Hypertension & Diabetes

[Kumar]

Hello all,

"carbohydrate absorption

Carbohydrate absorption tends to occur at the small intestine brush border:

fructose:
absorbed passively down a concentration gradient
binds to a specific carrier protein in the apical cell membrane
either:
diffuses passively out of cells and into capillaries
forms lactate which then diffuses into portal blood

glucose:
absorbed mainly in jejunum by active process
enters via a co-transporter protein on the apical side of the enterocyte
co-transporter requires presence of sodium ions
sodium ions pass down electrochemical gradient into cell to replace sodium ions which are actively being transported out of cell on basolateral membrane by Na+/K+ ATPase pump
glucose diffuses out of cell into intercellular space and from there to local capillaries
chloride ions and water accompany the movement of sodium and glucose; they may travel through the cell or through the intercellular space

galactose: absorbed by a similar sodium-dependent co-transporter as glucose
The dependence of water and salt absorption on the absorption of glucose is the reason why oral rehydration solutions contain all three components.
http://www.gpnotebook.co.uk/cache/818937895.htm "

In view of above consideration, It appears that Sodium & glucose (alongwith amino acids & water) can only be co-transported via active transpot( Na+/K+ ATPase pump)from intestine & these can only be transorted together not alone. I therefore fel that:-

Will then, excess of any salt or carbohyrades/sugar taken in food together, not result in excess absorption of salt & sugar causing excess salt/blood glucose in blood. Will salt or sugar taken alone, not result in their less absorption leading to control/lowering blood concentration of these in diabetic & hypertensive patients?

Since, diabetes & hypertension are becoming more common modern diseases, habits of taking more salt & sugar together by modern lifestyles can be a reason of epidemic type modern increase in these two diseases.

More commonly, people will develop insulin resistance (Type 2 Diabetes) rather than a true deficiency of insulin. In this case, the levels of insulin in the blood are similar or even a little higher than in normal, non-diabetic individuals. However, many cells of Type 2 diabetics respond sluggishly to the insulin they make and therefore their cells cannot absorb the sugar molecules well. This leads to blood sugar levels which run higher than normal. Occasionally Type 2 diabetics will need insulin shots but most of the time other methods of treatment will work.
http://www.endocrineweb.com/diabetes/2insulin.html

Under above consideration, I do not understand why oral hypogymic medicines or insulin is commonly prescribed? Insulin level can be higher in blood then what is the use of furthur raising its level by medications? Will it not cause complications as related to "hyperinsulinemia"? We may compare complications related to "hyperinsulinemia" & to metabolic syndrome X.



Pls inform me accordingly.

Best regards.

 

[Kumar]

"Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body's activities."
"Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops 'too low to provide enough energy' for your body's activities."

When glucose is taken by cells due to adding more insulin: How the question of 'too low to provide enough energy' comes in to picture? Total body glucose will be same & getting utilized due to excess insulin as per the theory.

A diabetic person with insulin resistance is having excess level of both insuin & glucose in blood. How then can we decide that (1) the responsible factor for insulin resistance is glucose not insulin (2) adding more insulin will help to reduce BG level? Can't it be a temporary effect due to differant exposure leading to more insulin resistance?(3) Can't it be possible that hypoglycemia shots are experianced by a IR patient due to adding more insulin which increases IR condition & due to non-utilization of insulin?

 

[hypatia]

A diabetic person with insulin resistance is having excess level of both insuin & glucose in blood. How then can we decide that (1) the responsible factor for insulin resistance is glucose not insulin (2) adding more insulin will help to reduce BG level? Can't it be a temporary effect due to differant exposure leading to more insulin resistance?(3) Can't it be possible that hypoglycemia shots are experianced by a IR patient due to adding more insulin which increases IR condition & due to non-utilization of insulin?

1) Usually insulin resistance is the result of a diet high in refined sugars and poor exercise habits. In the early stages, it is usually reversible by the adoption of healthier habits.

2) Patients with insulin resistance are not usually given insulin right off. More commonly they are given an oral agent to decrease insulin resistance. After a long period of insulin resistance, often the pancreatic cells eventually decrease or cease their production of insulin. At this point insulin is usually introduced into the regimen.

3) Yes, it is possible for a diabetic to take too much insulin, resulting in hypoglycemia. That's why diabetics should carry a source of quick sugar with them - hard candy or something - in the event of an insulin/glucose mismatch.

 

[Kumar]

1) Usually insulin resistance is the result of a diet high in refined sugars and poor exercise habits. In the early stages, it is usually reversible by the adoption of healthier habits.

I want to know basic cause. Both high glucose & high insulin are exposed to target cells at the same time in insulin resistance condition. How can we say it is not excess insulin exposure which may lead to IR condition?

2) Patients with insulin resistance are not usually given insulin right off. More commonly they are given an oral agent to decrease insulin resistance. After a long period of insulin resistance, often the pancreatic cells eventually decrease or cease their production of insulin. At this point insulin is usually introduced into the regimen.

Yes, it is true but oral agents(other than senstizers) also increses insulin secretions. If excess insulin can be a reason to IR then IR can be worsened furthur.

3) Yes, it is possible for a diabetic to take too much insulin, resulting in hypoglycemia. That's why diabetics should carry a source of quick sugar with them - hard candy or something - in the event of an insulin/glucose mismatch.

I didn't mean to ask this. I want to know that; can hypoglycemic effect be felt due to increase in insulin resistance condition as cells are not able to use glucose in this condition?

 

[MRC_Hans]

Kumar has this daft theory that insulin resistance is caused by excess insulin. I have tried elsewhere to explain that excess insulin BEFORE there is insulin resistance invariably leads to a hypoglucheamic episode, but Kumar only hears what he wants to hear.

Hans

 

[Kumar]

Mr.Hans,

Do you/we know real causes of getting insulin resistance? If yes, pls tell otherwise think of all possibilities esp. which are not yet tried? Be dynamic not just book-worm esp. in still unclear aspects.

 

[Kumar]

Elsewher, it is indicated that; high blood glucose & high insulin levels in blood can cause macro & micro-vascular complications in diabetes, respectively. It is therefore, indicative that 'high blood glucose leads to macrovascular AND high insulin level (natural, induced, injected or in insulin resistance) in blood can lead to microvascular complications of diabetes. Is it ok?