Tuesday, November 4, 2008

Diabetes: What Is It?

According to the Western allopathic model of medicine, diabetes is a disease that develops due to a diminished production of insulin (Type I) or a resistance to its effects (Type II and gestational diabetes), both of which result in excessive urination, increased thirst, increased appetite, and lethargy. The disease diabetes insipidus, which means "without taste", is a rarer form of diabetes that is caused by kidney or pituitary gland damage. For the next month on our blog, we'll be mostly discussing diabetes mellitus, meaning "to pass through [urine] honey/sweetness", a term for a group of diseases characterized by the increased concentration of sugar in the blood.

Diabetes mellitus Type I is also referred to as juvenile diabetes or insulin-dependent diabetes. Type I patients require exogenous insulin in order to survive. Diabetes mellitus Type II is also called adult-onset diabetes, obesity-related diabetes, and non-insulin dependant diabetes. These patients do not need exogenous insulin, and can be treated effectively through change of diet, weight loss, and/or management of stress factors in their lives.

In Vietnamese, diabetes is called đái đường, or "pee sugar". An old diagnostic method for the disease, once the other tell-tale symptoms were observed, was to see if ants were attracted to the patient's urine. Another way was to simply taste it yourself for sweetness. As a health care practitioner, I'm glad we have such modern technologies as blood tests, urine tests, glucose test strips and glucometers. These advances keep me from having to taste pee, and also help individuals with diabetes manage their own health.

So what exactly determines if one has diabetes? According to allopathic medicine, a fasting blood sugar level equal to or above 126 mg/dL, or a casual blood sugar level (two hours after eating) at or above 200 mg/dL. In some cases, the patient may be asymptomatic, but still show an elevated concentration of blood sugar which requires treatment and management.

In Chinese medicine, diabetes is often equated to the disease xiao ke, or "wasting and thirsting". The three common symptoms are also characterized as excessive urination, excessive thirst, and excessive appetite. There are several different patterns that stem from this diagnosis, dependent on the symptomatic presentation of the patient. In a patient that presents with mostly excessive thirst, they would be treated for heat accumulation or fluid damage. A patient who has excessive hunger may be be treated for intense heat in the Stomach, whereas the treatment for a patient with excessive urination may focus on the lack of warmth or Yang of the Kidneys. The Chinese differential diagnosis of patterns depends not only on the presence of the primary symptoms, but also on the patient's overall constitution coupled with other factors like sleep patterns, bowel movements, and temperature sensitivities, to name a few. Because each person can present with a variety of symptoms, and to varying degrees of each symptom, this model of breaking a disease state into more and more refined patterns allows a physician to better address each individual's needs.

Although there is no modern pharmaceutical or surgical cure for diabetes, patients with the disease have been able to manage their diabetes through diet, exercise, lifestyle changes, and careful monitoring. It is recognized that the primary treatment for diabetes is patient education, and that learning as much as one can about the disease process and the signs and symptoms can help to prevent future complications.

If you or someone you know has been diagnosed with diabetes mellitis, a consultation with a Chinese medicine physician can help them manage their disease. Acupuncture has been proven by the NIH and WHO to have metabolic effects on the body that can modulate systemic regulatory functions. There are various nutritional therapies, herbs, herbal formulas, and exercises such as Tai Chi and Qi Gong that a patient can benefit greatly from. Chinese medicine provides another metaphor with which to understand the disease process in the body, arming the patient with more information to help them better manage their care.

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