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Diabetes Matters: What Do Hormones Have To Do With Diabetes?

November 23, 2010

When most people hear the word "hormones," they tend to think of the familiar sex hormones such as estrogen, progesterone and testosterone. But the body produces numerous other hormones – chemicals released by cells or glands in the body that send out messages to regulate various body functions. Some of those hormones play leading roles in diabetes, as well as in cases of abnormally low blood sugar known as hypoglycemia.

"Diabetes is a chronic disease in which the body does not produce enough or does not properly use the hormone insulin, which helps the body convert blood glucose into energy," says Dr. Prasad Katta, an endocrinologist on the medical staff at Washington Hospital. "Insulin, which is produced by the pancreas, is only one part of the puzzle."

"Another hormone produced by the pancreas, glucagon, also has a role to play," adds Katta. "Both insulin and glucagon are produced in response to blood sugar levels, but insulin is secreted in response to high blood sugar levels while glucagon is produced when blood sugar levels are too low. Glucagon raises the blood sugar level by converting glycogen that is stored in the liver into glucose."

To help people learn more about the relationship between hormones and diabetes – including medications to regulate diabetes-related hormones – Washington Hospital is sponsoring a free "Diabetes Matters" class, featuring a lecture by Dr. Katta. The class is scheduled for Thursday, December 2, from 7 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium in the Washington West Building at 2500 Mowry Avenue in Fremont. A Diabetes Support Group session will follow the lecture.

Ever since the first human diabetes patient received an injection of insulin in 1922, medical science has made remarkable advances in developing medications to regulate the body’s level of insulin. Medications called sulfonylureas (such as Glyburide and Glipizide) and meglitinides (such as Prandin and Starlix) help the pancreas secrete more insulin. Other drugs, such as Metformin and Actos, can be used to increase the body’s sensitivity to insulin.

According to Dr. Katta, most of the time, patients have more than one factor contributing to their diabetes.

"It could be a combination of high glucagon levels in addition to insufficient insulin production or insulin resistance," he says. "There currently is no test to determine if a patient has high glucagon levels, but these medications may be added to the treatment regimen if other medications are not working effectively."

Be Aware of Potential Medication Side Effects

Dr. Katta cautions people to be aware that diabetes medications – like any drug – can have adverse side effects. Some may cause digestive system problems. Others may produce weight gain or fluid retention. In very rare cases, drugs that increase incretin levels and reduce glucagon levels may cause inflammation of the pancreas, so a person with a history of pancreas inflammation (pancreatitis) or pancreatic cancer should not take these medications.

"One side effect of various diabetes medications may be hypoglycemia – a sudden, dangerous drop in blood sugar," Dr. Katta says. "When you have hypoglycemia, you can experience a variety of symptoms, including heart palpitations, increased perspiration, hunger, drowsiness or dizziness.

"A lot of these symptoms can be caused by increased levels of hormones produced by the adrenal glands on top of the kidneys – cortisol and catecholamines, including adrenalin," he adds. "These hormones are released into the blood during times of physical or emotional stress, and they are telling the body to raise the blood sugar level. Hypoglycemia can happen at any time, and most of the time people will wake up if it happens at night."

Dr. Katta stresses that anyone with diabetes who is experiencing signs of hypoglycemia needs immediate access to sugar. "The preferred source would be glucose tablets, but fruit juice or soft drinks may be used instead," he explains. "Then you need to check your blood sugar levels after 15 minutes. If the blood sugar level hasn’t gone up by 50 points, you should consume more sugar and repeat the blood test again in 15 minutes. If the blood sugar level still has not increased by 50 points, call 9-1-1."

Prevention Is the Best Medicine

Not every person who has diabetes needs medications, since it often can be controlled with diet and exercise. In fact, proper diet and exercise can help prevent diabetes in the first place.

"Diabetes is becoming epidemic around the world, as more and more people are copying the unhealthy U.S. diet and becoming more sedentary" Dr. Katta says. "The National Institutes of Health is predicting that every third child born in the U.S. after the year 2000 will develop diabetes during their lifetime. The incidence of diabetes is only going to increase if we don’t change our lifestyles to eat healthier foods and get more exercise.

"I jokingly tell my patients that they only have to exercise on the days they eat," he adds. "Of course, that means every day!"

Come to the Diabetes Support Group

Success in managing diabetes has a lot to do with receiving and giving social support. For people who suffer from diabetes, the Washington Outpatient Diabetes Center offers a support group that allows people to have in-depth conversations about what’s happening in their lives and share information about dealing with diabetes in a positive and caring environment. The support group meetings are held at 8 p.m. every month immediately following the hour-long Diabetes Matters lecture which begins at 7 p.m. the first Thursday of each month. Family members and friends are also welcome. For more information about the support group or other classes and programs, call (510) 745-6556 or visit us on the web: www.whhs.com/diabetes

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