Mellitus comes from the Latin for 'honey'.

Diabetes Mellitus is a term often used to describe Type 1 diabetes or even diabetes in general. As we became exposed to the condition, the different names and types of diabetes was an initial source of confusion. Let us give you a little history lesson on the origin of the word and hopefully it will help to clear things up.

The term Diabetes is Greek and means ‘that which passes through’. It was originally used in the 2nd century to describe a patient of a Greek physician who was exhibiting the symptoms of excessive urination.

Later, in the 17th century, the term Mellitus was attached to the disease. This term has its origin in Latin meaning ‘honey’ or ‘sweet’ and was used to distinguish between those with sweet-tasting urine (diabetes mellitus) from those with urine with no taste (diabetes insipidus).

Today, the two predominant forms of diabetes – Type 1 and Type 2 – are both considered forms of diabetes mellitus. As such, the term diabetes mellitus has become somewhat synonymous with the general term diabetes.

Confused? Don’t be. If you simply ignore the ‘mellitus’ at the end of the term you’ll basically be back to simply ‘diabetes’. Because the vast majority of people suffering from diabetes have a form of diabetes mellitus, you’ll be ok with this generalization.

Once you’re back to simply reading things as ‘diabetes’, then all you have to do is understand the differences between Type 1 and Type 2 diabetes.

I hadn’t thought much about unconditional love until earlier this week.  It had never come up, never been forced upon me, never required that I prove it.  I had, possibly like most parents, simply taken it for granted.

Each weekend I looked forward to spending my spare time with my 7 year-old son.  Teaching him about sports, talking to him about anything, including him in my daily life.  Given that my enjoyments simply coincided with his, I was never required to think deeply about why and how much I cared.

Earlier this week however it all came surging forward and as I spent 3 days trying to navigate half the globe to get to a small hospital in Thailand to see him I had the time to really contemplate the concept:  unconditional love.

My son and my wife had been spending their traditional summer back in Thailand, visiting with the in-laws and assimilating him into Thai culture.  They had been gone almost 5 weeks when we found out her mother was terminally ill with cancer.  The news obviously took my wife for a profound loop and having lost her father very suddenly while she was out of the country, this time she had a chance to spend time with her mother before she left us.  We decided that she and my son should spend a few more weeks in the country helping to take care of her mother and saying their last goodbyes.

I, on the other hand, was in dire need of a simple vacation and with no family at home decided to take off down to El Salvador for some surfing with friends.  While sitting in the departure lounge I called back to Thailand to see how things were going.  My wife and son were fine and her mother was spending time going through a lot of tests at the local hospital.

“You’ll be amazed at how much Leighton is growing,” my wife mentioned.  “He’s eating everything in site and everyone says he’s getting so much taller.  I probably don’t see it because I’m around him all the time.  All I’m seeing is that he’s getting skinnier and skinnier.  It’s like he’s stretching out.

“And he’s drinking water all the time as well.  I’m trying to get him to slow down but he complains about being thirsty.  He’s drinking so much he has to pee every hour or so.  It’s crazy.  He even pee’d in his bed three times last night.”

“Hmm, that doesn’t sound really right to me.  If he’s peeing that much he may have a bladder infection or something.  You should take him over to the local clinic and see if they can give him something.”  I had no concept as to what may be going on with my son, but I knew that having to pee every hour was a bit odd.

“Yes, I was going to do that this morning.” With the time difference between the US and Thailand, they had just woken up and I was stepping onto a red-eye flight down to Central America.

“Ok darling, I’ve got to jump on a plane.  I’ll call you when I arrive and see how things are going with him.”  I didn’t give it much more thought and boarded the flight.

When I arrived and settled into my room I gave them another call.  It was now late at night their time and my wife answered the phone a bit more concerned than she had been over the last week.  The clinic had referred her and my son to the local hospital where they had run some tests.  The doctors had expressed that it may be more serious than we had originally thought.  As my wife had to take her mother to a regional hospital 3 hours north early the next morning, the local hospital arranged for her to get my son checked there as well.  She gave me a cell phone number I could call while she was spending the next few days up North.  I told her that I’d call again mid-morning the next day to find out what the hospital said.

