D1:Type of Diabetes by The Damage of Body Constitution

1. Diagnostic Criteria of Diabetes

The diagnosis of diabetes mainly based on the test of blood glucose. A. Diagnostic criteria of diabetes, American Diabetes Association (ADA) published in July 1997, is as follows. 

A. Normal Fasting Blood Glucose Level

• • 1. fasting plasma glucose concentration＜110mg/dL（6.1mmole/L）。

    2. Impaired fasting glucose～fasting plasma glucose concentration≧110 mg/dL & ＜126 mg/dL（7.0mmole/L）, Fasting means at least eight hours without eating.

B. Diabetes～Provided that they meet any of the following criteria, which can be diagnosed with diabetes.

• • 1. Polydipsia, polyuria and unexplained weight loss, and random blood glucose concentration＞ 200 mg/dL（11.1 mmole/L）. Random means whenever and no matter how long after dinner take the measure.

    2. Fasting plasma glucose concentration≧126 mg/dL（7.0mmole/L）. Oral glucose tolerance test(OGTT)：2-hour plasma glucose concentration of＞200 mg/dL（11.1 mmole/L）。

According to this standard, there are more than 2 million diabetics in Taiwan and more than 10 million (almost 100million) diabetics in the Chinese mainland.

2. Type 1 & Type 2 Diabetes in Western Medicine

Although diabetes is divided into 4 types, they are Type 1, Type 2, Special type, Gestational diabetes. However, the treatment is mainly divided into Type 1 and Type 2. Their main pathological feature is...

• 1. Type 1 Diabetes: Since islet β cells are destroyed and leading to absolute insulin deficiency, then, diabetes is caused.  

  2. Type 2 Diabetes: Insulin resistance and ( or ) secretion deficiency, and leading to a relative lack of insulin, then, diabetes is caused.

But, diabetes experts have different points of view. Such as...

• 1. Early in 1985, once though that Latent autoimmune diabetes in adults(LADA) should be called type 1.5 diabetes.

  2. In clinical, there are type 1 and type 2 diabetes overlapped called double diabetes.

  3. In the year 2001, Mc Garry suggested that the name of diabetes mellitus should be changed to diabetes mellipidus.

  4. Professor Xu, in his textbook "Diabetes Mellitus" Said that when diabetes undocumented discernible, Chinese medicine how to do?

These problems show that the treatment of diabetes is still difficult. However, In terms of the body constitution point of view to explore diabetes, we found that there are 3 types of symptoms for early diabetes.

3. Weakness Type of Diabetes

There are lots of symptoms for the main Weakness Type of diabetes. Such as, blood sugar disorders, polydipsia, polyphagia, polyurea, tired, listlessness, yawning, eyes blurred with more tears, poor sleep or drowsiness, impotence or menstrual abnormalities, he is easily hunger, powerlessness, trembling, spontaneous sweating, anxious, heart has a sense of loss, irritability, inability to concentrate, etc. before meals. He feels eager and greedy when he's eating. And, he feels listlessness and drowsiness, while drowsy sleep ( sleep for a long time, but he feels a short time, and he still feels fatigued after he wakes up).

Blood glucose disorder means that AC and PC of the patient are obviously variable. AC/PC standard levels for healthy people is below 110/160 mg/dL(6.1/8.9 mmol/L). But, the variability for weakness diabetes may be, for example, 180/260(10/14.4)、210/300(11.7/16.7)、170/310(9.4/17.2)、300/180(16.7/10). These levels are disordered and maybe not obvious with the quantity of food. But, they may significantly respond to poor living conditions, such as insomnia, nervousness, sadness, busy, tired, etc. Then, the blood glucose concentration will obviously increase. The patient has a poor immune ability for other diseases.  

The body constitution of weakness diabetes may be inadequate of "Environmental Balance Ability", which is one of "6 kinds of the ability of healthy body constitution." When the body constitution is weak, he may be too slow to reach equilibrium in the body. Then, the patient may appear many symptoms and blood glucose unstable. So that, the damaged point of body constitution is a weakness.

4. Stasis Type of Diabetes

Stasis type of diabetes is mainly caused by part of cells insensitive to insulin and glucose transport barriers between capillary to the cells. In general, the patient is fewer symptoms or almost no symptoms. Blood glucose is not chaos and is a fixed deviation. 

