About the name

Diabetes is a generally used name for a group of diseases where patients have high blood glucose. This short name, or even its full name, diabetes mellitus, does not really tell us much about the disease. It tells us only that our kidneys can only prevent a certain quantity of glucose from being washed out into the urine and then lost from our body. When kidneys get overloaded with glucose, because there is much more glucose in the blood than normally, excess glucose will stay in urine. A dramatic side effect of glucose in the urine is that an organism can no longer economize water. A volume of produced urine is large and a person urinates frequently. To keep the water balance, a person needs to drink significantly more. This is how much diabetes tells us.

So why are the name diabetes or in many languages sugar disease so widely used? Likely because features like large volume of urine, its honey-like smell and its attraction to insects have been the only diagnostic handles for thousands of years. But these names are misleading. Diabetic patients do have high blood glucose, but glucose is not at all the only blood nutrient that is raised. I told you before that inability to produce insulin results in emptying cell storages of proteins and fats. These get degraded to smaller molecules like fatty acids and amino acids their levels also significantly increase in blood. But they are much harder to measure compared to glucose and we can do such measurements sufficiently well only in the last decades. A much more appropriate naming of the disease would nowadays be wasting disease or catabolic disease.

What is then the story around sugar, around glucose? I made an argument that a raise in blood glucose is a defense line to prevent or delay protein and fat wasting. Obviously, it is cheaper for a body to risk loss of glucose and water through kidneys after blood glucose overload needed to kick enough insulin from pancreas. And enough insulin stops catabolism of more important proteins and fats. But what would be enough insulin for an organism? We will talk about that next time…