Day and Night Pharmacy – Sugar Tax

Day and Night They didn’t call her the ‘German Tanker ‘for nothing. She could drink as much as any well-bred Irish… even ‘better’ because Southern African beer is heavy duty stuff- it’s food and drink; a thick porridge-like fermentation of milled maize and sorghum. The brew has low alcohol content but it’s packed with carbohydrates which the digestive system breaks down to simple sugars… sweet ingredients to knock one’s metabolic system into Non-Insulin Dependent Diabetes NIDD aka type 2 diabetes.

Yes some people unfortunately have a pre-disposition to building fat, but show me someone who has grown fat from just breathing in and out?… I was watching Bruce’s ‘Tribe’ last night and I got thinking… these fellow brothers and sisters in the arid bushes between the south of Ethiopia and northern Kenya might never suffer from type 2 diabetes. No. There’s no place for this condition in a place like that. This is a condition primarily associated with abundance and indulgence.

Public Health NHS England has proposed a tax on sugar. Good try. I say no. Aren’t we paying enough taxes as it is? What’s next?… Tax on fat? Tax on milk? Tax on fruit?… Mammalian metabolic pathways are very clever and well adapted. Cows grow fat on green grass and dry grass! The equation is simple: energy consumption must balance out energy expenditure otherwise excess energy is stored in the form of fat.

Day and Night sugar-tax-picIn the past NIDD was a condition that was mainly observed after the third decade of one’s life. Nowadays children in adolescence are getting it. When we eat our pancreas produces the hormone insulin. Insulin enables our muscles to absorb glucose (‘sugar’). Any excess sugar is stored as glycogen and as fat; this is also facilitated by insulin. When we eat in moderation insulin continues to work well… but when- over time- we eat and eat and eat a bit more… metabolic trouble starts. The muscles start getting insensitive to insulin… Insulin resistance in muscles means that after having a carbohydrate meal or drink high levels of sugar keep floating in the blood stream because not much sugar can be drawn into muscles. Excess sugar in blood has to be gotten rid of somehow, so some of it goes out with urine: Sugar in urine draws with it lots of water. This pretty much explains why pre-diagnosed diabetics feel lethargic and pass large volumes of ‘water’. And if you are in the wrong part of the world diagnosis can take forever.

That was my mother. Now she shed the fat and stopped the booze except for the occasional merriment when I visit. She is on metformin which reduces muscle resistance to insulin and gliclazide to beef up insulin secretion before meals. Remember unlike in type 1 (Insulin Dependent Diabetes) whereby the cells that produce insulin have been destroyed by one’s own confused immunity, patients with type 2 diabetes may have low, moderate or normal insulin secretion levels- the main problem is resistance to the available insulin.

Although she lives in rural Zimbabwe (nothing like Bruce’s Tribe villages though) she has controlled her condition superbly. At diagnoses she had to check her blood sugar levels a few times each day until she understood the control well; meal sizes, medication doses and the interpretation of the meter readings before and after meals. Now she only ever checks herself when she is not too well.

In England random testing for type 2 diabetes is no longer recommended. The cost of test strips is seen not to be worthwhile because there is a blood test that can give a good indication of what the levels of blood sugar have been in the past 3 months.

Lest the swear of the Irish wrath be unleashed upon me, my drinking stereotype was in jest. I however make no apology for using ‘fat’ instead of ‘weight gain’. It’s just the good old English way, no riddle nor slight. The more we are honest with ourselves and our eating habits the less we tend towards type 2 diabetes and the less the number of taxes they will invent.

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