Have you heard people saying “I hardly eat much sweets or sugar then, how did I land up with diabetes?” This is such a common perception among people. Popularly, sugar is considered to be the culprit leading to diabetes. Is this a fact or just a perception that has had a strong snowball effect? To answer this question in a sentence – high or excess intake of sugar can be one of the many culprits causing diabetes. I would like to further explain this sentence so that you are equally convinced as much as I am.
There are mainly two forms of diabetes mellitus. What we are here referring to is the one which affects almost 95% of the individuals with diabetes i.e. type 2 diabetes mellitus. Previously, this condition was also known as non insulin dependent diabetes mellitus (NIDDM). Let’s first understand what happens in the human body in the normal state and in the state of diabetes.
In a healthy individual, the food that we consume is digested to form simple chemicals – glucose (simplest type of carbohydrate), amino acids (simplest form of protein) and fatty acids (simplest form of fat). These simple nutrients are absorbed in to our blood stream. Once in the blood stream, these nutrients are carried to their respective target organs where they are in demand. Any cell in the body that requires energy will demand for glucose. Now, when our muscles and adipose tissue (stores fat) need energy they signal the body to send more glucose to them. However, these tissues (muscle and adipose) are unable to use the glucose by themselves. This means they need some help! Insulin is the hormone which helps them. Insulin acts as a key to the tissue, opens the tissue door and helps the glucose enter in to these tissues. Once inside the tissues, the glucose provides energy to them.
Now, in case of an individual with diabetes, insulin is unable to act as a key to open the tissue doors. This essentially means that the tissues do not respond to the insulin and become resistant to it’s action. The glucose on the other hand, continues to remain in the blood stream. The cells of the muscle and adipose tissue starve as they have little energy (because glucose couldn’t enter the cell to provide energy). Their demand for energy i.e. glucose increases. The body diverts more and more amount of glucose towards these tissues. As a result, the glucose level in the blood increases and you have hyperglycemia i.e. high blood sugar.
We now come to the critical question – why do the cells become resistant to insulin action or why is there insulin resistance? Evidence from research studies states that high levels of free fatty acids (a form of simple fat) in the blood stream over a period of time causes insulin resistance.
So why do the levels of these free fatty acids (FFA) increase? A number of factors contribute to the rise of the levels of FFA. The first reason is – high fat content in your diet. If you eat much more fat than what your body needs then, the levels of FFA are bound to increase. Second reason is – excess consumption of simple form of carbohydrates. Simple carbohydrates are present in foods such as sugar, jaggery, honey, refined flour and all products which are made using these foods. To name a few – white bread, biscuits, buns, cakes, pasteries, other bakery foods, sweets, barfis, laddoos, kheer, chocolates, icecreams, sweetened carbonated beverages, fruit juices and so on. So if you are consuming these foods in high quantities then, the excess glucose in your body is converted to fat which can increase the FFA levels. Thirdly, both high fat and high carbohydrate diet increase your body fat content in turn making you overweight or obese. So, obesity especially abdominal obesity (if you have a paunch) is also a reason for increased FFAs. There are many other silent factors that may add to the above list – smoking, alcohol, stress, lack of sleep, depression, increasing age.
Now what would you say to anyone who said – “I hardly eat much sweets or sugar then, how did I land up with diabetes?” I assume you would be equipped enough to answer this question by yourself.