Does sugar cause diabetes mellitus? (Diabetes explained.)

Iren wanted nothing more than to get home and sleep. From the car breaking down in the wee hours of the morning, to the drama of not being able to run a fasting blood sugar test because she was ‘over-fasted’, and then to the clinic, and now a long two-hour ride home on a bumpy and dusty road.

What a day!

As soon as they got home, Iren and her mum, Mrs. Asahde, slowly made their way to their flat. The Asahde boys, Daddy and her brother, Timothy, were waiting for them.

“How was your outing?” daddy asked.

“Frustrating and tiring,” mummy replied, as she removed her head tie, and let the sofa feel her weight.

Iren didn’t bother saying anything. She was exhausted!

“Any food for the girls?” Mrs. Asahde asked.

“Well, we have some garium, kuli-kuli, and sugar,” Timothy responded from the dining table. “I was just about to settle my tummy with this one,” he added, tilting a bowl of garri to show them.

Iren went straight to the table and collected the bowl of garri and kuli-kuli from her brother. She sat opposite him, heaped six full spoons of sugar into the bowl, added some very cold water, and started devouring it.

Timothy’s mouth remained open in surprise.

“Stop looking at me. Go and make another one for yourself,” Iren said.

“Na wa o! Na so you hungry reach?” Timothy responded but Mrs. Asahde’s voice interrupted their exchange. “Iren! Iren! How many times did I call you?”

“Mummy, two times.”

“This sugar you’re eating is too much! Eating sugar causes diabetes! Only God knows what your test result would have been if we were able to run the fasting blood sugar test.”

“Ummh! Mummy, mummy! Diabetes is not caused by eating sugar.”

“I’m very sure I was born before you, and you haven’t seen what I’ve seen. No go take your hand carry wetin no concern you.” turning to daddy, she said, “Asahde 1, talk to your daughter.”

“Mummy na…” Iren started to protest.

“I’ve said my own,” Mrs. Asahde remarked, walking away.

“Listen to your mother,” daddy said and resumed reading his newspaper.

Arrgh!

Iren knew her mum could be extremely dramatic sometimes, but she sounded quite serious this time around. ‘Could eating sugar cause diabetes? Or is it just a myth that has been propagated to make people not eat so much sugar and sweet things?’ she wondered as she continued drinking her garri. Eventually, she pushed the thought aside.

The next day, Iren went for the next round of an internship interview. There were just four of them in the hall this time. The chief interviewer came in and addressed them.

“I’ll like to congratulate you all for making it this far. You should be very proud. Today’s interview is going to be in a ‘fastest fingers’ quiz format, and I’m your quiz master for today,” he announced with a hint of pride. “So when you hear a question and you know the answer, hit that shiny red buzzer and let it rip. All the best.”

Iren’s heart raced. She had no idea what the interview questions would be like, and she could only hope she was prepared enough. The added pressure of fastest fingers made small beads of sweat condense on her palms. She quickly wiped her sweaty palms with her pink handkerchief. “Calm down, Iren. You can do this,” she whispered to herself.

“This section will focus on diabetes mellitus. Let’s begin!” the quiz master continued in his deep baritone voice.

“Question 1: What is diabetes mellitus?”

Iren hit the buzzer with that confident smile that said ‘Duh! I know that.’ The explanation she received from the hospital’s head of laboratories yesterday was still fresh in her head.

“Diabetes mellitus is a disease that causes blood sugar to be too high, because the body is either not producing enough insulin or it is not responding well to the insulin produced,” she said.

“Excellent! Next question. What is insulin?”

Again Iren hit the buzzer first. “Insulin is a hormone produced by an organ called the pancreas, and its job is to reduce blood sugar levels by toasting the body cells to allow glucose enter them.”

“Toasting?” the interviewer asked, as he cocked his eyebrows at her.

“Yes, like how a boy toasts a girl…”

‘Iren! Borrow yourself brain o. Na interview be dis,’ she chided herself internally.

“Ummh… Okay, what I mean is that insulin is the hormone that tells the body cells to open so that glucose can enter them,” Iren said.

“Alright. That sounds better, and that is correct,” the interviewer said.

Phew!

