![]() ![]() ![]() Although these people can have very high levels of insulin in their bodies, their cells cannot recognize it, and therefore don’t respond by taking the glucose in. If the cell’s insulin receptors do not work properly, more and more insulin is produced by the pancreas in response to rising blood sugars. Non-insulin dependant diabetes, on the other hand, results from receptor failure. If not quickly resuscitated with supplemental glucose, the hypoglycemia brain can have permanent damage, and the person can die. If too low, the brain can’t get the food it needs to remain conscious, and disorientation or fainting can result. If too high too often, critical cells in blood vessels are injured and the long-lasting complications of diabetes will ensue: infections, loss of circulation, kidney disease, blindness, and early death. Because it is difficult, if not impossible, to duplicate this exact and rapid matching of insulin to glucose levels in the blood with injections, insulin-dependent diabetics can have high and low swings of blood sugar. Type I diabetics need to receive insulin in the form of injections (science has not yet perfected a form of insulin that one can swallow) and of course it is important to match the amount of insulin as closely as possible to the amount of carbohydrates ingested. This occurs rapidly and from moment to moment. Insulin is produced by the pancreas, and under normal circumstances the amount of insulin secreted exactly matches the amount of glucose rising in the blood stream. Such a person can eat carbohydrates, break them down into glucose units, and yet the cells can starve because there isn’t enough insulin to tell them that glucose is right outside waiting to come in. In insulin-dependent diabetics, the body (for whatever reason) has quit making sufficient amounts of insulin. This is where Type I and Type II diabetes differ. Secondly, there are potential problems with insulin production, and there are potential problems with insulin receptors. Without either insulin or these receptors, cells could literally be swimming in a sea of glucose and not know it! This action opens up the cell to glucose and brings it in, so that it can now be used by the cell for fuel. Each cell of our bodies has insulin receptors attached to it, and when insulin comes into contact with these receptors it activates them and signals to the cell that glucose is available. It must be informed that it is available for use, and this signal is insulin. However, the cell cannot recognize glucose floating in the bloodstream by itself. It is the basic building block of all forms of carbohydrates, which are eventually broken down into glucose for each of your body’s cells to use. Glucose is like avgas for your plane….without it, no work can be performed. ![]() First, every cell in your body needs fuel, and that fuel is glucose and glucose only. It is important to understand a couple basic premises. This will help you understand how these diseases operate, how treatment works, and then how the FAA deals with it. There are basically 2 types of diabetes, insulin-dependent (Type I) and non-insulin dependent (Type II.) In order to understand the difference, bear with me a short review of the biology involved. I would like to take this opportunity to describe briefly what diabetes is, why it is becoming an increasingly frequent problem, and what can be done about it….for one’s health, and one’s Medical. As with other medical problems, there are 2 sides to this coin…that of one’s health, and that of one’s Medical Certificate. As an Aviation Medical Examiner, I have encountered many diabetic pilots in my 20 plus years of performing flight physicals, and it is always disconcerting (mostly to the pilot, of course) when this diagnosis is made during a flight physical examination. However, when sweetness affects your body, not only is your health in jeopardy, but so is your Medical Certificate. ![]() Life is sweet, especially when one lives in Alaska and has an opportunity to fly wonderful airplanes to incredible places. ![]()
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