Diabetes is a metabolic disorder that is characterized by high blood glucose and either insufficient or ineffective insulin. 5.9% of the population in the United States has diabetes, and diabetes is the seventh leading cause of death in our country. Diabetes is a chronic disease without a cure, however, with proper management and treatment, diabetics can live a normal, healthy lives.
Insulin is a hormone secreted by specialized cells in the pancreas in response to (among other things), increased blood glucose concentration. The primary role of insulin is to control the transport of glucose from the bloodstream into the cells. After consuming a meal, insulin enhances the uptake of the energy nutrients (amino acids, glucose, and fatty acids). Insulin helps maintain blood glucose within normal limits and stimulates protein synthesis, glucose synthesis in the liver and muscle, and fat synthesis.
Without insulin, or when insulin is ineffective, glucose regulation falters and the metabolism of energy-yielding nutrients changes. In diabetes, there is too much glucose in the blood. When glucose builds in the blood instead of going into the cells, it can cause two problems:
- Your cells may become starved for energy
- Over time, high glucose blood levels may harm your kidneys, heart, eyes or nerves
There are two main types of diabetes, Type I and Type II, described below.
Type I Diabetes
(a.k.a. Juvenile Onset Diabetes, Insulin-Dependant Diabetes)
Insulin-dependant is caused by damage to the pancreas. The pancreas contains beta cells, which make insulin. With Type I diabetes, the deficiency of insulin is due to a decline in the number of beta cells the pancreas contains. It appears that certain genes make Type I diabetics more susceptible, but a triggering factor (usually a viral infection) sets it off. In most people with Type I diabetes, the immune system makes a mistake, attacking the beta cells and causing them to die. Without the beta cells, you cannot produce insulin. Glucose then builds up in the blood and causes diabetes.
Type I diabetes exhibits the following warning signs:
- Losing weight without trying
- An increased need to urinate
- Increased hunger
- Increased thirst
- Trouble seeing
- Feeling tired and/or
- Going into a coma
For Type I diabetics, treatment usually consists of a healthy diet, exercise, and insulin shots to replace the insulin that your body no longer produces. Most insulin-dependent diabetics test their blood at least four times per day to monitor their bloods glucose level. This is necessary to keep their blood glucose within certain limits. If blood glucose is not monitored, and if insulin levels are not kept in check, three things may happen:
1. Ketoacidosis occurs when your blood glucose levels are highly elevated, by either eating too much or taking too little insulin, by stress or illness. In this case, there is too little insulin in the blood. Your body then begins breaking down fat for energy, producing chemicals called ketones. Ketones can make you throw up, have difficulty breathing, cause excessive thirst, cause dry, itchy skin, or even cause coma.
2. Hypoglycemia occurs when blood glucose levels become too low. It can be cause by taking too much insulin, eating too little, skipping meals, eating at the wrong time, exercising too intensely or for too long, or by drinking alcohol on an empty stomach. If your blood glucose is too low you may feel hungry, confused, tired, shaky or nervous.
3. Complications elevated glucose levels in the blood over time can hurt your organs. Diabetes can damage kidneys, eyes and nerves, and makes heart and blood vessel disease more likely. Diabetics can defend themselves from complications by keeping their glucose levels under control.
Type II Diabetes
(a.k.a. Adult Onset Diabetes, Non-Insulin-Dependent Diabetes)
Type II diabetes is the most common form of diabetes, with about 90% of diabetes falling into the Type II category. With Type II diabetes, glucose builds up in the blood not because not enough insulin is present, but probably because cells lose their insulin receptors and become less sensitive to insulin. Type II diabetes usually (though not always) occurs in individuals who are over 40 years of age who are overweight.
Type II diabetes produces mild symptoms, and can be controlled with a healthy diet, exercise and weight loss. Type II diabetics should also monitor their glucose levels to be sure they are maintaining healthy levels. In some cases, weight loss, diet and exercise are not enough to control the glucose levels. In those cases, your physician may control your diabetes by prescribing diabetes pills or insulin shots.
Type II diabetes can cause three types of problems:
- High Blood Sugar high glucose levels in the blood are most likely when youre sick or under a lot of stress. High blood sugar can cause you to have a headache, blurry vision, excessive thirst and an increased need to urinate, and cause dry, itchy skin. Though less of a problem with Type II diabetes, ketones can build up in the blood when Type II diabetics have symptoms of high blood sugar, or when they are sick.
- Low Blood Sugar When blood sugar falls to low you may feel tired, shaky, nervous, hungry or confused. It may be caused by taking too much diabetes medicine, eating too little or skipping meals, exercising too intensely or for too long, or from drinking alcohol without eating.
