Food Into Fuel: The Multi-tasking Pancreas

Glucose is a simple sugar critical to life. It is produced by the digestion of carbohydrates (even complex carbohydrates, such as those in whole grains, must be broken down into simpler components). Blood levels of glucose rise after meals, but insulin keeps glucose levels within a narrow range; excess glucose is stored in the liver as glycogen, a chain of glucose molecules, to be used when food is not available or during strenuous exercise, when extra energy from is needed.

Levels of insulin and glucose in the blood must be maintained in careful balance. Chronic conditions of too much or too little glucose in the bloodstream can damage to the heart, kidneys, eyes, nerves, and blood vessels; acute disruptions of the insulin/glucose balance can be life-threatening.

The pancreas, located behind the stomach, that secretes digestive enzymes into the duodenum of the small intestine, which then combine with bile, produced in the liver. The majority of cells in the pancreas (some 98%) are cells arranged in grapelike clusters that produce these important enzymes. The other 2% of pancreatic cells are those that produce insulin and other hormones that govern sugar metabolism. LESS

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There are 3 main types of diabetes:

• Type 1 diabetes develops when the body’s immune system attack the pancreatic cells that produce insulin; people with type 1 diabetes must compensate for this deficiency with insulin delivered by injection or pump.


• Type 2 diabetes develops when cells in the body can no longer use insulin effectively, which triggers the pancreas to produce more of the hormone; eventually, the overtaxed pancreas loses its ability to produce insulin.


• Gestational diabetes is a form of glucose intolerance that appears in about 4% of women with no prior history of diabetes, usually in the later stages (most women are screened for this condition between their 24th and 28th weeks of pregnancy).

Because diabetics either can’t make insulin or can’t use it effectively, the dietary challenge they face is to maintain blood sugar within a narrow range. Foods high in sugar, fat, and refined flours starches can deliver a huge spike in the body’s demand for insulin.

The incidence of type 1 diabetes has remained the same, reflecting the strong genetic component to this form. The incidence of type 2 diabetes has exploded. Once called adult-onset diabetes because it was virtually unknown in children, type 2 diabetes is being diagnosed in thousands of kids annually.

Researchers and public health experts believe that widespread obesity is a key factor in driving the surge in type 2 diabetes and so have tried to identify people who are showing signs or are at high risk of developing the disease. These potentially reversible conditions, often referred to as prediabetes, are characterized by blood sugar levels higher than normal, but not high enough to be classified as diabetes. LESS

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Diabetes is the 7th leading cause of death based on U.S. death certificates, but is believed to be widely underreported. It is the leading cause of new cases of blindness among adults (more than TK,000) , the leading cause of kidney failure, and a leading cause of lower-limb amputations (more than 65,000). Between 60% and 70% of people with diabetes have mild to severe forms of nervous system damage. In addition, poorly controlled diabetes over the long term can also contribute to heart disease.

In 2010, among U.S. residents ages 65 years and older, 10.9 million, or 26.9%, had diabetes. Nearly 2 million people ages 20 years or older were newly diagnosed with diabetes. If you include the numbers of people at risk, the scenario gets even scarier. According to recent data, more than one third of all U.S. adults ages 20 years or older had pre-diabetes and half of all adults ages 65 years or older had prediabetes. Applying this percentage to the entire U.S. population in an estimated 80 million American adults ages 20 years or older with pre-diabetes.

Diabetes is estimated to cost $174 billion annually in direct and indirect health care. In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease. A total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant.

Incidence of diabetes:

7.1% of non-Hispanic whites
8.4% of Asian Americans
11.8% of Hispanics/Latinos
12.6% percent of African Americans
14.2 percent of American Indians and Alaska Natives
33.5% percent among American Indian adults in southern Arizona.

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