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Diabetes Mellitus Update

Knowing the proposed pathophysiogenesis of Diabetes Mellitus (DM) and other chronic diseases help patients in addressing their disease condition.  Here’s my take.  Good Luck!

Medical researchers have long understood that type 1 DM is caused by an autoimmune inflammatory reaction that attacks and destroys the insulin producing cells (beta cells) of the pancreas.  Type 2 DM may also be related to this inflammation of the pacreatic beta cells.

Hyperosmolality (high viscocity of blood--thick blood) and high glucose concentration, which is seen in chronic water deficiency, which has multiple ways of expressing chronic disease, may be the leading cause of diabetes mellitus and is the proposed mechanism involved in DM.  Pancreatic beta cells are sensitive to cell volume changes and cellular dehydration.  When the body is chronically dehydrated from the increasing daily consumption of milk, soda, juice, liquid candy, coffee, tea, alcohol, and other beverages, and the increasing consumption of animal products that require extra amount of water for digestion and metabolism, as well as not drinking enough water chronically, will lead to cellular disruption and cell death of insulin producing cells, as well as the many other different types of cells in the human body.

The pancreas is made up of small clusters of glandular epithelial cells.  About 99% of the cells are arranged in clusters called acini and constitute the major exocrine portion of the pancreas.  The cells within the acini secrete a mixture of fluid and digestive enzymes called pancreatic juices, which are usually very alkaline in pH.

The remaining 1% of the cells of the pancreas is organized into clusters called pancreatic islets of Langerhans.  They (pancreatic islets) form the endocrine portion of the pancreas and consist of cells that secrete the hormone glucagons by the alpha cells (20%), insulin by the beta cells (70%), somatostatin by the delta cells (5%), and pancreatic polypeptide by the F cells (5%).

Each day the pancreas produces 1200-1500 ml (about 1.3-1.6 quarts) of pancreatic juice, which is mostly water (with some salts, sodium bicarb and enzymes) buffers the acidic gastric juice (from acidic pH of 1 to alkaline pH of 7.1-8.2) in the form of chyme from the acidic gastric content of the stomach to prevent autodigestion (self-burning) of the small intestine, to stop the action of pepsin from the stomach, and to create the proper pH (alkaline) for the action of digestive enzymes in the small intestine.  In other words, we need a lot of water in the form of pancreatic juice to extinguish the acidic fire from the stomach when it gets to the small intestine so the small intestine does not get burned.

In chronic water deficiency (see definition in the book, Diseases of Unknown Origin), the amount of water that is needed to buffer acidic juice maybe decreased.  This may result in the diversion of some of the water from the beta cells of the pancreatic islets of Langerhans to make adequate pancreatic juice.  In the long run, there may not be enough water left for the beta cells in particular to function to produce enough insulin to meet the demanding metabolic needs of the body especially in chronic water deficiency.  When persistent chronic dehydration is in the background, these pancreatic beta cells will eventually slowly die off as a result of chronic water deficiency.

In general, during repeated chronic persistent water deficiency in the body, cell deaths may occur.  Otherwise, the cells of the tissues and organ systems may enhance and augment the breakdown of their cellular components and may produce abnormal proteins.  These cellular debris, abnormal protein components, wasted proteins, or fragmented proteins of wear and tear as a result of chronic cell volume depletion or cellular dehydration may start to accumulate.  These break-down proteins may be recognized by the immune system as foreign substances or antigens.  In response to the presence of cellular debris and abnormal protein fragments, the immune system will try to eliminate these breakdown proteins from the body.

"As we aged, from womb to tomb--from a fetus to an aged individual, our body becomes chronically and increasingly dehydrated unintentionally due to the lack of understanding of the importance of proper hydration--please glimpse at The Picture in Chapter 1, page 4 of Diseases of Unknown Origin."

"As our body reaches a state of chronic water deficiency, the cells of the body undergo many constant adaptations in order to adjust to the hyperosmolar changes that are going on in our body.  In other words, as the total body water decreases, the cell volume decreases as well.  In chronic water deficiency, for the cells to continue to support their vital structures and functions, they have to do drastic measures, namely alteration in protein synthesis, etc., to overcome the changes, even to the point of cellular disruption and cell death."

Once the body is keyed up and stressed out by these allegedly cellular debris and abnormal protein fragments, as if these breakdown proteins were labeled as foreign antigens (even though these breakdown proteins came from the body itself), the immune system calls upon the help of the one and only, "The Inflammation."

Guess What!  Who are the main actors and the messenger chemicals or mediators involved in inflammation?  The answer is obvious.  The inflammatory messenger chemicals are the same osmoregulator chemicals involved in the maintenance of water balance in the body.  Well, of course, in inflammation, it also involves different types of inflammatory cells, namely, the phagocytes, macrophages, etc., which secrete inflammatory factors, such as the tumor necrosis factor (TNF), the interleukins, the complements, histamine, and other chemical mediators, etc.  When the immune system attacks the body itself of its breakdown cells and proteins, autoimmune diseases occur.

Let's go back to the pancreas.  When the beta cells die off one cell at a time due to repeated chronic persistent water deficiency, the immune system of the body has to get rid of it of the dead beta cells.  And this might be the reason why DM is both autoimmune and inflammation disorder, and water has got to do with it and the other diseases with unknown origin.

In short, drinking the recommended daily allowance for water to prevent chronic water deficiency is one of the best things that we can do (aside from consuming whole food-plant based diet which are nutrient/antioxidant-rich, high-water content) to prevent diabetes and other chronic water deficiency-related illnesses.

Ref: "Diseases of Unknown Origin, The Abandoned Theory".

The practice of medicine is an art.  You can paint it anyway you want.  The science part is God’s business and not our business.  Humans tend to distort it.  –Eliasar A. Simon, M.D.