or insulin. And dont be afraid if a diabetic child comes to your house for a sleep-over. Yes, talk to the childs parents about the childs routine. Yes, the child will probably have to check their sugar with a finger poke and may have to give themselves some insulin. But these are things the child does everyday like brushing their teeth. The diabetic child is going to be no more or less trouble at the sleep over than any other kid.
Diabetes is a complicated condition, but it is nothing to be afraid of. Diet and exercise should always be part of any diabetes treatment plan. My little stories about locks and keys are an overly simplified sketch of diabetes. But I hope they shed a little more light on a disease that effects around 9 million of us Canadians. Dont be afraid of fishing with diabetics or having diabetic children over to your house. Knowledge is the key to fighting fear. And now I have to fight my fashion fears and to go talk to my 10 year old daughter.
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Canadian Diabetes Association www.diabetes.ca