…to be continued

Hypoglycemia occurs when the body does not have enough glucose to produce energy.  In people with diabetes, it is typically a result of having too much insulin relative to the amount of carbohydrates you have eaten.  As insulin helps glucose be absorbed by your body’s cells, having too much causes your body to seek out sugars when nothing is there.  People with diabetes typically experience this excess insulin either by not eating enough or calculating the wrong dosage for their injections or pump. The opposite of this, having too much glucose in the body is termed hyperglycemia.

You can also experience hypoglycemia after strenuous exercise.  With exercise, your body is seeking out more energy than normal and so it requires greater levels of glucose.  Often times, with exercise, it is not during the exercise that people first experience hypoglycemia.  Instead it can be minutes or even hours after the exercise has stopped and your body is recovering.

It is not uncommon for people with diabetes to experience mild hypoglycemia.  It is very difficult to accurately measure carbohydrate intake.  Also, sometimes the duration of your last insulin injection is shorter than anticipated or you don’t have a chance to eat right in time, or you’re taking part in a busy lifestyle.  However, the consequences can be severe and so always having some form of quick acting glucose (sugar) around is important.

Before you were around someone with diabetes had you ever thought about your pancreas?  Probably not.  But once forced to understand glucose levels and insulin dosage you’re bound to really want to know what this organ was meant to do.

Essentially one of the core functions of the pancreas is to produce a protein hormone called insulin.  The production of insulin occurs continuously but fluctuates based on how many carbohydrates you are consuming.

As you eat carbohydrates they change into glucose and travel around your body.  The pancreas then kicks into action and produces just the right amount of insulin to counterbalance the glucose (amazing!).  As insulin is produced, it too travels around attaching to cell receptors throughout your body.  When glucose passes by, these insulin-laden receptors enable the cells in your body to absorb the energy or calories associated with the glucose.  The more glucose you have traveling around, the more insulin you need to absorb those calories.

Within the pancreas there are cells called beta cells that are responsible for creating your insulin.  This is where things have gone terribly wrong with Type 1 diabetes.  The beta cells have been destroyed and so the pancreas is no longer able to produce the insulin needed to help the body absorb glucose.

Without insulin in the body, a person can eat and eat but will eventually starve.  The inability to absorb the energy associated glucose (because insulin is not there on your cells) means that your body will start to look elsewhere for energy.  This is why extreme weight loss in a child is one of the warning signs of diabetes.

For those with Type 1 diabetes, because the pancreas is no longer able to produce insulin, they must provide their bodies with insulin by giving themselves injections or through a pump utilizing man-made insulin.

Though the onset of diabetes is devastating, it does help to remind us of the amazing complexity of the human body.

Author: James Hirsch

Review: Very good

James Hirsch has been surrounded by diabetes his entire life.  He was diagnosed with Type 1 at age 11, his older brother is a leading diabetologist, and as he was researching this book, his 3-year-old son was diagnosed with Type 1 as well.  It would be very easy to expect him to write a passionate portrayal of life with diabetes.  But Mr. Hirsch is also a well known and respected journalist for the New York Times and Wall Street Journal and as such he is able to combine his own life experience with well documented and researched thoughts and information about the state of diabetes in our society.

Mr. Hirsch’s personal journey was a comfort as I read his book on the plane flying to join my newly diagnosed son in the hospital.   At the time I knew very little about diabetes and held all the typical fears associated with knowing your child is suffering from a lifelong and potentially debilitating disease.  Mr. Hirsch’s ability to convey his own emotions associated with tending to his son as well as his ability to place the disease within the larger aspects of his own successful life (it just becomes another aspect of you), helped to calm my fears and set me down a path with a set of principles that I too hope will help my child excel.

Along with his inside story however was Mr. Hirsch’s excellent detailing of the history and research behind the disease.   I had no idea how brutal this disease was just a half century ago and had no idea the endurance exhibited by my previous generation.  In detailing the history, Mr. Hirsch also provides a very straightforward explanation of the causes and management of diabetes.  By the time I had landed I was well armed to question the doctors that were looking after my son.

The final few chapters of Cheating Destiny start to take on more of Mr. Hirsch’s own views and personality as they explore the current research and politics surrounding the disease.  Science and academia are rife with political behavior and I commend the fact that Mr. Hirsch did not shy away from stating his own views of the issues.  Not everyone will agree with those views, but I feel it’s always better to have the viewpoints of the author be explicit so you’re sure where they are coming from.

For a parent of a child with diabetes or anyone who wants to learn more about it, this is a book that will enable you to get emotionally drawn in while at the same time gaining a true understanding of the magnitude and manageability of this disease.