The Science of Diabetes: an introduction

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Science of Diabetes: Insulin

For diabetes patients and their families an argument can be made that understanding the disease helps them cope. In ancient magic traditions, to know an object’s true name was to have power over it. Our 21st century reinterpretation of this concept can be framed in several ways. When you truly know a person, you know how they think and you can predict what they will do. When you truly know yourself you understand the ebbs and flows of your moods and passions. Disease throws a wrench in this. Your body does things that seem alien. You have become possessed. We researchers and health care professionals use scientific knowledge to create therapies and predict outcomes. However, for the non-scientist, understanding the science behind the disease can be every bit as useful. Scientific understanding is, in a very real and ancient sense, the act of identifying the true name of the thing.  Disease robs you of your health, of course, but it also robs you of your dignity. Part of this is physical but the insidious part is the fear and worry that is always present.  If we know its “true name”, i.e. if we truly understand the disease, we can predict how it will behave and understand why we feel the way we do. This replaces fear with understanding and with it, some power over our condition and our lost dignity.

Dignity is often wrapped up with capability. Heart disease and asthma can seriously decrease one’s physical abilities. Depression and epilepsy can likewise decrease one’s mental abilities. Diabetes can be different, however. While there are several different forms of diabetes (each their own very unique disease), ultimately, managing the disease comes down to an enforced healthy lifestyle. If the diabetes patient keeps his or her  blood glucose levels in the acceptable range, apart from the (considerable) hassle of drug dosing, the disease will have no consequence. Unfortunately, failure to adhere to that healthy lifestyle has significant consequences which we will discuss at length later. These terrible consequences: blindness, kidney failure, amputations, and heart disease to name a few, are not necessarily unavoidable. We can fight them and we can do this with the tools at hand.

It is an easy thing to say “we can fight them”. Doing it is altogether different. It requires an almost religious commitment and discipline. Finding time to exercise when the kids need to be taken to 7 different events and finding time to cook a healthy meal when you can’t even find time to shop is a huge issue. Understanding the science of diabetes will not give you the extra time you need to get on the elliptical trainer but it will give you the knowledge of exactly what needs to be done and what is superfluous. At least we scientists would like to think so…(lets see…is coffee good for us or bad for us this month?).

The body, like all aspects of nature, is an incredibly beautiful thing. It is that appreciation of the beauty buried within the complexity that draws us biologists (like moths) to continuously circle it – attempting but never achieving union. To understand diabetes we need to understand the body as a whole and I would claim that this act alone is worth the trouble.

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