One of the most common questions we receive during our travels is about Diabetes (formally known as Diabetes Mellitis) in a grid-down scenario. Diabetes is problematic for the survival medic in that the medications used to treat the worst cases are unlikely to be manufactured or keep their potency in a long-term collapse scenario. I’m not just interested professionally: I’m also a father with a severely diabetic son who has already had kidney failure (2012 kidney/pancreas transplant) and partial blindness as complications of the disease, I am personally invested in formulating a viable strategy for the uncertain future.
“Diabetes” comes from the Greek word for “to pass through” and Mellitis comes from the Latin word for “honeyed” or “sweet”. These words refer to one of the most common characteristics of diabetes mellitis: Large amounts of sweet-smelling (and, I’m told, sweet-tasting) urine. Early physicians noticed that it even attracted ants. Diabetes is also characterized by high sugar (also called “glucose”) levels in the blood.
I’m sure most people have heard of “Carbs” and the importance to eat a balanced diet. Carbs (Carbohydrates) come in many forms, and most foods have some carbohydrate content. All carbohydrates are broken down into simple sugar (called “glucose”) in your body, some faster and some slower. The resulting simple sugar ends up in the blood.
Cells in the pancreas (a large gland located behind your stomach) monitor the sugar in the blood and release a hormone known as “insulin”. Insulin is necessary to move the sugar from the blood into the cells where it can be converted to energy. If insulin is unable to control high sugar levels in the blood (also called “hyperglycemia”), damage occurs. The various organ systems involved include eyes, heart, kidneys, and nerves.
The incidence of Diabetes has been increasing over time in developed countries. This may be due to some societies converting to “Western” diets or perhaps due to issues relating to rising obesity rates. In 2011, 25.8 Americans were recorded as having the disease (more than 8% of the entire population).
Diabetes is separated into various types, the most common of which are:
Type 1 Diabetes was known in the past as juvenile-onset or insulin-dependent diabetes. It results from the failure of cells (called “Beta cells”) in the pancreas to produce insulin (called “Beta Cells”). Failure or destruction of these cells is thought to be caused by some type ofautoimmune response. This means that the body’s own immune system attacks parts of itself: In this case, the pancreas. Type 1 diabetes is often first diagnosed in childhood as it was in my son. Today, however, 60% of new cases are now found in those over the age of 40. These patients need insulin from an external source.
Type 2 Diabetes was known in the past as adult-onset or non-insulin dependent diabetes. It is more commonly the result of the resistance of the cells in your body to the insulin produced by the pancreas. There is some insulin produced, but your body is less sensitive to its sugar-reducing effects. Type 2 diabetics may require some oral medications or even insulin to keep glucose under control. Lifestyle and dietary changes is often helpful in this form of diabetes. Usually diagnosed after age 40, the increased incidence of obesity these days is causing Type 2 diabetes even in children. Type 2 diabetes is, far and away, the most common type.
Pregnancy-Related (also called Gestational) Diabetes is a condition not uncommon even in normally non-diabetic women. Disturbances in glucose metabolism can lead to organ damage, overly large babies (and the problems sometimes seen in delivery of same), and worse. Some believe that those women that get diabetes during their pregnancies may be prone to the condition later in life.
It’s important to recognize the signs and symptoms of hyperglycemia (elevated sugars). The three classic symptoms of diabetes are:
- Excessive thirst (also called “polydipsia”)
- Excessive hunger (also called “polyphagia”)
- Frequent urination (also called “polyuria”)
These are exactly the symptoms that my son began to manifest at age 8. As well, I noticed:
- His breath had an unusual “fruity” odor sometimes seen in starving people. (This is due to acetone and commonly called “ketosis”.
- He began to wet the bed.
- His urine smelled vaguely “sweet”
- He was losing weight.
Cuts and scrapes, especially in a diabetic’s extremities, are slow to heal. Over time, nerve damage occurs which causes numbness, pins and needles sensations and, in the worst cases, gangrene. Many severely uncontrolled diabetics may require amputation later in life.
There are two common diabetic emergencies. These are related either to very low or very high glucose levels. If a diabetic, especially Type 1, fails to eat regularly or injects too much insulin, he or she may develop a “hypoglycemic” reaction (low blood sugar). Hypoglycemia can occur very rapidly; symptoms include sweating, loss of coordination, confusion, and even loss of consciousness.
On the other hand, very high glucose levels lead to a condition called “Diabetic Ketoacidosis”. This occurs as a result of missed insulin doses and/or chronically under-dosed Insulin. The patient will have a characteristic “fruity” odor to his or her breath, as previously mentioned in my son’s case. In addition to previously-mentioned symptoms, there will be nausea, vomiting, dehydration, hyperventilation, and abdominal pain as well. This is a major emergency which could lead to coma and even death. Once the patient is in full-blown ketoacidosis, the prognosis is grave without insulin and other interventions.
Now that you have an overview of the disease, we will concentrate our next article on both conventional and alternative methods of prevention and therapy of each type of diabetes. We will especially concentrate on situations where you have limited supplies and no way to monitor glucose levels.