Does Diabetes Affect Metabolism?

Diabetes is a condition which is characterized by increase in level of sugar in the blood. The condition may either be insulin dependent or non-insulin dependent. Diabetes is one of the criteria required for a patient to be diagnosed with metabolic syndrome. It is due to the fact that diabetes alters various metabolic reactions inside the body due to high level of sugar in the blood. The body fails to convert the sugar in to energy and thus, requires an alternate route for energy synthesis. Also, the body tries to manage the increased sugar level and, in the process, increases the rate of various metabolic processes.¹ Thus, it is apt to state that diabetes affects the metabolism of the body.

During diabetes, body has to alter the metabolic reaction and processes due to two major factors. First, as sugar is primary source of energy and in diabetes, body has to start using chemicals other than sugar for energy. Second, as the high level of sugar leads to various health complications, the reactions in the body are shifted to the direction that helps in eliminating excess sugar from the blood. Some reactions, for example polyol pathway, are accelerated due to excess seem sugar.

The major alteration in the metabolic process in liver due to diabetes is due to the higher concentration of insulin in the blood. Hepatic processes are highly sensitive to the concentration of insulin. Insulin inhibits lipolysis, thereby reducing the concentration of free fatty acids in the blood. Insulin also inhibits glucagon thereby inviting the process of gluconeogenesis in liver. However, in case of insulin deficient diabetes, the lipolysis increases leading to the increased concentration of fatty acids. These fatty acids are the alternative sources of energy leading to ketosis and metabolic acidosis. Unmanaged metabolic acidosis may lead to diabetic coma.

Also, there is a reduced amino acid uptake by the cells in absence of insulin, leading to high levels of amino acids in blood. This triggered gluconeogenesis and further increase in plasma glucose. As the urination in diabetes is increased, there are chances of dehydration which leads to reduction in blood volume. This reduced blood volume may lead to cardiac complications. Insulin deficiency also leads to high protein degradation, high muscle wasting and increased weight loss.^{2, 3, 4}

Carbohydrate is absorbed from the gastrointestinal tract and reaches to the blood from where it is transported into the cells for energy production. Carbohydrate is the primary source of energy followed by fats and proteins. Insulin, a hormone secreted by pancreas, is required to transport sugar from the blood to the cells for energy.

Diabetes can be divided in to following types:

Type I Diabetes: In this type of diabetes, the body fails to produce insulin, a hormone which is required to help the sugar enter into cells.

Type II Diabetes: In type II diabetes, although the insulin is present in the blood, but the cells fail to identify it and thus, does not respond for available sugar.

Gestational Diabetes: This diabetes occurs in pregnancy and goes away once the period of pregnancy gets over.⁵

Increased Thirst: As the concentration of sugar in the blood is high, thirst is experienced by the patient to reduce the concentration of sugar.

Increased Urination: As the body is trying to manage the increased plasma sugar level, more and more sugar is excreted through urine. This leads to increased frequency of urination.

Increased Hunger: In diabetes, the food is not converted in to energy and thus the patient feels hungry.

Weight Loss: Increased amino acid degradation and increased muscle wastage may lead to weight loss. Further, the lipolysis is also increased leading to weight loss.

Fatigue: As the body is deprived of energy, the patient may feel tired and fatigue.⁶

Diabetes affects metabolism in number of ways. Although the alteration of metabolism differs in Type I and Type II diabetes but both these conditions, if remained untreated, may lead to severe complications such as retinopathy, neuropathy, nephropathy, cardiac complication, organ amputation, diabetic coma and even death. The majority of metabolic effects of diabetes are seen on liver, muscles and adipose tissue.

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