“Question three: What are the two main types of diabetes mellitus that you know?”

Iren buzzed first again.

“We have type 1 diabetes mellitus, where the problem is that the pancreas isn’t producing enough insulin. We also have type 2 diabetes mellitus, the commonest type, where the body cells do not respond properly to the insulin that the pancreas produces. In both types, the blood sugar is high.”

The quiz master tilted his head to one side and said, “We? I definitely know I don’t have any type of diabetes, but that is the correct answer! Well-done!”

Iren let out a small laugh at the quiz master’s sense of humour.

“Alright! Question four: What causes diabetes mellitus?”

A young man buzzed first this time. “Type 1 diabetes mellitus develops when for some strange reason, a person’s body begins to see its own pancreas as a stranger, so it produces antibodies that attack and destroy the parts that produce insulin. As a result of this, the body can no longer produce sufficient insulin to regulate the blood sugar.

Type 2 diabetes mellitus is caused by the body cells becoming resistant to the activity of insulin. They do not allow glucose enter them as well as they should and because of this, the pancreas works extra hard to produce more insulin, with the hope that more insulin will make the body cells cooperate. If the cells remain insulin resistant, after a while, the pancreas gets exhausted and can’t meet up, and so the blood glucose remains high.”

“Fantabulous! You guys are genius!

Question five: What things make a person likely to develop diabetes mellitus?”

Another lady buzzed first this time. “The tendency to have type 1 diabetes mellitus is inherited from a person’s parents so a person has a higher risk of developing it if his/her parents or siblings have it. Also, any disease or infection that can affect or destroy the pancreas can cause this.

On the other hand, type 2 diabetes mellitus is more complicated. It is more likely for a person to develop it if one or both parents or siblings have it, but it is also greatly influenced by other factors such as being overweight or obese, a lack of regular exercise, increasing age (above 45 years), and having high blood pressure or abnormal cholesterol levels, among others.”

The quiz master seemed impressed. “I’m feeling you guys!

Let’s move to… Question six: Eating sugar causes type 2 diabetes mellitus. True or false? Give reasons for your answer.”

Iren wanted to hit the buzzer, but she hesitated a bit as she remembered what her mummy said. Another guy hit the buzzer.

“False. Contrary to what many people think, eating sugar doesn’t cause type 2 diabetes mellitus by itself. However, if sugar is eaten in excess of what the body needs, it is stored as fat in the body cells, and makes a person become overweight or obese. The excess fat could make the body cells insulin resistant, and that makes developing type 2 diabetes more likely. So it is being overweight/obese, especially when the fat is around the tummy, that increases the risk of type 2 diabetes, and not just eating sugar.”

“Absolutely correct! Nice work!” the quiz master said.

That’s when Iren understood what her mummy was trying to say, too much sugar being the watchword.

“A round of applause for our contestants. We’ll take a break now and we’ll be back after the commercial.”

‘Commercial?’ Iren wondered. ‘When did commercial breaks become part of an interview?’

“Iren! Iren!” The sound of her mum’s voice startled her. ‘What is mummy doing here?’ Iren thought.

“My interview on diabetes isn’t over mummy,” Iren said lazily.

“My friend wake up. NEPA don carry light. Go upstairs and sleep and continue your interview,” Mrs. Asahde said sounding bemused.

Iren opened her eyes, only to realize that she had been dreaming. She had fallen asleep while watching an episode of Health and stories on television where someone was being interviewed on diabetes, and her mind had replayed the information in her dream.

“Chai!” she muttered, shaking her head as she dragged her tired body to bed. She definitely needed to rest.

*********To be continued**********

Sugar and causes of diabetes mellitus explained (footnotes).

Garium: slang name for garri, a West African Staple diet made from cassava.

Kulikuli: A snack made from roasted groundnuts; can be eaten alone but often used as an accompaniment to garri.

Na wa o! Na so you hungry reach: Pidgin phrase meaning, ‘Are you that hungry?’

No go take your hand carry wetin no concern you: Pidgin phrase, loosely meaning ‘don’t be the architect of your own doom’.

Toasting: a pidgin slang that means to woo or encourage.

NEPA don carry light: Pidgin phrase meaning ‘the electricity is out’.