by Jennifer Harshman

Created on: September 20, 2010

Diabetes is like a teeter-totter gone wild. It is not a fun ride, and it can be deadly.

On the right side of the teeter-totter sits the blood sugar level. Pushing down on the left side are things that make the right side and the blood sugar rise - things like carbohydrate intake, stress, and illness. Push down just the right amount, and the blood sugar stays level, or within the normal range. Push down quite a bit, and the blood sugar rises significantly. Don’t push down enough on that side, and the blood sugar drops too low.

In a nondiabetic, the pancreas produces just the right amount of insulin in response to the amount of carbohydrates eaten, and the body’s cells “listen” to that insulin and allow it to escort the sugar from the bloodstream into the cells. A nondiabetic eats, pushing down on the left side of the teeter-totter, raising his blood sugar. His pancreas secretes just the right amount of insulin, the cells “listen” to it, and his blood sugar quickly drops back into the normal range. This happens every time he eats or drinks anything containing carbohydrates. The teeter totter only moves a little, and is rebalanced quickly.

In a diabetic, something goes wrong in that process. Either there is a problem with insulin production or with insulin resistance, or both. It may be that no insulin is produced by the pancreas or not enough of it is being made (Type 1 diabetes), the cells are not “listening” to the insulin (insulin resistance or Type 2 diabetes), or there is not enough being made and the cells resist what insulin there is (Type 1.5 diabetes). The blood sugar level moves too much, and takes too long to come back to balance.

Eating carbohydrate-containing foods pushes down on the left side of the teeter-totter. Pushing down on the right side are the things that make the blood sugar drop - things like exercise, some medications, insulin (whether produced by the body, or taken by injection), and not eating for a while.

If a diabetic went long enough without eating, he wouldn't need any insulin or other medication to get his blood sugar into the optimum range, because it would fall into the normal range just from the energy his body is using for everyday functions like breathing and walking. If he went long enough without eating, his blood sugar would even drop too low.

Maintaining a balance on this teeter-totter is important. The blood sugar must not get too high or too low. Unlike children in the park on a real teeter-totter, where bouncing high and slamming back down again can be thrilling and fun, blood sugar highs and lows are not only no fun, but can be deadly.

Uncontrolled blood sugar is the leading cause of diabetes complications – such as neuropathy (the painful death of nerves), kidney damage and failure, death, and the thing many diabetics fear more than death: amputation.

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