The fundamental problem in diabetes is the bodies inability to metabolize glucose, which is a common form of sugar. This is a major process in creating body cell energy. Glucose is a chemical derivative of the carbohydrate in foods after they have been ingested. Carbohydrates can also be called starch, saccharide, sucrose, or sugar. Under normal conditions, glucose is stored in the form of glycogen, or animal starch in the liver and muscles for future use. At that time, (when it is needed) it is converted to glucose.

Insulin is necessary for both the storage and re-conversion of glucose. The metabolic failure will come about because of an insufficient amount of insulin. The body is not able to respond to it normally for a number of reasons. The failure to metabolize glucose results in an abnormal accumulation of sugar in the blood stream.

1. insulin-dependent form- is caused by failure of B-cells to produce adequate amounts of insulin.

2. non-insulin dependant form- appears to involve failure of insulin to facilitate the movement of glucose into the cells.

In both disorders the blood glucose concentration is elevated above the normal range. Some of the glucose is excreted in the urine and water follows the glucose, causing excessive urination and dehydration of body tissues. This causes excessive thirst. The failure of the blood sugar to reach the blood stream is somewhat similar to starvation. A person who is starving themselves will eat no food, and the diabetic eats food but cannot use the carbohydrates. Because of this they cannot get enough energy from the protein and fat content of it. After a starving person has used all of their previously stored glycogen, the body must metabolize it's stored fat for energy. The diabetic, without insulin, cannot do this. The result is weight loss, which is often an early indication of diabetes.

Degradation of fat increases, producing ketone bodies. The latter are acidic and poisonous. Blood cholesterol level rises. Healing power is impaired. As the glucose accumulates to above normal levels in the diabetic's bloodstream it is filtered by the kidney's and stays in the urine. Additional amounts of urine are then produced to contain the excess glucose. This, then leads to dehydration and an extreme thirst.

The bodies need to get energy from glucose and convert the glucose to glycogen is continuous. It is always changing quantitatively. To meet those needs, you must have a constantly fluctuating amount of effective insulin. Non-diabetics are able to produce these needed amounts no matter what they eat or do. This will then maintain a steady state of metabolism. Diabetics cannot achieve this steady state by simply taking insulin. They must also change their diets and their activities. Many times there will also need to be a change in medications.

Diabetes is not an all or nothing disease. It can be mild, moderate, or severe. It can fluctuate in any one person over a long period of time or even within a day. There is very little known about why these changes take place. It is known that diabetes will get worse when you are ill. It can become worse due to stress and during pregnancy as well.

Symptoms: The diagnosis of diabetes is not a hard one to make. The symptoms of rapid weight loss, extreme hunger, general weakness, frequent urination, and constant thirst make it easy to recognize. Finding glucose in the urine along with increased glucose in the blood will usually confirm the diagnosis. Glucose in the urine alone does not always indicate the presence of diabetes. Some people with unusual kidney function can have glucose in their urine with normal blood levels.

Treatment: The treatment begins with controlling the diet. It is, however, similar to what a normal person of the same age should eat. The major change would be in reducing the caloric intake of an over weight diabetic. Diet may be the only treatment that is needed for many adult dietetics. Each diabetic’s diet has to be individualized to a certain degree. The physician must learn the eating habits, customs, and preferences of his patient before he can help him/her to make the changes. Children should have diets that are similar to that of their friends. They must be made to understand that they should stay away from foods that have concentrated sugars in them.

Oral drugs have been available since the late 1950's. The are mainly used to treat mild cases of diabetes that develop in people over the age of forty-five. Younger people can sometimes be maintained on these drugs rather than on insulin. For these drugs to work, some islet cells must be producing insulin or be capable of producing it. These drugs will either work very well, or they will not work at all.

Another option is, of course, to use insulin. This has to be given by injection just beneath the skin. The method of preparation of insulin will help to determine the timing of its action. Insulin is classified into three basic types:

Rapid

Intermediate

Prolonged

Ideally, insulin that is injected once a day should mimic the normal insulin action of a non-diabetic. That is the purpose of the intermediate and long-acting insulin's. A diabetics basic insulin dose will initially be determined by the severity of the disease. The dose is usually determined by the glucose levels in the urine and in the blood, the doctor’s judgment, and trial and error. Many diabetics will take the same dose for many years. Others are constantly having to readjust theirs.

The amount of glucose in the urine will help provide a barometer of a diabetics control. The amount in the blood at any given point will be a better indicator. That is why it is so important for a diabetic to test their urine and blood on a daily basis.

Once a diabetic has learned the fundamentals of their diet, insulin, or any other medications and has establish sufficiency's in his daily physical activities; he is well on his way to leading a normal life.