Should the government regulate sugar

Diabetes mellitus

The sugar metabolism is regulated in a very complex way. Because both too high and too low glucose levels in the blood are dangerous. The hormone insulin produced in the pancreas is responsible for lowering blood sugar levels. The cells in the liver and muscles in particular are equipped with insulin receptors. These receive the signal to take up glucose inside the cell in order to store it or use it for muscle activity.

Diabetes is based on a disorder of the insulin balance. On the one hand, this can be due to insufficient or absent production of insulin, and on the other hand, due to insufficient sensitivity for the hormone insulin. In both cases, the metabolic disorder leads to an increased level of glucose in the blood.

The main antagonist of insulin is the hormone glucagon. Like insulin, it is made in the pancreas. But adrenaline, cortisol, thyroid hormones and somatostatin also raise the glucose level. Glucagon production starts as soon as the blood sugar level has fallen below the narrowly defined target range. The stored glucose is then released in the liver. Glucagon also boosts the conversion of fatty acids and amino acids into glucose. So it ensures that other sources of energy are used in addition to carbohydrates.

Characteristics of type 1 and type 2 diabetes

When people talk about diabetes, they usually refer to type 2 diabetes mellitus. It is by far the most common form. At the onset of type 2 diabetes, formerly known as adult-onset diabetes - but also in women with gestational diabetes - the beta cells in the pancreas produce less insulin than is needed. The blood sugar values ​​remain above the target value, one speaks of a relative insulin deficiency. This is different with type 1 diabetes. Here the immune system destroys the beta cells of the pancreas. As a result, the pancreas releases little or no insulin into the blood.

The situation is different again in the late phase of type 2 diabetes mellitus and in the metabolic syndrome, a metabolic situation that is characterized by excessive weight, “derailed” sugar and fat metabolism and high blood pressure. Then there is enough insulin available, but the insulin effect and thus the glucose uptake in the cells are limited. This condition is known as insulin resistance.

A rough distinction between the two forms of diabetes is already possible based on the age of onset. Type 1 diabetes manifests itself predominantly in childhood, type 2 diabetes predominantly in adulthood. In addition, type 1 diabetes tends to affect children of normal weight and begins relatively fulminantly, i.e. usually suddenly and in connection with physical stress or a harmless infection; the children are very thirsty, have to go to the bathroom frequently and inadvertently lose weight. Type 2 diabetes, on the other hand, tends to affect severely overweight children and adults without any characteristic symptoms; unspecific symptoms such as tiredness, weakness and feeling of hunger are possible. Type 2 diabetes is therefore usually discovered by chance during a medical laboratory examination.

German Center for Diabetes Research

The German Center for Diabetes Research (DZD) is one of the six German Centers for Health Research funded by the Federal Ministry of Education and Research and the federal states. It pools expertise in the field of diabetes research across Germany - with the aim of developing individualized prevention and therapy concepts.

Risk factors: Eating too much, too little exercise

If it was previously assumed that type 1 diabetes is hereditary and type 2 diabetes is the behavior-induced form of the metabolic disorder, the distinction is no longer so clear today. Type 2 diabetes also occurs in families; so there is a genetic predisposition. Nevertheless, obesity, sedentary lifestyle and smoking - modifiable lifestyle factors - are of great importance. It is only through them that the disease manifests itself. Therefore, they are considered to be classic risk factors for the development of type 2 diabetes mellitus.

Lifestyle factors play little or no role in type 1 diabetes. This is where the immune system begins to form antibodies against the beta cells in the pancreas, for reasons that have not yet been clearly understood. The immune system attacks its own body because the surface of the beta cells has changed and the body therefore classifies them as foreign. It destroys the insulin-producing cells of the pancreas, so that patients with type 1 diabetes have to take insulin for life.

Metabolic programming through lifestyle

For a long time it was assumed that diseases are either congenital or caused by lifestyle. In the meantime, the picture has also become more complex with diabetes mellitus. Because environmental influences can switch genes on and off or modulate their activity. The science of epigenetics examines how this happens in detail.

It is now known that in addition to the genetic predisposition for type 2 diabetes mellitus, an appropriate lifestyle must be added in order for the disease to break out. If a person barely moves, for example, the number of insulin receptors on the surface of the muscle cells decreases. Because under these circumstances they do not need the insulin-mediated absorption of glucose.

There are interactions not only in one's own body, but also between that of the mother and that of the unborn child. Children of mothers with gestational diabetes who were exposed to elevated glucose and hormone levels in the womb are more likely to develop diabetes themselves. Because the maternal glucose levels also influence the gene activity in the fetus.

Results of health research