CHAPTER I0

DIABETES
Diabetes mellitus or 'sugar diabetes' is the most common glandular condition in
North America. It affects to to 25 million people, most of whom have yet to be
diagnosed. Diabetics run an above-average risk of developing heart disease
and stroke, the leading causes of death in the USA and Canada. Given that
most types of diabetes and its complications are related to lifestyle and
environment, this is for the most part a preventable problem.
Diabetes mellitus is an insulin disorder that impairs the body's sugar me-
tabolism. The important hormone insulin is responsible for the absorption of
sugar into cells for on-demand energy and into the liver and fat cells for en-
ergy storage. There are two main types of diabetes mellitus.
In type I diabetes mellitus, insulin-producing cells in the pancreas are
destroyed. With regular injections of insulin, the patient may lead a normal
life. Without it, he or she may lapse into coma and die.
In type 2 diabetes mellitus, pancreatic production of insulin is diminished or
the body gradually loses its ability to utilize it. This is by far the most common
form of diabetes and is usually linked to bad eating habits, obesity and poor
life-style.

108 GLUTATHIONE
 Both type i and type 2 diabetes are generally characterized by high blood
sugar (hyperglycemia) but in cases of overmedication or illness/stress dur ing
medication blood sugar levels can plummet (hypoglycemia). Both events are
potentially serious.
Hyperglycemia produces excessive thirst and urination, fatigue, weight
loss, and dehydration. Occasionally, life-threatening illnesses (hyper-osmolar
coma or ketoacidosis) may result from excessive sugar levels. These are
medical emergencies requiring immediate hospitalization.
Some diabetics take insulin injections or pills to lower sugar levels and
are susceptible to the complications of low blood sugar levels. This may
happen because they take too much medication, miss a meal, increase their
energy expenditures, become sick or febrile, or suffer any sort of stress. This
condition too must be treated immediately. Usually, a sweet drink or food is
enough and produces rapid results.
Apart from the emergencies resulting from such blood sugar imbalances,
most diabetics fall ill from complications of diabetes itself, of which there
are two types: reduced ability to fight infection and damage to the circulatory
system, including both small and large blood vessels. These complications can
cause symptomatic problems with the eyes, muscle, kidneys and bladder.
They can also reduce energy levels, promote thirst, and cause tingling in the
extremities. Cardiovascular plaque buildup is another result of diabetic
complications.

DIABETES AND THE IMMUNE SYSTEM

Diabetics should be considered immune-compromised because they are
prone to many more infections than they can normally resist. Their im -
mune systems may be overwhelmed by thrush and other fungal infections
of the skin and even of the bloodstream. Bacterial infections are more com-
mon and their consequences are serious— gangrene (especially of the toes and
foot) and sepsis. Diabetics with any sort of infection must always be treated
immediately and aggressively.
Most illness and death in diabetics is due to circulatory damage from
heart disease, myocardial infarction, high blood pressure, atherosclerosis,
stroke, renal failure, neuropathy, blindness and other effects of impaired
blood circulation. In fact, diabetic complications are the major cause of
blindness in the USA. Diabetics are also more prone to cataracts and glaucoma
(see chapter 17).

GL U TA TH I O NE 'S R O LE I N D IA BE TES
GSH plays an important role in the fight against diabetes. We have seen
that it can prevent circulatory problems such as arteriosclerosis and stroke-

10-DIABETES 109
the main causes of diabetic death (see chapter 9). GSH also enhances the
immune system. Many visits to the doctor or hospital could be avoided if
diabetics were less prone to infection. Elevated GSH levels may help by
providing:
 Immune system support against infection
 Decrease of oxidative stress from hyperglycemia
 Decrease of platelet aggregation
 Prevention of vascular complications including:
 Atherosclerosis (including heart disease, stroke)
 Nephropathy (kidney damage)
 Retinopathy (retinal damage)
 Neuropathy (nerve damage)
In this way, GSH can help a weakened immune system combat bacterial
infection and fungal infection, support compromised circulation against hard-
ening of the arteries (arteriosclerosis), kidney failure (nephropathy), visual
loss (retinopathy) and neurological problems (neuropathy). It also retards oxi-
dative stress and anemia in dialysis patients.
It is clear that the small blood vessels of diabetics are subject to accelerated
degeneration, but the causes of this particular illness are still being identified.
Recent studies demonstrate that diabetics are more prone than others to oxi-
dative stress and free radical formation. In fact, the blood and tissues of dia-
betics are marked by critically low GSH levels.
R.K. Sundaram's studies suggest that this antioxidant deficiency precedes
the subsequent complications of diabetes. K. Yoshida and his research group
have shown that low or weak GSH synthesis leads to increased cellular
damage and other complications. Going one step further, Thornalley's tri-
als revealed a correspondence between low GSH levels and higher diabetic
complications. S.K. Jain and R. McVie suggest that the low GSH levels
characteristic of diabetes play a role in impaired insulin secretion in uncon-
trolled diabetic patients.
Many researchers have established a link between low GSH levels and a
higher likelihood of endothelial damage, with increased platelet aggregation.
Other researchers have looked more specifically at the relationship of
GSH to isolated complications such as hypertension, diabetic neuropathy
and nephropathy, with favorable results. The role of GSH in protecting red
blood cells from oxidative damage in the case of renal dialysis is also very
promising (see chapter 16).

110 GLUTATHIONE
 CASE STUDY
Deana was a motivated, positive entrepreneur who developed a
wellness health center even though she suffered from a serious case
of diabetes. Increasingly fatigued, this 32 year-old Texan continued
to run her center even after receiving and rejecting a kidney
transplant, failing eyesight and dialysis treatments. Eventually she
developed a chronic foot infection that required weekly debriding
of dead tissue. Her doctor feared that amputation might prove
necessary. She began taking high doses of the whey protein isolate
Immunocal and found her energy levels increased over several
weeks. Kidney function tests and hemoglobin levels improved.
Medication doses for her anemia and hypertension were decreased
or eliminated. Peripheral circulation was better. Five months later
the foot was healed. Deana has since married and continues to run
her clinic.

CONCLUSION
Circulatory damage contributes substantially to diabetic complications and
GSH helps fight the oxidative damage that contributes to this damage. In
fact, the blood and tissues of diabetics are marked by critically low GSH
levels. These complications could be avoided or minimized if diabetics were
less prone to infection, and elevated GSH levels may help accomplish that (see
chapter 3).

1O-DIABETES 111
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