The Beta Version

My name is Beta (β). I am a cell of the body. People refer to me as a Beta Cell. I live with hundreds of thousands of Beta Cells in the body, all of them in a gland situated in the abdomen called the pancreas. This is my story, narrated for me by the writer.

l, the Beta Cell, will begin my story talking about glucose in our food. Whenever you eat food, it gets digested to form glucose, a major source of energy in the body. This glucose enters the blood and there is some additional glucose produced by organs such as the liver. The body uses all this glucose for energy. But when the glucose level is higher than normal, my work load increases. We, the Beta Cells, then release our army of little chemicals called insulin. This insulin helps to lower the high blood glucose to normal by making the various organs promptly drink up the glucose in the blood for their energy requirements.

However, some people have high blood glucose levels despite all that we, the Beta Cells do, resulting in a condition called Diabetes which if untreated, leads to numerous complications. Diabetes happens because of biological genetic reasons as well as environmental reasons. Genetic reasons cannot be corrected (as some humans say, "You cannot change your parents!"). However environmental reasons, such as diet control, physical activity and stress reduction can, at least to an extent, be under the control of your own free will.

How do these environmental factors affect my work as a Beta Cell? A bad lifestyle leads to two problems high glucose intake and more obesity/ weight gain. High glucose means that I, the Beta Cell, now have to make even more insulin, a workload that tires me out. And obesity means that the insulin I make does not work, because obesity causes a condition called insulin resistance. This means that I now have to make even more insulin, which tires me out even more. Eventually, I will not be able to meet the ever-increasing need for insulin. Thus, the blood glucose levels rise and rise and this requires medicines. Dear human, you will note that now there are two problems one, that I cannot make insulin, and secondly the insulin I make does not work. Combination of the two problems is referred to as Type 2 Diabetes and is the commonest cause of Diabetes in the world.

How can you, a human, help me, your Beta Cell, to help you? The good news is that by reducing excess sugar in your diet, by being physically active and reducing stress- you will be able to help me by giving me rest and rejuvenating me. And then, I will be able to make some more insulin. Also, the insulin I make following a period of good lifestyle changes always works better, because weight loss and stress reduction due to improved habits can reduce insulin resistance. Thus, Type 2 Diabetes can be prevented and easily treated.

However, if people with Type 2 Diabetes continue to eat junk food, remain sedentary and live a stressful life, then we, the Beta Cells begin to die following an excess workload, a process called apoptosis. When we Beta Cells begin to fail and die, this process may take years, but is sometimes inevitable. The process of our Beta Cell death by apoptosis leads to a continuing increase in blood glucose levels over time­ requiring stepwise addition of medicines. Eventually, insulin is required, because we Beta Cells can no longer produce insulin. Unfortunately, insulin gets digested if you eat it, so insulin has to be injected. The use of modern medications, including insulin has helped preserve, resurrect and rejuvenate us, the Beta Cells, thus making Diabetes control better.

Sometimes even in people who follow strict lifestyle measures, more medications are needed because of the biological /genetic aspects of the Diabetes. This abnormal biology/ genetic alteration results in destruction of all Beta Cells like me. Some people have a form of Diabetes called Type 1 Diabetes, where the body mistakenly attacks me and the beta cells like me a form of biological self-harm often called an autoimmune attack. This is called Type 1 Diabetes because it is due to one problem­ that of us Beta Cells not being able to produce insulin. Type 1 Diabetes is not a lifestyle disease and people with Type 1 Diabetes require insulin injections lifelong. This is different from the more common Type 2 Diabetes, which can be managed in early stages by lifestyle changes, and later by medications.

If you have Type 2 Diabetes that is newly diagnosed, by simply following a good diet and being physical activity and reducing your weight, you may be able to help keep the blood glucose in the normal range.

Stress reduction is very important, as stress releases hormones, like adrenaline, which increase glucose levels, making my work as a Beta Cell harder. Hence please reduce stress on us Beta Cells, by reducing your own stress.

Being a cell, I do not have a brain and certainly I cannot control the millions and millions of cells which make up humans. But you, dear reader, are often gifted with the ability to read, and hence, do go through authentic Diabetes related information. The right information will help you follow nutrition, physical activity, be regular with monitoring and medications and live a stress free life. As they say, Know Diabetes More Means Diabetes No More!

Happy reading.

Dr Unnikrishnan AG, Editor