Diabetes Explained: Making It Understandable

Whether you or a loved one have recently been diagnosed with diabetes, it’s important to grasp the basics of this condition in order to effectively manage it. So, what exactly is diabetes? In simple terms, diabetes occurs when your body cannot properly process the glucose obtained from food. Glucose is a type of sugar that provides energy to cells for their normal functioning. When glucose cannot enter the cells, as is the case in diabetes, they are unable to perform their tasks effectively.

So, what happens to the excess glucose that remains in the bloodstream? This condition is known as hyperglycemia. Having an excessive amount of glucose in your blood is similar to having thick motor oil in your car’s engine—it disrupts the normal functioning of your body. This imbalance of biochemical processes can lead to various health problems, including high cholesterol, high blood pressure, heart and kidney disease, and vision issues.

Now, you might wonder why your body can’t use glucose properly. This is where insulin comes into play. Insulin is a hormone produced by the pancreas, an organ located behind your stomach. Its main role is to help your body use glucose by allowing the sugar to enter cells. Cells have a protective mechanism that only permits the entry of certain substances, and insulin serves as the key to unlock their doors. Once the cells are unlocked, glucose can enter and be used as fuel. However, there are two ways in which the partnership between insulin and glucose can break down: either the pancreas stops producing insulin altogether or the cells become unresponsive to insulin, resulting in a condition called insulin resistance. In both cases, the energy supply to cells is disrupted, leading to two consequences: cells starve and unused glucose accumulates in the bloodstream. This disruption and excess glucose circulation can cause a range of complications, making diabetes a complex and serious disease.

Type 1 Diabetes: A System Malfunction

Type 1 diabetes arises when the pancreas loses its ability to produce insulin. It occurs because the body’s immune system, for reasons not fully understood, attacks and destroys the insulin-producing cells. People with type 1 diabetes quickly notice something is amiss due to the sudden and severe symptoms, including lethargy or drowsiness, weight loss, excessive hunger and thirst, vision changes, labored breathing, and increased urination.

In the past, type 1 diabetes was commonly referred to as juvenile diabetes since about half of the cases were diagnosed in childhood or early adolescence. However, we now know that around 10% of adults diagnosed with diabetes have type 1, often initially misdiagnosed as type 2 diabetes due to the usual focus on adults.

Type 2 Diabetes: A Production Shutdown

Type 2 diabetes is the more prevalent form, accounting for about 95% of all diabetes cases. Unlike type 1 diabetes, the pancreas in type 2 initially continues to produce insulin, but the hormone becomes less effective for reasons still unclear to scientists. Consequently, cells do not receive the necessary glucose for their functions. The end result is the same as in type 1—cells starve while glucose accumulates in the blood.

While type 1 diabetes requires insulin injections because insulin production stops completely, type 2 diabetes is characterized by the pancreas working overtime to produce more insulin in an attempt to remove excess glucose from the bloodstream. However, over time, the pancreas may become exhausted, leading to reduced insulin production and further complications in blood glucose regulation.

Type 2 diabetes shares many symptoms with type 1, such as fatigue, frequent urination, increased thirst and hunger, unexplained weight loss, blurred vision, and slow wound healing. However, these symptoms typically develop gradually, often making it difficult to notice the disease until it has progressed. Unfortunately, type 2 diabetes can cause damage long before it is diagnosed.

Although type 2 diabetes predominantly affects individuals over 50 who are overweight and out of shape, it is increasingly affecting children, just as type 1 diabetes is increasingly seen in adults. Obesity plays a role in increasing the risk of type 2 diabetes by contributing to insulin resistance.

However, it’s important to note that not all individuals with type 2 diabetes are overweight or out of shape. Genetic factors may have a stronger influence on type 2 diabetes than type 1. Some evidence suggests that the same genes responsible for predisposition to diabetes may also predispose individuals to obesity. Additionally, certain ethnic groups, including African Americans, Asian Americans, Hispanic Americans, and Native Americans, have a higher prevalence of type 2 diabetes. Nevertheless, lifestyle choices and habits passed down through generations can also contribute to the rising incidence of type 2 diabetes worldwide.

Given these combined factors, managing diabetes almost always involves lifestyle changes aimed at weight loss, regular exercise, and adopting a healthier way of life.

Prediabetes: The Early Warning System

Due to the gradual onset of type 2 diabetes and the potential for damage during this period, doctors now diagnose a condition known as prediabetes. Prediabetes indicates higher-than-normal blood glucose levels that do not reach the threshold for a diabetes diagnosis. The National Institutes of Health estimate that around 84 million American adults fall into this category.

A prediabetes diagnosis serves as an alert that action should be taken. Without intervention, a person with prediabetes has a high chance of developing full-blown type 2 diabetes within ten years. However, the good news is that prediabetes can be reversed, and the onset of type 2 diabetes can be prevented. On the other hand, leaving prediabetes unaddressed increases the risk of heart attacks, strokes, and other cardiovascular problems, just like type 2 diabetes. Elevated blood glucose, even without reaching diabetic levels, can cause damage throughout the body.

Gestational Diabetes: A Pregnancy Surprise

Gestational diabetes refers to diabetes that occurs during pregnancy. Approximately 2 to 10% of pregnant women develop this condition. Maintaining good control over blood glucose levels during pregnancy significantly reduces the risks associated with gestational diabetes for both the mother and the baby. The condition typically resolves after delivery, but women who had gestational diabetes during one pregnancy are more likely to develop it in subsequent pregnancies. Furthermore, women with gestational diabetes have a higher risk of developing type 2 diabetes within 15 years.

Managing Diabetes

Diabetes is a serious condition that, if not properly managed, can lead to severe and life-threatening complications such as heart attacks, strokes, high blood pressure, kidney failure, nerve damage, and vision loss. However, with careful monitoring—including regular medical check-ups—and healthy lifestyle changes, it is possible to control blood sugar levels and prevent such complications.

Managing diabetes effectively requires working closely with a diabetes care team, which consists of healthcare practitioners familiar with the unique concerns of individuals with diabetes. This team usually includes a primary care physician, an ophthalmologist, a podiatrist, and a dentist. If you have diabetes, it is important to schedule regular visits with your primary doctor every three to six months (every two to three months if using insulin), and even more frequently if your blood sugar is poorly controlled. During these visits, your doctor will review your diabetes care plan, check your weight and blood pressure, conduct an A1C test to assess your average blood sugar levels, review your blood sugar monitoring, evaluate all the medications you take (not just diabetes medications), and discuss any symptoms that could indicate complications.

Improving blood sugar levels is achievable by adopting healthier habits such as eating a balanced diet and engaging in regular exercise. Losing weight can help you better control your blood sugar and potentially avoid or delay the need for diabetes medications. It can also reduce the risk of complications like heart disease, as well as eye and kidney damage. Even small changes to your lifestyle can set you on the path to better blood sugar control and overall health.

Understanding the different types of diabetes and how they affect the body is crucial for effective management. Whether it’s type 1, type 2, prediabetes, or gestational diabetes, each condition requires attention and appropriate measures to maintain healthy blood sugar levels. By working closely with a healthcare team and making positive lifestyle changes, individuals with diabetes can lead fulfilling lives while minimizing the risk of complications.