Fixed Deviation means that AC/PC standard levels for healthy people is below 110/160 mg/dL(6.1/8.9 mmol/L). Because of glucose transporting from capillary to the cells exists some difficulty, our body will increase blood glucose concentration for promoting osmosis pressure. Then, AC/PC may become to, for example, 100/140 mg/dL（12.5/7.8 mmol/L）、150/190（8.3/10.6）、160/200（8.9/11.1）. The blood glucose concentration will be increased according to the difficulty of transporting glucose from capillary to the cells.

But, the difference between AC and PC is still kept about 40 mg/dL（2.2 mmol/L）. This condition is called "the fixed deviation of stasis diabetes." Blood glucose level is a less obvious relationship with diet. The patient will get fat if he may eat more food, and mostly systemic uniformity, compaction of obesity, and with the slightly larger and bulged belly (the following figure shows). 

And, this fatness is different from that the following figure showed.

After stasis diabetics using SRT, his blood glucose declines slowly. He needs a longer time to be cured. Correspondence situation for stasis diabetes by utilizing SRT is "fewer symptoms, slowly declines and slowly be cured." If Stasis Diabetics has symptoms such as tiredness or listlessness, then he might combine weakness diabetes.

5. Inflamed Pancreas Type of Diabetes

An inflamed pancreas type of diabetes is caused by inflammation of the pancreas. β cells of the pancreas are the only organ in the body for secreting insulin. When inflammation of the pancreas leading to a lot of β cells was killed, then, insulin is insufficiently secreting. The blood glucose increases and he becomes a diabetic patient.   

The inflamed pancreas divided into acute inflammation and chronic inflammation. The patient, biased in acute inflammation, due to intense changes in physiological functions, has lots of diabetic symptoms just like "weakness diabetes." Otherwise, the patient, biased in chronic pancreatitis, since the physiological function changes more slowly, the body will be unconsciously self-regulation, so that he is fewer symptoms of diabetes, just like "stasis diabetes." So, features of Inflamed pancreas diabetes is blood glucose disorder. It displays a fixed deviation, and the width of deviation has a relationship with the quantity of food he ate.

AC/PC standard levels for healthy people is below 110/160 mg/dL(6.1/8.9 mmol/L). The blood glucose deviation of Inflamed pancreas diabetes has a relationship with the quantity of food mainly in PC. For example, blood glucose levels may be 120/200 mg/dL（6.7/11.1 mmol/L）、130/300（7.2/16.7）、125/320（6.9/17.8）. For earlier Inflamed pancreas diabetics, his AC is almost normal, and, he almost has no hypoglycemia symptoms before the meal. 

6. The Damaged Point of Body Constitution for Inflamed Pancreas Diabetes 

Inflamed pancreas diabetes is type 1 diabetes, its damaged point of body constitution is that the β cells of the pancreas were spoiled, and leads to diabetes for absolute insulin deficiency.

7. The Damaged Point of Body Constitution for Stasis Diabetes 

We've ever introduced "adjustment pathological changes" in "03-What is good body constitution." When organ A is injured, then, it may lead to system B to adjust its function for the purpose of reducing the damage of the whole body's health for elongating its life. For example, patients with severe gallstones may lead to hypertension. And when renal function is damaged, it may also lead to hypertension.

For the same reason, some cases display that when an organ is in chronic inflammation, it may lead to the phenomenon of a shortage of energy. For the purpose of increasing the supply of glucose, the body may lead to "adjustment pathological changes" that both blood glucose concentration and insulin concentration are increasing. 

It is a normal Physiological phenomenon that when insulin increases then blood glucose concentration decreases. So, the phenomenon of " insulin increases with blood glucose decreases " is called insulin resistance, and this is the feature of Stasis Diabetes.

Therefore, the damaged point of body constitution for stasis diabetes is chronic inflammation of an organ. Insulin resistance is one of the symptoms, and is not the damaged point of body constitution.

8. The Damaged Point of Body Constitution for Weakness Diabetes

The result of researching "the time table of type 2 diabetes" shows that "insulin is abnormal secreting" happened about ten years ago before diabetes was found. Before 3-4 years ago when the patient was checked out diabetes, insulin-secreting is suddenly increasing. Before (about 0-3 years)the patient was checked out diabetes, the insulin-secreting is suddenly decreasing. The phenomenon of "flip" or "not flip" will form two different types of diabetes. 

