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What Happens in Diabetes
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By definition, when the level of glucose in the blood rises above a certain limit, this condition is known as diabetes. The reason for the increasing glucose level could be either a decrease in the quantity of a hormone called Insulin or a decreased efficacy in the working of insulin.

To understand the relation between glucose and insulin, it is important to know the working of the body at cellular level.

How our body works:

Our body is made up of millions and millions of cells. Each cell is a complete unit in itself. A number of complex metabolic processes are taking place in these cells for which the required energy is provided by glucose. Whatever we eat (carbohydrate) is converted to glucose after digestion in the intestine. This glucose enters the blood and through the blood vessels is distributed all over the body. When we are in a fasting state, glucose comes from liver (Hepatic Glucose Output).

It means that even in a fasting state glucose is continuously reaching the blood through liver. This is why liver is known as the store house of glucose and in emergency situation when no food is available it helps in maintaining all the body functions by releasing glucose  into the blood. Glucose then acts as a fuel for carrying out the various metabolic processes of the body. In a way it can be said that glucose is to our body what gas is to a car. Hence, whether we eat or are in a fasting state, glucose level in blood is maintained at all times.

Now the next step is that this glucose should enter the cells where it will be used as a source of energy by the cells to carry out the various metabolic processes.

The body cells have a door called the GL UT4. Under basal state this door GLUT4 is closed. For glucose to enter the cells this door (GLUT 4) must be open. When this door opens, glucose enters the cells of the body and provides energy to the cells. The process of entry of glucose from blood into the cells is complex and is carried out by a hormone called insulin. Insulin opens the door on body cells and makes glucose entry in body cells possible which then provides energy to the cells. Thus relationship between glucose and insulin lies in the fact that insulin opens the lock allowing glucose to enter inside the cells.

What is Insulin?

In our abdomen there is an organ lying behind the stomach called Pancreas. It contains groups of hormone producing cells called Islets of Langerhans.

Insulin is produced by one such group  of cells found in Islets of Langerhans. This insulin producing group is known as beta cells.

Whenever the level of glucose increases in blood, the beta cells secrete insulin. This insulin enters the blood vessels and reaches various body cells, making way for glucose to enter the cells. Insulin binds to a receptor on cells and this in turn activates GLUT4 which is the door for glucose entry into the cells. This glucose in turn provides energy for the various metabolic processes of the cell.

It can be said that insulin is a very important hormone of the body with multiple functions, one of them being to facilitate the entry of glucose into the cells. Besides this, insulin has a major role to play in blood pressure and cholesterol control.

Insulin has a role to play in a number of metabolic processes of the body, therefore it can be labeled as the master key of the chemical machinery of our body.  

Insulin and Diabetes:

When pancreas is producing less insulin or there is insulin resistance, the resulting condition is called Diabetes Mellitus.

During the state of insulin deficiency or insulin resistance, glucose present in blood cannot enter the cells (as the gate remains closed). This results in two important events, first is increased blood glucose level and the second is the non-availability of glucose for cells to use as energy.

Hence it can be said that diabetes is a state, in which although the blood glucose level remains high, the cells do not actually get enough glucose to carry out the various metabolic processes. Thus in Diabetes Mellitus glucose levels rise in blood due to its lack of transfer inside the cells. Hence, in spite of very high glucose level in the blood, cells of body are deprived of glucose, the fuel.

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