About 1,4 million Americans suffer from insulin-dependent diabetes. The problem is usually discovered when the condition is very serious. It often begins quite suddenly. The person may feel fine, and then, with hardly any warning, falls so seriously ill that emergency hospitalization may be necessary.

At first, a person may overlook some of the symptoms of diabetes or think they are due to something else. Reaching for that extra bottle of Coke, one might think, “It certainly is hot today!” A person with a sudden need to urinate more than usual might pass it off with the thought, “I shouldn’t have had that extra glass of milk before bedtime.” If a child suddenly begins wetting the bed, parents are more likely to wonder about emotional problems than to suspect diabetes. Taken together, though, these symptoms spell out a very clear warning. Since each of us has about one chance in five of developing diabetes at some time in life, it is a warning we should all learn to read.

Who Gets Type I Diabetes?

Although Type I diabetes usually first appears in children, teens, or young adults, it can occur in tiny babies or in middle-aged or older adults. It strikes both sexes and is found equally among males and females. It is rare among Asians, Africans, and Native Americans.

What causes diabetes? Why can’t the body handle the sugars it needs to provide energy? What other effects does the disease produce? Before examining what goes wrong in the body of someone with diabetes, we need to know something about how the healthy body works.

The Factory Inside Us

Your body is a miniature chemical factory. While you sit reading this book, countless numbers of tiny production lines are busily turning out the chemicals you need to breathe, read, turn the page, and think.

Like any factory, the body needs fuel and raw materials. The foods we eat supply them. Starches, such as those found in potatoes and bread, are digested into sugars, which can pass easily through the walls of the digestive tract into the bloodstream, and then into the body cells. (Both starches and sugars belong to the group of foodstuffs called carbohydrates.) Proteins, the main ingredients in meat and fish, are digested into smaller units called amino acids. Fats and oils are broken down into their component parts, called fatty acids and glycerol.

All three types of foodstuffs—carbohydrates, proteins, and fats—can be used as fuel by the body. But if there is enough sugar available, the body will generally use that as fuel in preference to proteins and fats. Proteins are the main building materials of the body; they form the bulk of muscles and skin. The brain, nerves, and other body tissues contain large amounts of fats.

Generally the body uses what food it needs and stores any extras. Sugars are stored in the liver and muscles in the form of a starch called glycogen. Proteins may be changed into sugars or fats for storage, or may be broken down and sent out of the body in the urine. Fats are stored in “fat depots” in various parts of the body, for example, the belly and buttocks. If food does not contain enough materials to support all the body’s activities, the body will live off its reserves, drawing out sugar from the glycogen in the liver and muscles, then taking fat from the fat depots, and, if necessary, even pulling proteins out of the muscles.

Scientists call the sum total of all the chemical reactions that go on in the body metabolism. Chemicals called hormones act on each other and on the cells of the body to control the body’s metabolism. Hormones are produced by the body’s endocrine glands, which send their secretions directly into the bloodstream to coordinate many activities in the body.

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“What about a seizure that lasts more than twenty minutes? Will it recur?”

Only one in ten febrile seizures lasts more than twenty minutes, and most of those prolonged seizures are the initial seizure only. A child who has had a prolonged first febrile seizure is no more likely to have a prolonged second seizure than if the first seizure were short.

“Can’t these seizures be prevented?”

Certain medications can markedly decrease the chance of another febrile seizure, but there are risks as well as benefits. You will have to weigh the risks of the medicine and the benefits of avoiding another febrile seizure against the risks of having another seizure.

Phenobarbital is the most effective medication for preventing recurrence of febrile seizures, although ineffective when the child already has the fever. If it is given on a daily basis in sufficient quantities, there will be a marked decrease in the chance of another seizure. The amount of phenobarbital in the blood should be checked periodically to be sure that there is enough.

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Lung cancer

Eighty percent of lung cancer deaths are attributable to smoking. There is some evidence that a diet rich in fresh fruits and vegetables that contain p-carotene could be protective in smokers.

Colorectal cancer

A high-fat diet that includes a large amount of red meat increases risk, as does a diet low in dietary fibre. Eating lots of fresh fruits and vegetables with other sources of dietary fibre – cereals and pulses – might be protective. There is limited evidence that some fibre supplements are useful preventive agents.

Breast cancer

Some studies suggest that a high-fat diet is a risk factor but others show that the amount of fat in the diet is irrelevant. There could be a link with high alcohol consumption but results of such studies are again variable. Obesity is probably more important because rapid growth rate in young girls results in early menarche – an accepted risk factor. Eating lots of fresh fruits and vegetables has been shown to be protective in several studies.

Prostate cancer

A high-fat diet high in red meat seems to increase risk; a high-fat diet seems to raise the risk of cancer developing more quickly.

Pancreatic cancer

Diets high in fat and high intake of alcohol increase risk; eating lots of fruits and vegetables decreases risk. Smoking is a major risk factor.

Lymphomas and leukemias

There is no known link between diet and risk.

Liver cancer

High intake of alcohol is a risk factor.

Cancers of the female reproductive system

High-fat diet is a risk factor. Fruits and vegetables decrease risk.

Cancers of the nasopharynx, oesophagus and stomach

There is a positive association between salted and smoked foods and cancer here. Aflatoxins and alcohol also increase the risk. Fruits and vegetables are protective.

Brain cancers

There is no known link between diet and risk.

Urinary tract, including kidney

Obesity seems to be a risk factor and fruits and vegetables might be protective.

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