Diabetes, part 1: endogenous and endogenous management of glucose
publication date: Aug 23, 2010
I think the most basic point in understanding diabetes is in recognizing that blood glucose is managed from inside when a person has healthy metabolism---the liver, the brain and tissue insulin sensitivity use a feeback system to maintain blood glucose in a stable range.
When a person's metabolism is damaged, glucose (and fatty acids) are no longer stabilized in a healthy range by internal control mechanisms. A type 2 diabetic who is injecting insulin and ingesting carbohydrate is no longer relying on that internal system. He or she is trying to control blood glucose from the outside. Exogenous control, managing inputs from the outside to effect an inside variable, can never be as effective as endogenous controls, which rely on the instantaineous levels of variables and feedback loops to stabilize blood glucose.