Abstract
Readers are bound to wonder why in a book on diabetes we have not discussed blood sugar levels at sufficient length so far and why it is delayed till the 12th chapter. The common perception of diabetes begins with blood sugar and often ends with blood sugar. We saw in Chap. 3 that there are a series of paradoxes associated with the existing theory of glucose homeostasis and the conventionally perceived etiology of hyperglycemia. The alternative picture needs to resolve all the paradoxes. We can attempt to do so at this stage since by now I think sufficient background about the new interpretation has been built on which we can construct a new model of normal glucose regulation and altered glucose dynamics in T2D. Discussing sugar so late in this book also serves as a gesture intended to emphasize that sugar levels in blood are actually not as important in diabetes as generally believed. Raised blood sugar to diabetes is just what fever is to typhoid. It is only one of the many symptoms. However, it is one that is easiest to monitor and therefore the first indication in diagnosis and one that can also be conveniently used to follow the progression of the illness as well as any recovery from it. But that is its limitation. Just as fever is not everything in typhoid, blood sugar is not everything in T2D. Typhoid is an infection, and fever is only a symptom. If typhoid is cured, fever will certainly vanish, and the body temperature will return to normal. The reverse is not true. Fever can be reduced by antipyretic drugs or other physical means. Keeping the body on ice can also reduce the body temperature temporarily. But fever gone is not typhoid gone. The relation of blood sugar to T2D is very similar. Bringing blood sugar back to normal is not an indication of diabetes gone.
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Watve, M. (2012). Why Blood Sugar Goes Up. In: Doves, Diplomats, and Diabetes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4409-1_12
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DOI: https://doi.org/10.1007/978-1-4614-4409-1_12
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