“THE DOC IS IN…”

by Beth A. Burns DO, Internal Medicine
June 2010

The Sugar Story

Did you know that 17 million Americans have some form of diabetes?  How about that US Dept of HHS estimates another 57 million Americans (one in four) may be pre-diabetic or have problems ‘handling’ sugar and may not be aware of it?  Yikes! These numbers are staggering and need to be taken seriously because they reflect what is happening to our health now and in the future.  Let’s back up and define some things:

Your body’s main source of energy at the cellular level is glucose, a type of sugar.  Your body gets glucose from two places.  The first is by ingesting sugar itself or other foods that are broken down easily into sugar, called carbohydrates.  The second is by making glucose through one of your liver pathways – this happens when you are not eating/in between meals or “fasting.”   Insulin is the natural peptide/protein that puts the glucose into the cells by using their receptors on the cell walls.

Type I Diabetes, often called juvenile-onset, involves a lack of enough insulin to do this job.  These folks usually show their disease at young ages and often with dramatic onset because it is dangerous to lack enough insulin naturally and they can get very ill quickly.

Type II Diabetes, formerly called adult-onset (even though we now see it in children), involves years of high circulating glucose levels with the eventual situation where the receptors for the insulin are no longer sensitive.  The sugar goes up in the blood after ever increasing amounts of natural insulin are no longer enough to hit those receptors and get the sugar put away.  This often comes with overweight states and leads to further weight gain and lipid problems.

The bad news is that both forms, because of the high sugar levels, lead to kidney disease, heart and vascular disease, eye disease and nerve damage, among other problems.  So it is very important to diagnose and treat early and to the goal numbers which have been shown to make a difference.

So, what is a normal “fasting” (6 hours no food) blood glucose?  60-100. What if our fasting sugars are creeping up in the 100-125 range ? This disease now has an offical name: Impaired Fasting Glucose. And guess what ? Without intervention it usually turns to Type II Diabetes within 2 years. 

Other folks have normal fasting levels, but their sugar goes up abnormally high (140-199) 2 hours after a sugar load.  This has an official name too – Impaired Glucose Tolerance. 

Because diet and BMI ( Body Mass Index ) play such and important role here – I thought we would spend the next few monthly editorials going through ideal body weight goals and the various popular diets out there in order to simplify the data so everyone can make a good decision for their particular situation.

So, here’s a bit of homework: First, find out your last fasting glucose level.  Second, get your height and weight and calculate your BMI:

Go To:  www.cdc.gov/nccdphp/dnpa/bmi. 

‘Till next month…

Beth A. Burns, DO

Avalon Park Internal Medicine

3701 Avalon Park Blvd Suite 205

Orlando FL 32828

407-306-0982