The Taste of Sweet Urine

A doctor holding an apple and a donut.

In the Middle Ages, what is now known as diabetes mellitus, was coined the term “The Pissing Evil”. It was those they found affected by frequent and sweet tasting urination (someone had to taste it!). Things were certainly dire in ancient times with Greek physician Aretaeus describing the intense thirst of these patients and “melting down of flesh and limbs into urine”. “Diabetes” is derived from the Greek word ‘siphon’ (to pass through) whilst “mellitus” means ‘honey’ in Latin.

Commonly known as “the sugar disease”, it is easy to think that sugar must be the sole culprit. How does one therefore develop Type 2 diabetes if they don’t add sugar to their tea or coffee, or have sweets or sugary drinks? Or are all sweet foods the culprit, even those that are natural such as fruit? What exactly is diabetes?

Diabetes is when the body is unable to utilise the glucose (sugar) in the body efficiently. This may be due to the body either not making any, or enough insulin, or is resistant to insulin. There are three main types of diabetes – Type 1, Type 2 and the third is gestational diabetes.

To keep an analogy as simple as possible, it’s time to imagine a concert. You have a building venue, different entrance doors, and concert-goers that are keen to get in. You also need keys to open the entrance doors. If there are not enough keys to open the doors, or the keys themselves don’t work very well at opening the doors, less doors would be opened and concert-goers can be left outside for a for a much longer period of time. They can start to get angry and potentially cause a riot for being left outside for so long. Let’s connect this analogy with our bodies. In basic terms, the building venue is your entire body, and all the entrance doors are your body cells ready to take on board the glucose to be used or stored for fuel. The keys to open those doors are the insulin. If there isn’t any or enough insulin, or the cells are resistant to the insulin, this leaves the glucose hanging around in the blood stream. Insulin also acts as a monitor to regulate how much glucose the liver itself produces. Hence the efficiency of insulin is important, as it also acts as a feedback messenger for the body. Similar to the angry concert-goers, high levels of glucose lurking around in the bloodstream long term causes complications. Also, If the body is not able to access the fuel it needs, this will cause immediate and potentially severe complications. 

In 2018, it was estimated (from the Virtual Diabetes Register) that 253,000 people had diabetes in New Zealand. Diabetes NZ notes Type 2 accounts for 90% and it is estimated that 1 in 4 New Zealanders are living with undiagnosed pre-diabetes symptoms. Diabetes can occur at any age. Type 2 diabetes, which was previously known as adult-onset diabetes, is now being diagnosed in young children, which was previously unheard of.

It is important to note that Type 1 diabetes is an autoimmune condition where the body attacks its own beta cells in the pancreas that make insulin. It is not a condition that can be prevented but can be well managed through medication, diet, and lifestyle. Gestational diabetes is temporary and occurs during pregnancy due to hormonal changes and foetal requirements. However, having gestational diabetes can increase the risk of developing Type 2 diabetes by 50 to 60 per cent in the future.

There can be a genetic predisposition to diabetes, though it can also occur with no family history. Regardless, it is important to first manage what you can control. This includes your diet, activity levels, and managing your overall lifestyle. Focus on what you can change, and what is sustainable and realistic long term.

To know where you’re at, discuss with your doctor whether testing would be right for you.  Levels are then compared to what is normal, and what is considered pre-diabetes and diabetes. Pre-diabetes, also known as impaired glucose tolerance (IGT), is borderline, where levels are higher than normal but not quite enough to confirm diabetes. It is crucial to manage pre-diabetes in an aim to prevent tipping over to diabetes.

There is no need to purchase specific diabetic food products. Be mindful not to fall for food-marketing traps! In general, eating well for diabetes is the same as eating well for everyone, and meals that can benefit the whole family. Carbohydrate foods (which breaks down into sugar) is an important component to manage in diabetes, but there is no need to avoid carbohydrates altogether, particularly natural sources such as fruit. The context of your overall diet is important, inclusive of fats and protein, and to eat sources of food as nature intended. You or your loved one may feel you are already eating well and eating healthy, yet are having difficulty getting the blood results to budge, or you may need overall guidance or just a check-in. Let me know how I can help, so I can tailor the right requirements for you.