Type 2 diabetes

As a result of being unceremoniously poled in a competitive joust, King Henry VIII latterly suffered from ill health. A leg injury prevented him from physical activity and so he ate. It is difficult perhaps today, given the popularity of gluten free cook books and Fitbit bracelets, to fully appreciate the physical consequences of long days spent lounging around on chaise longs, sustained only by the rich, savoury fare of the palace kitchen and the occasional sweaty grope of a lady-in-waiting; but Henry got fat. It is reported his trousers had a waist measurement of 54 inches, which is very fat indeed. Obese in fact, when set against the government guidelines of today. Henry had to be moved around with winches and other mechanical inventions and his obesity is thought to have hastened his death at the age of just fifty-five. He died on 28th January 1547 on what would have been his father’s ninetieth birthday. Historical scholars have since feasted themselves on Henry’s ill-health, with many theories served up to explain his untimely demise. Variously he is thought to have suffered from syphilis, gout, McLeod syndrome, and mental issues; the latter as result of his multiple marriages. A more recent theory though, suggests that the big man’s symptoms bore many of the tell-tale signs of untreated type 2 diabetes, a metabolic disorder that keeps today’s health czars and Government think tanks in a state of perpetual tizz.

Type 2 diabetes is all about insulin. Specifically, about not having enough insulin. Insulin is a hormone. It’s a sort of chemical messenger that helps the body turn glucose in the blood into energy. It’s like a key that unlocks the door to the body’s cells. Once the door is open, the glucose can enter the cells where it is used as fuel. If the door gets jammed and the glucose can’t get into the cells, it builds up in the blood. If glucose builds up in the blood cells are not able to function properly. One consequence is dehydration as the kidneys are unable to deal with high sugar levels and so there is an increasing need to go pee. This results in large amounts of water being lost from the body, hence the dehydration. Another consequence is a diabetic coma. Or hyperosmolar hyperglycaemic non-ketotic syndrome. Indeed. This happens when a person gets so dehydrated they become too weak to get to the vending machine and, unable to make up for the fluid loss, they fall into a state of slumped silence. This is not good. A diabetic coma is a life threatening complication. Long term, high glucose levels in the blood can also damage nerves and narrow the arteries which could well result in a heart attack or stroke and lead to damage to the kidneys and eyes. All in all, a bad business.

Perhaps contrary to the wheezing of the Daily Mail and doom-laden Government White Papers, diabetes has a long history. It is not a recent phenomenon. It is, in fact, one of the first diseases ever recorded. An ancient Egyptian manuscript harking back to 1500BC made mention to what is loosely translated as “too great passing of the urine”. Indian physicians around the same time were also on it, noting that some urine would attract ants. It fell upon the Greeks though, to actually call it something, and the term diabetes was first coined by Apollonius of Memphis, a seasoned physician who lived in and around the third century BC. Today the World Health Organisation reckon there are over 382m people with diabetes, about 4m of them staring goggle eyed at TVs in the dispiriting cul-de-sacs of the UK; a pack of Doritos in one hand, a smartphone in the other.

The exact cause of diabetes is a combination of both genetic and lifestyle factors. Now there is not much anyone can do about genetics. That’s a lot that is cast by the Fates and best dealt with by a thin lipped grunt and a ruffle of the Racing Post. There are over thirty genes that have been fingered as being likely to contribute to the disease but even when lumped all together genetics is still a long way from being the main cause of diabetes. The reason the Czars are all het up is because diabetes is largely as a result of lifestyle factors; things like diet, exercise, sleep and stress. Excess body fat is to blame in the majority of cases in Europe, less so in Asia, and pretty much every single incident of the disease in Pacific Islanders. Go figure. Smoking, as you might imagine, is also linked to the disease, but then smoking is linked to pretty much every disease going, much to the irritation of the tarred fingered cigarette executive.

It is here that the profit hungry food companies are likely going to face a sticky future. That they worked out if they took out fat and replaced it with artificial sweetener the dim witted public would buy more, was a boon when the implications of a daily diet of processed food were poorly understood. But thanks to Jamie Oliver they have now been exposed as monsters, blindly fattening our children on Turkey twizzlers to the benefit of their own share based compensation plans. Having spawned an industry of fat free, fat-lite, diet branded ready-meals, the experts have recently pulled a U-turn and decreed that fat is not the enemy, it is actually sugar that’s to blame. Sugar though sells. Even better – read the food industry memo – strip out the sugar to give the marketing suits an easy strapline and then, when no one is looking, slip in some artificial sweetener to give the customer the ill-intentioned sugary fix. For a long time, we all thought eating cereal was good for us. Basically, God Bless Jamie Oliver.

Still the rise of childhood obesity is a real problem for the future of the developed world. An ageing population will need a healthy youth, fit enough to work the long hours that will be necessary to fuel the tax take to keep them all in free dentures. Yet It’s not just diet, it’s also about exercise. It’s about the breakdown of the family unit, the sedentary spell of YouTube and the frenetic pace of modern living that leaves little time to prune roses, pickle prunes and wake up without an alarm. It’s a potent cocktail; a perfect storm.

Eat more fresh food. Buy some trainers. Get a dog. You don’t want to give type 2 diabetes a chance.

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