Diabetes mellitus is a disorder of glucose metabolism. Diabetes can be caused by the lack of insulin or lack of response to insulin, which results in glucose elevation. Glucose is the most readily available energy source for the body. When glucose can't be used due to a problem with insulin, proteins and fats are used as alternative energy sources.
Types of Diabetes
There are two main types of diabetes: diabetes mellitus Type 1 and Type 2. Diabetes mellitus Type 1 is caused by the destruction of cells that produce insulin by the immune system. This results in lack of insulin production. Diabetes mellitus Type 1 is commonly seen in younger, non-obese people. Diabetes mellitus Type 2 is caused by the body's resistance to insulin due to abnormal dieting that results in chronic elevations of glucose. When glucose is high in the blood, insulin is high as well. When this happens over time, the body becomes desensitized to insulin. Diabetes mellitus Type 2 is commonly seen in older, overweight people.
Fats
Fats are primarily the storage form of energy in the body. Fats provide twice as much energy per gram in comparison to carbohydrates and proteins. Fats are only used for energy when there is insufficient carbohydrates or a problem with the use of carbohydrates. In diabetes, because glucose can't be used by the cells, there is increased lipolysis or the breakdown of fats to release energy. In diabetes, there's an increased level of cholesterol and triglycerides in the blood due to lipolysis; cholesterol and triglycerides are carried by lipoproteins in the blood.
Lipoproteins
To flow in blood, lipids have to be carried by the lipoproteins. HDL and LDL cholesterol are the two most important lipoproteins that influence the levels of cholesterol and triglycerides in the blood. HDL cholesterol is known as the good cholesterol because it primarily takes up cholesterol from the blood and sends it to the liver. LDL cholesterol is known as bad cholesterol because it tends to deposit cholesterol as it flows through the blood.
Diabetic Ketoacidosis
Diabetic ketoacidosis, or DKA, is most commonly associated with diabetes mellitus Type 1 due to the lack of insulin production. In diabetes, the increased breakdown of fats to release energy results in the production of ketone bodies, which are acidic. Ketone bodies acidifiy the blood, causing a derangement of bodily functions. Clinically, DKA is associated with nausea, vomiting and abdominal pain. DKA also causes transient paralysis of the intestines. In most cases, a person with DKA experiences alterations in mental status that can range from sleepiness to coma, according to UMM.edu.
References
- UMM.edu: Diabetic Ketoacidosis
- AmericaHeart.org: LDL and HDL Cholesterol: What's Bad and What's Good?
- "Harrison's Principles of Internal Medicine": Kasper M.D., et al., 2005
