What Is Diabetes?

The Balance of Glucose and Insulin

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you take in is digested and broken down to a simple sugar, known as glucose. The glucose then circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high. There are two main types of full-blown diabetes. People with Type 1 diabetes are completely unable to produce insulin. People with Type 2 diabetes can produce insulin, but their cells don't respond to it. In either case, the glucose can't move into the cells and blood glucose levels can become high. Over time, these high glucose levels can cause serious complications.

 

Pre-Diabetes

Pre-diabetes means that the cells in your body are becoming resistant to insulin or your pancreas is not producing as much insulin as required. Your blood glucose levels are higher than normal, but not high enough to be called diabetes. This is also known as "impaired fasting glucose" or "impaired glucose tolerance". A diagnosis of pre-diabetes is a warning sign that diabetes will develop later. The good news: You can prevent the development of Type 2 diabetes by losing weight, making changes in your diet and exercising.

 

Type 1 Diabetes

A person with Type 1 diabetes cannot make any insulin. Type 1 most often occurs before age 30, but may strike at any age. Type 1 can be caused by a genetic disorder. The origins of Type 1 are not fully understood, and there are several theories. But all of the possible causes still have the same end result: The pancreas produces very little or no insulin anymore. Frequent insulin injections are needed for Type 1.

 

Type 2 Diabetes

A person with Type 2 diabetes has adequate insulin, but the cells have become resistant to it. Type 2 usually occurs in adults over 35 years old, but can affect anyone, including children. 95 percent of all diabetes cases are Type 2. Why? It is a lifestyle disease, triggered by obesity, a lack of exercise, increased age and to some degree, genetic predisposition.

 

Gestational Diabetes

Gestational diabetes (GD) affects about 4 percent of all pregnant women. It usually appears during the second trimester and disappears after the birth of the baby.

 

Type 1 Diabetes

What It Is

Type 1 diabetes is a completely different disease than Type 2. Type 1 is an autoimmune disease of the insulin-producing beta cells of the pancreas. Scientists believe that it may be a virus that triggers the immune system to attack the cells and permanently destroy them. The pancreas can no longer make the insulin necessary to transport sugar from the blood into the other cells of the body for energy. Sugar builds up in the blood and over time can damage internal organs and blood vessels.

 

Insulin and Blood Sugar

What does this mean to the person who is diagnosed? Someone who has Type 1 diabetes must take insulin everyday to survive. It becomes a delicate balance of finding the right amount of insulin necessary to keep the blood sugar level as close to normal as possible. The person with diabetes has to check their blood sugar levels often and then inject themselves with the correct amount of insulin to counteract the amount of sugar. This mimics the action of the pancreas.

 

Warning Signs for Type 1

This can be an overwhelming process for the newly diagnosed person, especially since Type 1 diabetes typically strikes children and young adults, although adults age 40 and older, can get Type 1. The onset of the disease happens quickly. As the insulin stops being produced and the blood sugar rises, this causes hyperglycemia. Several warning signs appear. Increased thirst, increased urination, fatigue, weight loss and blurred vision are a few of the most noticeable signs of Type 1 diabetes.

 

Testing Blood Sugar

Frequently testing blood sugar levels helps to let you know how much insulin you will need to keep your levels as near to normal as possible. The usual times to test are: before meals, before bedtime and maybe one to two hours after meals or a big snack. Also test before you exercise because exercise will lower blood sugar also, and you don't want your blood sugar to drop too low either. This is called hypoglycemia.

 

When and What to Eat

For diabetes, when you eat is as important as what you eat. Eating meals that are approximately the same size and combination of carbohydrates and fats at the same time everyday helps to keep blood sugar regular and predictable. The best diet is one that is low in fat, low in salt and low in added sugars. Complex carbohydrates such as whole grains, fruits and vegetables are preferable over simple carbohydrates like sugary soft drinks and candy.

 

Living a Healthy Life

Until the 1920's, when insulin was first discovered, people usually died from Type 1 diabetes. Today with all the advances of medicine that are available, a person diagnosed with Type 1 diabetes can live a very normal, long life. There are many adjustments that need to made and skills that need to be learned, but these can be incorporated into a daily routine, and can become just as automatic as brushing your teeth. Working with your doctors and a nutritionist will give you the tools you need.

