Dianetes

• Diabetics must become experts in the management of their own condition, matching up dietary intake with insulin doses and exercise regimes in order to keep their blood glucose within definite limits.

Type 1 diabetes

In Type 1 diabetes, little or no insulin is released into the blood after a meal. Without sufficient insulin, most of the glucose that entres the blood from the intestins after digestion cannot get into cells. Glucose accumulates in the blood, and the cells, which are starved of their main fuel, turn to alternatives - lipid and protein.

Five of the major symptoms of Type 1 diabetes are:

• excessive thirst - the excess glucose in the blood lowers the water potential and triggers the sensation of thirst,
• excessive urinating - a consequence of excessive drinking,
• weight loss - the cells repire stores of lipid,
• glucose in the urine - there is so much in the blood that the kidney cannot re-absorb it all,
• the fruity smell of ketones on the breath (a by-porduct of lipid metabolism).

All of the above are caused by hyperglycaemia - high blood sugar. Other symptoms include blurred vision, poor wound healing and frequent skin infections, such as thruch.

With Type 1 diabetes, the aim is to keep blood glucose levels within the range of 4 to 11 millimoles per litre. A millimole is one thousandth os a mole. Non-diabetics maintain their blood glucose to within about 4 to 9 millimoles per litre.

When they wake up in the morning, Type 1 diabeties usually test their blood sugar. This is done by pricking a finger and putting a drop of blood ona test *****, though there are sophisticated 'watches' than can take reading straight through the skin. Blood glucose levels will be low, following a night with no food. Any blood glucose value of less than 4 is regarded as hypoglycaemic, although some diabetics get no symptoms until the value approaches 1.

After taking the reading, the next step is usually to inject some insulin; it can't be taken orally, insulin is a protein and would be digested…