The Mudcat Café TM
Thread #128026   Message #2862828
Posted By: JohnInKansas
12-Mar-10 - 02:48 PM
Thread Name: BS: Diabetes... another thread
Subject: RE: BS: Diabetes... another thread
The "definition" of Type I vs Type II varies from place to place only because there are several different ways of saying the same thing, and different places have different concepts of what way of saying it will be best understood by the patient.

"Type I diabetes" means that your body does not produce sufficient insulin.

"Type II diabetes" means that your body produces insulin, but the insulin is not effective in transporting the sugar through the cell walls so that it can be used.

As even "normal" people vary in the amount of insulin they produce, there probably are very few cases of "pure Type I" in which no insulin at all is produced. It probably is more common for an individual to produce some, but an inappropriate amount, of insulin. Individual doctors may vary in the level of insulin production that marks a borderline at which they will declare a patient to be "Type I."

Ideally, the body should respond to an increase in sugar circulating in the blood by producing more insulin, and should produce less insulin when blood sugar is low. The principal organs that produce insulin generally do well at the regulation, but insulin can be produced in lesser amounts by a variety of tissues that do not "regulate" their production, and dump a more or less constant stream of insulin regardless of sugar level.

If insulin production is not regulated normally, the cells themselves may learn to "ignore an excess." This may a significant factor in the development of Type II diabetes, also called "insulin resistant diabetes," in which there is "sufficient" insulin, but it doesn't work right at the level of the cells. Some Type II diabetics may actually produce an excess of insulin, but it just doesn't work at all effectively.

Some adipose tissue (fat cells) are a type of cell that can "excrete" small amounts of insulin (along with other things). This may be part of the reason why obesity seems to be a "cause" of Type II diabetes; but the obesity may also be partly a response by the body to poor cellular management of the insulin present.

(The "other things" produced by some fat cells include hormones, and/or serum components that "act like hormones." The majority of these substances tend toward "feminising" effects. Particularly in adolescent boys, obesity frequently produces a degree of "feminization" that's fairly obvious to impartial observers.)

Medications used for Type II diabetes are mostly intended to facilitate the effectiveness of insulin present, so that it can "open the holes" in the cells and transport the sugar into the cells.

It is entirely possible for a person to have both Type I and Type II diabetes, if insufficient natural insulin is produced, and at the same time the insulin that is present doesn't work very well. A person in this "fuzzy area" that crosses over between, or overlaps, the two types may need additional insulin along with medications to improve how well the insulin works.

Most general practicioners, in my experience, will "assign" one or the other of the types to an individual patient partly for simplicity in discussion - - but mostly because of their (probably appropriate?) belief that patients may have difficulty with understanding a detailed diagnosis.

This causes no particular problems with "easily managed" diabetes, and most GPs will refer "difficult" patients to direct management by an endocrinologist for more specialized advice.

The key to understanding, for diabetics especially, is remembering that, "Ma Nature is a messy b**ch," and simple "definitions" are usually, at least partly, wrong.

Note that I am not a doctor; but I have been dealing with an "incredibly difficult" diabetic for more than a decade, along with having a degree of Type II tendency of my own. We've been to lots of "training" with specialists - but yours may disagree with ours.

John