146 THE CHINA STUDYIn both types, the disease begins with dysfunctional glucose metabo-
lism. Normal metabolism goes like this:- We eat food.
- The food is digested and the carbohydrate part is broken down
into simple sugars, much of which is glucose. - Glucose (blood sugar) enters the blood, and insulin is produced by
the pancreas to manage its transport and distribution around the
body. - Insulin, acting like an usher, opens doors for glucose into different
cells for a variety of purposes. Some of the glucose is converted to
short-term energy for immediate cell use, and some is stored as
long-term energy (fat) for later use.
As a person develops diabetes, this metabolic process collapses. Type
1 diabetics cannot produce adequate insulin because the insulin-pro-
ducing cells of their pancreas have been destroyed. This is the result
of the body attacking itself, making Type 1 diabetes an autoimmune
disease. (Type 1 diabetes and other autoimmune diseases are discussed
in chapter nine.) Type 2 diabetics can produce insulin, but the insulin
doesn't do its job. This is called insulin resistance, which means that
once the insulin starts "giving orders" to dispatch the blood sugar, the
body doesn't pay attention. The insulin is rendered ineffective, and the
blood sugar is not metabolized properly.
Imagine your body as an airport, complete with vast parking areas.
Each unit of your blood sugar is an individual traveler. After you eat,
your blood sugar rises. In our analogy, then, that means lots of travel-
ers would start to arrive at the airport. The people would drive in, park
in a lot and walk to the stop where the shuttle bus is supposed to pick
them up. As your blood sugar continues to rise, all the airport parking
lots would fill to capacity, and all the people would congregate at the
shuttle bus stops. The shuttle buses, of course, represent insulin. In the
diabetic airport, unfortunately, there are all sorts of problems with the
buses. In the Type 1 diabetic airport, the shuttle buses simply don't ex-
ist. The only shuttle bus manufacturer in the known universe, Pancreas
Company, was shut down. In the Type 2 diabetic airport, there are some
shuttle buses, but they don't work very well.
In both cases, travelers never get to where they want to go. The
airport system breaks down, and chaos ensues. In real life, this corre-
sponds with a rise in blood sugar to dangerous levels. In fact, diabetes