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Diabetes is a complex disorder involving many aspects of body function. One of the most striking and important features of diabetes is an impaired ability of the body to use glucose as a source of energy. It is a very common disorder in the community but it is unusual for it to start in childhood. We do not yet know the full explanation for diabetes or why it develops, and much of what is known is exceedingly complicated. The explanation that follows is naturally very much simplified, and provides only an outline of present knowledge of diabetes. Enormous research is going on and leading to new knowledge.

Carbohydrate foods are digested to form glucose

Food, when it is eaten, is digested in the stomach and intestines, and absorbed into the body. Much of the food, the carbohydrate, is digested and absorbed into the bloodstream as a simple sugar called glucose. Other common sugars in food are ordinary cane sugar (sucrose), and sugar of milk (lactose). Glucose is one of our main sources of fuel; it circulates in the bloodstream to all parts of the body, entering the body tissue cells, to be used there as energy for body functions, for activity and to provide warmth. Some body tissues can store energy if it is not immediately needed. This is the particular role of fat tissues, but the liver is also important as a store for glucose.

To be used properly glucose needs insulin

Although glucose circulates readily in the bloodstream, it cannot easily enter all cells without active assistance. This assistance is provided by a vital chemical substance. This substance, which is made in the body, is called insulin.

Insulin is therefore an essential part of the chemical system which allows the body to work efficiently. Without it, the sugar cannot properly enter cells, and be used as fuel. Without insulin, glucose builds up in the bloodstream and rises to excessive levels there. Most of the body cells can use fat as an alternative form of fuel, but excessive burning up of fat in the absence of adequate usable glucose can itself be harmful.

Insulin is made in the pancreas

Insulin is produced by a gland in the body called the pancreas. When food is eaten, and glucose starts to enter the bloodstream, the pancreas manufactures sufficient insulin to circulate with this sugar, to enable it to enter cells and be used at once or stored until required.

The pancreas is situated in the abdomen, and in animals it is called the ’sweetbread’.

In diabetes, the pancreas makes insufficient insulin

In diabetes in young people, the pancreas gradually fails to produce enough insulin to meet the needs of the body.

This happens because the cells in the pancreas that make insulin are being damaged, and gradually, as more and more insulin cells are damaged and lost, the pancreas loses its ability to make enough insulin. The result is that glucose produced from food and released from body stores builds up in the bloodstream and cannot be used.

Unused glucose is excreted in the urine

This excess of glucose in the blood ‘overflows’ into the urine, because the kidneys have the function of excreting any substance that is in excess in the body. To wash out this excess sugar, more and more urine must be produced; so the diabetic, before he is treated, passes large amounts of urine. Some children at this stage may wet the bed at night because of this excessive production of urine.

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