Diabetes affects about 21 million people in the US, and much more around the world. It raises our risk for other diseases as well. Here you will learn what it is, and how to avoid it altogether.

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Health forums category: Diabetes

What is it?

Diabetes, or by its long medical name diabetes mellitus, is a condition in which there is an abnormally high level of sugar in the blood.

Sugar. You blood is rich in it when you have diabetes. Photo by Uwe Hermann.

Who gets it?

That depends. There are 2 types of diabetes:

Type 2 diabetes:
Even though it’s number 2, this is actually the most common type. 90% of people with diabetes have type 2. This is an adult disease, as opposed to type 1 diabetes, although it is seen more and more in children. There are some risk factors which can put you at risk for diabetes type 2 -

1. Obesity – If you have a high BMI you’re at risk
2. Inactivity – The less exercise you do and the more sedentary you are, the greater your chances are of getting it
3. Family history – If someone in your close family has it, you are more likely to get diabetes
4. Race – People at higher risk include African Americans, Hispanics, American Indians and Asian Americans.
5. Age – As you get older your risk rises.

As Western society gets more sedentary and more fat, so is the disease spreading more rapidly. That is why more and more children get diabetes type 2.

Type 1 diabetes:

This is a disease which usually starts in childhood. No one knows the reasons behind why it develops, but it possibly runs in families (meaning it’s genetic), which means that if someone in your close family has it, your chances are probably higher than the rest of the population.

What causes it?

It all starts with insulin. This is a hormone produced by our pancreas, which is an organ that sits in our abdomen. When we eat, sugars from the food we ate are broken down into a molecule called glucose. Glucose fuels our body. Glucose gets into our bloodstream and then enters the cells in our body, fueling them. It can’t enter the cells, though, unless insulin is present in the blood.

In diabetes, little or no insulin is produced by the pancreas. This causes glucose to stay in the blood and not enter the cells, causing a high level of glucose in the blood (a situation which in medicine is called hyperglycemia).

This video shows it graphically:

Why it happens differs between the two types of diabetes:

Type 2 diabetes:

There are two things happening here:

The first is called insulin resistance, and it happens early in the disease. In this stage, the pancreas produces insulin, but the body is resistant to its effects, for an unknown reason. The pancreas, in turn, produces more and more insulin, until, with time, it produces less and less of it. This is the later stage of the disease.

Type 1 diabetes

In this type, the body attacks its own pancreas. Antibodies, the molecules the body usually uses to fight infections, are used against the body itself. Diseases in which antibodies attack the body are called autoimmune diseases. We covered several of those in the past, including lupus, celiac, Crohn’s disease, vitiligo and others.

The antibodies lead to the destruction of the pancreas, which can no longer produce insulin.

How does it feel?

There’s a groups of symptoms characteristic of diabetes:

1. Frequent urination and Increased thirst – In diabetes glucose builds up in the blood, and the kidneys want to get rid of it. To do this, they produce more urine. This is why people with diabetes urinate more, and as a result feel more thirsty.
2. Extreme hunger – Since sugar doesn’t enter the cells (since there is no insulin to help it do that), the body screams that it needs fuel, causing hunger.
3. Unexplained weight loss – Again, since sugars don’t get into the cells and are lost in urine, there is no weight gain.
4. Fatigue

How is it discovered?

Diabetes is discovered by simply taking a blood sample and watching the level of glucose in it. It can be done after fasting or without fasting. In both these circumstances, the level of sugar in the blood will be excessively high.

How is it treated?

That depends on the type and extent of the diabetes:

In type 2 diabetes, drugs are given which work in several ways to increase the amount of insulin produced by the pancreas, or  increase the body’s responsiveness to insulin. With time, though, the pancreas may stop producing insulin altogether, which may require the use of artificial insulin, which is injected by the patient.

In type 1 diabetes usually insulin, and not drugs, is given, since early in the disease the pancreas gets destroyed and not enough insulin exists in the body.

What happens after treatment?

Diabetes is a life-long disease. If it is discovered early and treated carefully, people can live with it a normal life.

If, on the other hand, treatment isn’t adequate, complications can develop, including:

1. Diabetic ketoacidosis – This is a condition that’s more common in type 1 diabetes. It’s a life-threatening condition in which the body breaks down fat since it is starved for energy. It then turns the fat into toxic acids known at ketones, which are dangerous for the body.
2. Blood vessel problems – Diabetes increases the risk for atherosclerosis, heart attacks and strokes.
3. Nerve damage – Excess sugar in the blood can damage the small arteries which supply oxygen to our nerves, especially the ones in the legs, causing them to get damaged. This can lead to anything from numbness and tingling, to a complete loss of feeling in the legs, which in turn can lead to dangerous infections. These sometimes necessitate amputation of the legs.
   Other nerves which can get damaged include those in our digestive system, which can lead to nausea, vomiting, diarrhea or constipation. In men, the nerves responsible for erection can get damaged as well.
4. Kidney damage – This can lead to failure of our kidneys, which may necessitate dialysis or a kidney transplant.
5. Eye damage – The blood vessels in our retina (a part of our eye) can get damaged, leading to blindness.

The bottom line – How do I avoid it?

If you have type 2 diabetes you can help to prevent it (this unfortunately doesn’t apply to type 1 diabetes, which no one knows yet how to prevent).

You can do this by taking the following steps:

1. Lose weight – If you’re overweight, losing the excess pounds can lower your risk of developing diabetes. You can start by reading our article about using the Internet to lose weight.
2. Get more physical activity – The American Diabetes Association recommends 30 minutes a day of moderate physical activity. They say that if you combine this with a 5-10% reduction in your body fat, you lower your chances of having diabetes by 60 percent. You can read their recommendations for exercise here.
3. Eat healthier – This means foods that are lower in fat and calories. You should instead opt for more fruits, vegetables and whole grains. Again, you can read the American Diabetes Association’s recommendations about diet here.

What next?

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