Diabetes

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VOICE ONE:

This is Steve Ember.

VOICE TWO:

And this is Bob Doughty with Science in the News, a VOA Special
English program about recent developments in Science. Today, we tell
about the disease diabetes.

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VOICE ONE:

The World Health Organization
estimates that as many as one-hundred-twenty-million people have the
disease diabetes. Diabetes is the name for several diseases with one
thing in common: there is too much glucose, or sugar, in the blood.
The disease develops when the body does not produce enough insulin
or produces no insulin. Or the disease develops when the body cannot
use insulin.

Insulin is a hormone that is necessary to change sugar,
carbohydrates and other food into energy. In healthy people, the
body changes food into a sugar, called glucose. Glucose is the
source of fuel for the body. When food is changed into glucose, it
enters the bloodstream and is taken to all parts of the body to feed
muscles, organs, and tissue.

VOICE TWO:

When the body senses that there is too much glucose in the blood,
it sends a signal to the pancreas. The pancreas is the organ that
produces insulin. The pancreas sends insulin into the bloodstream.
The insulin lowers the level of blood sugar by letting it enter
cells. Insulin helps muscles, organs and tissues take glucose and
change it into energy.

That is how the body operates normally, in most people. Diabetes
is present when too much glucose remains in the bloodstream and does
not enter cells. If the amount of glucose in the blood remains too
high, the body begins showing signs of diabetes. Over time, the
disease can cause blindness, kidney disease, and nerve damage. High
glucose levels in the blood also can lead to strokes and heart
disease. Blood circulation also is affected, especially in the legs.
Often, victims of diabetes must have a foot or even a leg removed
because of blood circulation problems linked to the disease.

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VOICE ONE:

There are two main kinds of diabetes, Type One and Type Two.
Between five and ten percent of those suffering from diabetes have
Type One. It usually begins before the age of thirty in people who
are thin.

It is most commonly found in children under the age of sixteen.
It is caused by the body's defense system. The bodies of Type One
diabetes victims produce a substance that attacks and kills some
cells in the pancreas, blocking the production of insulin. These
cells are called islet cells. Scientists are not sure why this
happens. They believe there may be a number of causes.

They include viruses, the presence of insect-killing pesticides
in the environment or molecules known as free radicals. Free
radicals are produced as part of normal chemical processes in the
body. In people with diabetes, too many of these free radicals are
present in the body. Scientists are not sure which of these causes
is the most important to the development of Type One Diabetes.

VOICE TWO:

People suffering from Type One diabetes must carefully control
their diets. And they must exercise often. People with this kind of
diabetes almost always require insulin injections. Patients must
always know their blood sugar levels. When the level of glucose in
the blood is too high, they must inject insulin into their bodies to
reduce the amount of glucose. The patients must inject insulin every
day, often several times a day. In most developed countries, insulin
is easy to get and does not cost much money. However, doctors
believe that these injections can cause long-term problems. They
believe that the injections cause levels of glucose to change often.

Scientists believe that many quick changes in glucose levels can,
over time, result in damage to the body. This damage can be
blindness, kidney failure, heart disease, or poor blood flow in the
body.

VOICE ONE:

Type One Diabetes also is known as
juvenile onset diabetes, because it usually starts in children or
young people. Scientists believe it is the form of the disease that
they will most likely be able to cure some day. Among the treatments
being studied is a vaccine to prevent the disease. A vaccine is
injected into the body or taken by mouth in the form of a pill.

Another possible treatment for Type One Diabetes is placing new
islet cells into the pancreas to help it make insulin. Doctors have
been transplanting islet cells into diabetes patients for several
years. However, these healthy islet cells have failed to permanently
replace the need for insulin injections.

Scientists also are studying special cells called stem cells to
treat the disease. Stem cells develop into all the different kinds
of cells in the body. Scientists believe that stem cells from unborn
babies could be used to treat diabetes and other diseases. However,
it would be a long time before such treatment is possible.

VOICE TWO:

While some scientists continue to seek ways to cure Type One
Diabetes, others are searching for easier ways to get insulin into
the body. New devices are being developed that could replace
injections. One device being tested is an inhaler.

This device would permit patients to breathe insulin into their
bodies. The insulin is in the form of a powder, like dust. When the
insulin reaches the lungs, it quickly moves into the bloodstream to
reduce glucose levels.

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VOICE ONE:

Type Two Diabetes generally is found in people more than forty
years old. Most of these people are too fat. Their bodies can not
produce enough insulin to reduce the levels of glucose in their
blood. Or, their bodies do not react correctly to the action of
insulin.

Type Two Diabetes is more complex than Type One. Experts say Type
Two Diabetes is really a group of diseases, with many possible
causes. Scientists see little hope in developing a cure for this
kind of diabetes. Instead, they are searching for better ways to
control it. Many people suffering from the disease can control it
with exercise and by carefully controlling their diet. Also, many of
them do not need to inject insulin into their bodies. Type Two
Diabetes is sometimes called non-insulin dependent. Still, patients
often need drugs to treat the disease.

VOICE TWO:

There are a number of drugs that can be used. However, many of
them can cause other problems. One of the drugs is called
sulfonylurea. It has been used for many years to help the pancreas
make more insulin. But after several years, the drug loses its
effects on the pancreas. Also, it can cause patients to gain weight.

The drug metformin appears to be more effective. It lowers the
amounts of glucose in the blood. It does this by helping the body
make better use of its own natural insulin. It does not cause weight
gain. However, metformin can be dangerous for people with damaged
kidneys. It should not be used by people who drink large amounts of
alcohol, or those with kidney, liver or heart problems.

VOICE ONE:

Genes seem to be more important in the development of Type Two
Diabetes than in Type One. About ninety percent of those with Type
Two Diabetes have parents and ancestors who also had the disease. In
recent years, scientists have found several genes that may be linked
to Type Two Diabetes. Some of these genes also are linked to extreme
overweight, known as obesity. About eighty to ninety percent of
people with Type Two Diabetes are obese. Often doctors do not
discover that patients have diabetes until one of the disease's
serious results is found. For example, a doctor examines a patient
suffering several health problems.

The doctor carries out tests and finds the problems are the
results of poor kidney performance. Tests then show the patient is
suffering from diabetes, which can cause kidney problems and even
failure.

VOICE TWO:

Although great progress has been made in the treatment of
diabetes, it is still widespread and threatens the health of
millions of people. Scientists hope that their research will lead to
a cure for Type One Diabetes. And they hope they can find new ways
to improve treatment of Type Two Diabetes. In future programs we
will discuss new developments in diabetes research as they are
reported.

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VOICE ONE:

This Science in the News program was written by Oliver Chanler.
This is Steve Ember.

VOICE TWO:

And this is Bob Doughty. Join us again next week for more news
about science in Special English on the Voice of America.