Sugar Metabolism

Any person undergoing yoga therapy for diabetes should know the principlesinvolved. Diabetes mellitus is a disorder of the body’s metabolism characterized by a high blood sugar level and the subsequent excretion of sugar in the urine. The human body requires sugar for energy to maintain the organs and tissues of the body. The sugar, which is taken into the body in the form of carbohydrates, enters the blood in the form of glucose (mainly), fructose and galactose. These sugars are either immediately used by the body or else are stored for later use in the liver and muscles in the form of glycogen.

When we eat a meal containing protein, carbohydrate and fat, the following things happen in the normal situation.

• Glucose enters the bloodstream from the intestines.
• Insulin is then released from the pancreas in order to help the glucose (from carbohydrates) and amino acids (from proteins) to be assimilated by the body.
• Insulin pushes the glucose into skeletal muscle, fat cells and liver.
• Fat from the meal, in the form of triglyceride, is also pushed into fat cells by insulin.

Because we do not eat continuously, periods of relative abundance alternate with food-free periods. During fasting the insulin levels reach their nadis and fat is released as a source of fuel. It is from this fat that ketones can build up to toxic levels in some people with diabetes.

The blood sugar regulates its own level. When the blood sugar level is high, the Islets of Langerhans (a group of endocrine gland cells in the pancreas with the specific function of secreting hormones) secrete insulin to lower the sugar level. The opposite effect occurs when glucagon, another Islet cell hormone, is secreted. Thus balance is achieved.

The regulation of sugar by the body is a very complex thing as glucose is the basic energy supplier of all body tissues. It plays an important role in all body functions and therefore requires sensitive and precise interaction of the pancreas, pituitary gland, skin, kidneys and nervous system. So glucose monitoring and control is a very complex thing. It is easy to understand, therefore, why diabetes is beyond the reach of medical therapy alone.

Diabetes mellitus is a chronic imbalance in the mechanism regulating blood sugar level. When it occurs, the glucose absorbed into the blood from the digestive system is prevented from being effectively used in the muscles and tissues, or from being stored in the liver in the form of glycogen or as fat. It is caused either by a relative or absolute lack of the hormone insulin.

Absolute (juvenile-onset) Diabetes

In this condition for various reasons, the pancreas stops producing insulin. It can completely stop its production or it can dribble out insufficient quantities. This prevents glucose from entering the body cells, with the result that they starve, even though there is a high level of food in the form of glucose in the blood stream. This starvation affects the beta cells of the pancreas, compounding the problem and turning it into a vicious circle. This form of diabetes most commonly occurs in young people, and is a case of “Water, water everywhere, but not a drop to drink!” This form of diabetes can be best tackled only by the knowledge of yoga.

Relative (mature-onset) Diabetes

Due to malfunction or imbalance in the nervous, hormonal and digestive systems, there is thought to be an inappropriate secretion of insulin at the wrong time, and/or the body tissues have become less responsive to insulin. In this form of diabetes, insulin release appears to occur too late in the cycle, so the blood sugar level rises to a high level before insulin is secreted. When insulin is finally liberated, there is not enough to cope with the high blood sugar level. The pancreas tries to secret more insulin, but it is too late, for by then the liver has started to release glucose in response to the call from the starving body cells. Thus the level of sugar in the blood rises even higher. In addition to this, the insulin that is released may be ineffective in letting the glucose into the cells because the cells themselves cannot take it in or because insulin is poorly manufactured. There are various degrees of this type of diabetes, from mild to severe. Some cases are even unnoticeable (latent). Factors involved in mature-onset diabetes seem to be heredity, increasing age, obesity, infections and stress.

Symptoms of Diabetes

The high blood glucose concentration causes more glucose to pass through the kidneys, drawing out with it large quantities of water. This results in:

• Excessive urine with a high glucose content
• Excessive thirst
• Dehydration
• Excess glucose in all body fluids, supplying food for bacteria, making one more prone to infections. For instance, simple wounds tend to fester badly.

The cells in order to keep alive start using fat as a fuel instead of glucose. This produces an added penalty in the form of fatty acids (called ketones) in the tissues. As a result, the patient develops severe acidosis. This, in association with dehydration, can cause diabetic coma (unconsciousness). Death may result unless the condition is treated immediately with the appropriate doses of insulin.

The more advanced case of diabetes, the more extreme symptoms will become. Mature-onset diabetes occurs predominantly in affluent middle-aged persons who are abnormally obese. It is due to relative lack of insulin. This stems from the fact the diet is generally heavy in sugar-rich carbohydrates, and this is often combined with insufficient exercise to work off the large amounts of glucose, which are consumed.

It is our belief that many persons who now suffer from mature-onset diabetes could have completely avoided the disease if they had limited their intake of sugar-rich carbohydrates to a reasonable level and participated in daily exercise, preferably yogic in nature. The daily practice of meditation would also have helped to reduce the chance of contracting diabetes by establishing balance in the nervous system, thereby not allowing the body to become out of tune with itself.

It is with mature-onset diabetes that we are mainly concerned. It affects the larger proportion of diabetics, and is potentially reversible. Juvenile diabetes with absolute lack of insulin can also be greatly helped through yoga, though its reversal is rare. Yoga can help prevent the complications of juvenile-onset diabetes.

All diabetics are encouraged to take up yoga so that they may gain increased health through this science. All can benefit depending on how much effort is put into the practice. The longer you have had diabetes, the more effort you will require. A positive attitude and persistent practice of the correct techniques over a long period will pay valuable dividends, even in the severest case of diabetes. Even a young person who has just discovered he has high blood sugar level has a good chance of eradicating the problem.

Unfortunately, most people do not come to yoga until they realise that medicines are no answer to their disease. This is an important point to remember. Combination of medicines and yoga are the best way to attack diabetic problems especially before it becomes set into the body.