 

Type 2 Diabetes

Up to 95% of all people diagnosed with the disease have Type 2 diabetes. Although Type 2 diabetes is not always caused by obesity, being overweight is a risk factor for developing the disease.

 

Risk factors for type 2 diabetes
  1. Obesity
  2. Poor diet
  3. Sedentary lifestyle
  4. Increased age — 21% of people over 60 have diabetes
  5. Family history — Diabetes tends to run in families
  6. Ethnicity — Diabetes is more common in the African-American, Native American, Latino, Pacific Islander and Asian-American populations
  7. History of metabolic syndrome
  8. History of gestational diabetes

 

How Does High Blood Glucose Happen?

Food is broken down into glucose during digestion. The glucose is released into the blood and the digestion process activates the pancreas to release insulin, which helps the glucose enter the cells of the body where it's used for energy. When someone is resistant to the effects of insulin, the glucose keeps circulating in the blood and does not reach the body's cells. This causes the body to try to get rid of the glucose in other ways.

 

Symptoms
  • Frequent urination
  • Increased thirst
  • Unplanned weight loss
  • Weakness and fatigue
  • Numbness or tingling in hands, legs or feet
  • Blurred vision
  • Dry, itchy skin
  • Frequent infections
  • Slow healing of cuts and bruises

 

Why Does High Glucose Cause Complications?

Excess glucose in the blood causes a lot of problems. The cells cannot get enough of the glucose they need, and when glucose levels in the blood become too high, it causes damage to nerves and blood vessels, usually in the feet, hands, kidneys and eyes. Other complications of high blood sugar and insulin resistance include increased risk of heart disease and stroke.

 

Complications
  • Neuropathy — nerve damage, especially in extremities
  • Nephropathy — kidney damage, kidney failure
  • Retinopathy — vision problems, blindness
  • Cardiovascular Disease — heart disease and increased risk of strokes
  • Erectile dysfunction in men and decreased desire in both men and women
  • Depression
  • Amputation

 

How Do I Know If I Have Diabetes?

Type 2 diabetes often does not have any noticeable symptoms, and you may not know that you have it. Regular check-ups with your physician and some basic blood tests will help you find out early in the disease if you have it. Early detection helps you to get control of your blood sugars. If your blood sugar is controlled, then your risk for complications is reduced. Diagnosis includes a fasting blood glucose test and an oral glucose tolerance test.

 

What Are The Treatments Available?

Medications are usually prescribed in addition to lifestyle changes. The medications work in different ways but their effect is to lower blood glucose and help the body's own insulin become more effective. If oral medications are not enough, insulin injections may be used to help gain control of glucose levels.

 

Type 2 diabetes can sometimes be turned around with weight loss, a healthy diet and exercise. If your doctor feels that is the case, then positive lifestyle changes that help you lose the excess weight, and regular daily exercise may be enough. With medication or not, diabetes still requires a healthy diet and physical activity for optimum health.

 

Treatment
  • Medications — oral antihyperglycemic agents, injectable antiyperglycemics, insulin
  • Blood glucose monitoring
  • Keeping excess weight off
  • Dietary changes — more vegetables and fruits, complex carbs and whole grains, fewer over-processed, fatty, starchy, sugary choices
  • Daily exercise

 

Can I Prevent Diabetes?

Prevention is possible. If you do have risk factors for developing type 2 diabetes, it is possible to prevent the disease. Healthy eating, maintaining a normal weight and daily exercise will not only help you feel your best, but may reduce your chances of getting diabetes.

 

How Can I Adjust to My Diagnosis?

If you are diagnosed with type 2 diabetes, you may feel overwhelmed. It may seem that everything about your life has to change. It is true that having diabetes changes the way you live your life, but with time, you can incorporate the necessary changes and create a new lifestyle that has your health and well-being at the center of it. It is important to remember that it is possible to control your diabetes instead of letting it control you. Like Type 1 and Type 2, your body cannot use glucose effectively and blood glucose levels get too high. When GD is not controlled, complications can affect both you and your baby. Your doctor will help you work out a diet and exercise plan, and possibly medication. Having GD increases your risk for developing it again during future pregnancies and also raises your risk of Type 2 diabetes later in life.