- Complications Elevated blood glucose over many years can hurt organs, including the eyes, kidneys, and eyes. It can also make heart and blood vessel disease more likely. The best defense against complications is a careful monitoring of blood glucose, a healthy diet and exercise.
Risks for Diabetes
- Individuals with parents or siblings with diabetes
- People over the age of 45
- People who are overweight
- People who do not exercise regularly
- People with low HDL cholesterol or high triglycerides
- Certain racial and ethnic groups (African Americans, Latinos, Asians and Native Americans)
- Women who had gestational diabetes or who had a baby weighing 9 pounds or more at birth.
Warning Signs of Diabetes
*individuals with Type II diabetes often have no symptoms
For More Information, Contact
Contact the American Diabetes Association
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Diabetes Mellitus ("diabetes" for short) is a serious disease that occurs when your body has difficulty properly regulating the amount of dissolved sugar (glucose) in your blood stream. It is unrelated to a similarly named disorder "Diabetes Insipidus" which involves kidney-related fluid retention problems.
In order to understand diabetes, it is necessary to first understand the role glucose plays with regard to the body, and what can happen when regulation of glucose fails and blood sugar levels become dangerously low or high.
The tissues and cells that make up the human body are living things, and require food to stay alive. The food cells eat is a type of sugar called glucose. Fixed in place as they are, the body's cells are completely dependent on the blood stream in which they are bathed to bring glucose to them. Without access to adequate glucose, the body's cells have nothing to fuel themselves with and soon die.
Human beings eat food, not glucose. Human foods get converted into glucose as a part of the normal digestion process. Once converted, glucose enters the blood stream, causing the level of dissolved glucose inside the blood to rise. The blood stream then carries the dissolved glucose to the various tissues and cells of the body.
Though glucose may be available in the blood, nearby cells are not able to access that glucose without the aid of a chemical hormone called insulin. Insulin acts as a key to open the cells, allowing them to receive and utilize available glucose. Cells absorb glucose from the blood in the presence of insulin, and blood sugar levels drop as sugar leaves the blood and enters the cells. Insulin can be thought of as a bridge for glucose between the blood stream and cells. It is important to understand when levels of insulin increase, levels of sugar in the blood decrease (because the sugar goes into the cells to be used for energy).
The body is designed to regulate and buffer the amount of glucose dissolved in the blood to maintain a steady supply to meet cell needs. The pancreas, one of your body's many organs, produces, stores and releases insulin into the blood stream to bring glucose levels back down.
The concentration of glucose available in the blood stream at any given moment is dependent on the amount and type of foods that people eat. Refined carbohydrates, candy and sweets are easy to break down into glucose. Correspondingly, blood glucose levels rise rapidly after such foods have been eaten. In contrast, blood sugars rises gradually and slowly after eating more complex, unrefined carbohydrates (oatmeal, apples, baked potatoes, etc.) which require more digestive steps take place before glucose can be yielded. Faced with rapidly rising blood glucose concentrations, the body must react quickly by releasing large amounts of insulin all at once or risk a dangerous condition called Hyperglycemia (high blood sugar) which will be described below. The influx of insulin enables cells to utilize glucose, and glucose concentrations drop. While glucose levels can rise and fall rapidly, insulin levels change much more slowly. When a large amount of simple sugar is eaten the bloodstream quickly becomes flooded with glucose. Insulin is released by the pancreas in response to the increased sugar. The glucose rapidly enters the cells but the high levels of insulin remain in the bloodstream for a period of time. This can result in an overabundance of insulin in the blood, which can trigger feelings of hunger and even Hypoglycemia (low blood sugar), another serious condition. When blood glucose concentrations rise more gradually, there is less need for dramatic compensation. Insulin can be released in a more controlled and safer manner which requires the body experience less strain. This more gradual process will leave you feeling “full” or content for a longer period of time. For these reasons, it is best for overall health to limit the amount and frequency of sweets and refined sugars in your diet. Instead eat more complex sugars such as raw fruit, whole wheat bread and pasta, and beans. The difference between simple and complex sugars (carbohydrates) is exemplified by the difference between white (simple) and whole wheat (more complex) bread.
Insulin is the critical key to the cell's ability to use glucose. Problems with insulin production or with how insulin is recognized by the cells can easily cause the body's carefully balanced glucose metabolism system to get out of control. When either of these problems occur, Diabetes develops, blood sugar levels surge and crash and the body risks becoming damaged.