Homeostasis and Diabetes: How Do You Restore A State of Balance

The American Heritage Dictionary defines homeostasis as a state of equilibrium, as in an organism or cell, maintained by self-regulating processes: The kidneys maintain homeostasis in the body by regulating the amount of salt and water excreted. Based on this definition, diabetes results from a disruption or failure of homeostasis.

The Natural Balance of Glucose and Insulin

In someone without diabetes, the pancreas and the liver coordinate the production of insulin and the production of glucose autonomously. When the body needs energy, the liver breaks down stored glucagon into glucose. The pancreas responds to this automatically, producing exactly enough insulin to allow the intake of glucose by cells in the body. Once the glucose is absorbed into the cells, there is no longer a need for insulin, and the pancreas stops producing.

This balance of production is homeostasis, where the coordination of needs and responses is perfect.

Approximating Homeostasis

When the diabetic patient uses insulin, it is an attempt to restore homeostasis. Measuring blood glucose levels multiple times during the day and dosing oneself accordingly is meant to mimic that perfect control our bodies once exhibited. Unfortunately, the best we can do is approximate.

For the patient who wears an insulin pump, coordination is closer, but still not perfect. At this point in time, insulin pumps are still only an attempt to mimic the perfect balance of sugar and insulin. These pumps release a continuous flow (baseline, or basal) of insulin, at low levels, with additional dosages (boluses) at mealtimes.

While this is closer to what happens in someone without diabetes, the fact that both the basal and bolus amounts of insulin received are approximations of what the body needs means that homeostasis is also only approximated.

Artificial Pancreas

There is a lot of research into the creation of an artificial pancreas. Ideally, this would be able to sense the amount of glucose in the blood and respond immediately with the exact amount of insulin necessary for the glucose to be fully absorbed.

Unfortunately, such an invention is a long way off.

In the meantime, with frequent testing we can learn the pattern of glucose levels for our own bodies, and respond with the appropriate amounts of insulin at the appropriate times. This will be the closest we can get for the foreseeable future.

Source: Medscape.com
Photo: Pixabay