On "the time table of type 2 diabetes", "not flip" is the stasis diabetes, because the body can maintain "adjustment pathological changes." So that, the diabetic patient won't feel either any diabetes symptoms or just feel very little diabetic symptoms. More detailed discussion please refer to “Decipherment of The Body Constitution of Diabetes Mellitus” Chapter 04.

The damaged point of body constitution for weakness diabetes is on "chronic inflammation of an organ" and weak body constitution. They may lead to the phenomenon of "flip" on "the time table of type 2 diabetes." So that, blood glucose is suddenly increasing, and insulin-secreting is suddenly decreasing (the response of β cells turns to "not sensitive"). 

Although, insulin-secreting is decreasing, in the short term, it may still display "relative insufficiency" of insulin, and belongs to type 2 diabetes. This is because the body can't maintain "adjustment pathological changes" and produces disordered symptoms. That is why weakness diabetes has lots of symptoms.

So that, the damaged point of body constitution for weakness diabetes is on "chronic inflammation of an organ" and weak body constitution.

9. There are 3 types of damaged body constitution for diabetes

So that, according to the point of damaged body constitution, diabetes could be divided into 3 types as follows.

A. Inflamed Pancreas Diabetes

• • • Belong to type 1 diabetes.

    • The damaged point of body constitution is that the β cells of the pancreas were spoiled, and leads to diabetes for absolute insulin deficiency.

    • Having some of the diabetic symptoms.

B. stasis diabetes

• • • Belong to type 2 diabetes.

    • The damaged point of body constitution is on "chronic inflammation of an organ" and leads to diabetes for relative insulin deficiency.

    • Almost having no diabetic symptoms.

C. weakness diabetes

• • • Belong to type 2diabetes.

    • The damaged point of body constitution is on "chronic inflammation of an organ" and weak body constitution and leads to diabetes for relative insulin deficiency.

    • Having lots of diabetic symptoms.

10. The Course Changes of Diabetes

According to "04-The damage and changes of body constitution", the chronic illnesses will be going...

• 1. Evolutions... becoming more seriously

  2. Complications…asking for more chronic diseases.

So that...

• 1. The higher blood glucose of Stasis Diabetes might easily lead to inflammation of other organs, then, the patient may combine with type 2 diabetes.   

  2. The higher insulin secretion of Stasis Diabetes, when the body constitution is getting so weak that the body can't maintain the higher insulin secretion, then the patient may combine with Weakness Diabetes. And, when β cells kept higher insulin secretion, they will be dying because of damage by too tired, then the patient may combine with type 1 diabetes.

  3. The disordered conditions for Weakness Diabetes will lead the pancreas easier to be affected, then the patient may combine with type 1 diabetes.

So, when diabetes keeps developing and deteriorating, the three types of diabetes may combine together. The patient will have lots of disordered symptoms and pathological changes. Then it is harder and harder to treat by differential symptoms of Chinese medicine and controlled by chemical drugs of Western medicine. 

11. Body Constitution Tries to Explain Diabetes Doubts 

As mentioned earlier, diabetes experts have different viewpoints for diabetes divided into type 1 and type 2. From the viewpoint of body constitution, they may explain as follows.        

• • Early in 1985, Latent autoimmune diabetes in adults(LADA) should be called type 1.5 diabetes.

.......LADA Should be called inflamed pancreas diabetes.

• • In clinical, there are type 1 and type 2 diabetes overlapped called double diabetes.

   ....The pathological basis of type 1 and type 2 are different, so that, they are not Non-extremes of both sides, and they cannot be compared.

   ....The pathological basis of type 1 and type 2 are different, so that, they can be gotten respectively and lead to double diabetes.

• • In the year 2001, Mc Garry suggested that the name of diabetes mellitus should be changed to diabetes mellipidus.

   .... High cholesterol is one of diabetes symptoms, and is not the damage point of body constitution. So, it is unnecessarily to change name. 

• • Professor Xu, in his textbook "Diabetes Mellitus" said that "when diabetes undocumented discernible, how Chinese medicine doctor to do?"

   ... Stasis Diabetes may always has no symptoms, but, doctors may treat Stasis Diabetes to aim at the damaged point of body constitution.

12. Let's keep on studying...

The theory about diabetes seems feasible, but, in practical, how to treat diabetes? Let's keep on studying...

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