Guest Post | One chronic disease isn’t enough? A review of Crohn’s Disease and Diabetes

Mark has kindly invited me to contribute to this forum. I see this as an opportunity to research all the issues associated with Crohns disease and Diabetes. Writing about something does sharpen your focus.

I’m a Crohns sufferer who was recently diagnosed with the prediabetic Syndrome X. I’m also a health professional, specifically paramedicine. Crohns disease and diabetes are both chronic conditions and don’t fall within my area of practice, however when the the clinician gets sick the clinician reads. I’m interested in evidence based management of my condition. Ignorance is not a point of view.

Although Crohns disease can cause significant disability it is unlikely to kill me. Diabetes on the other hand will likely kill me through clots in my brain or heart, not to mention increasing obesity, medications, my feet going numb, my legs dying and my sexual potency diminishing. Not really a future I relish!

So I’m going to talk about diabetes first. Some of what I’ve learnt so far runs against current medical orthdoxy, I’ll share that with you. I’ve also got some questions I want to find the answers to.

What is diabetes and why does it get worse?

• What are the roles of Carbohydrate, Fats and Protein in the diet?
• Why, after 30 years of experts telling us to eat less fat are we fatter than ever?
• Why does diabetes cause kidney failure?
• Why does diabetes increase risk of heart disease?
• Is there a relationship between Diabetes and Crohns disease?
• Does diet play a part in the management of Crohns disease?

And anything else that catches my attention along the way. Watch this space.

What is Diabetes?
Diabetes Mellitus means honey urine. In effect the diabetic had such a high concentration of glucose in the blood that it exceeds the kidney’s ability to reabsorb it in it’s normal filtration process and what can’t be reabsorbed is excreted in the urine. Physicians used to drink urine as the diagnostic test. Even into the 1950s dip sticking the urine for glucose was the prime measure of progress of the disease and was often used as a tool for management of a patient’s blood sugar.

Glucose is moved into the cells by insulin. Insulin is produced in a specialised cell type in the pancreas called Beta cells. In Type 1 (or juvenile) diabetes these cells are destroyed, possibly by a virus of an autoimmune process. In Type 2 (or mature onset) diabetes cells become resistant to the actions of insulin which results in beta cells producing even more insulin to overcome this resistance. Eventually beta cells burn out and insulin production is not able to keep up with the influx of glucose and high blood sugars result.

Preservation of beta cell function is an important goal for diabetes management. How I’ve been advised to manage my blood sugar and why will be the subject of my next post.

Read Scott’s next post on Carbohydrates here.

Scott S.