What exactly is Diabetes?

Over 23 million Americans, or 8% of the population, live with Diabetes everyday. While the news is filled with articles on preventing Diabetes and the incidence of Diabetes in children and adults, most people really have no idea of what Diabetes actually is. Mayo Clinic has an excellent website that explains each type of Diabetes. In order to fully understand Diabetes, you will need to understand how a healthy individual processes carbohydrates.

All of your cells use glucose for energy and without it, they will die. However, your cells can’t pick up glucose without insulin. When you eat or drink anything with carbohydrates enzymes in your mouth, stomach, and small intestines start digesting the food. As your body digests the food, glucose (a form of sugar) enters your blood. Your pancreas senses this rise in blood glucose and releases a hormone called insulin from its beta cells. Insulin acts as a key for your body cells to pick up glucose – insulin binds to the cells and then allows the glucose to enter.  Insulin continues to be secreted by the pancreas until your blood glucose levels decrease to a their normal levels (around 70-100mg/dl).

Diabetes is a condition where one’s body doesn’t process glucose properly. There are a few different kinds of Diabetes – Type 1 Diabetes, Type 2 Diabetes, and Gestational Diabetes. I will also briefly discuss Pre-Diabetes.

Type 1 Diabetes: Previously called Juvenile Diabetes. This is an autoimmune disease, which means one’s own body attacks its own cells. In Type 1 Diabetes, one’s body attacks its healthy beta cells. As beta cells die, the pancreas’ ability to release insulin decreases. Eventually all of the beta cells die and the individual can not release any insulin. Since this is autoimmune, it starts at a young age and is usually diagnosed before an individual reaches 20 years old.

Type 2 Diabetes: This is the most common form of Diabetes and is associated with poor diet and excess weight. When your cells on constantly exposed to high levels of insulin (due to inconsistent meal patterns with high levels of carbohydrates) they eventually become desensitized to insulin. Think of this like a door bell on your house. It works great for years, but eventually you need to push it harder to get it to ring. Think of the insulin as your finger pushing the door bell. It is there asking to get let in, but your cells don’t know until enough insulin is there to stimulate “the door bell to ring.” In the meantime, glucose in your blood continues to rise. Eventually, the glucose level in your blood will be at a new set point (>125 mg/dl). When this happens, an individual is officially diagnosed with Type 2 Diabetes. As of now, there is no cure for Diabetes, so the condition cannot be reversed. However, it can be managed with minimal complications through diet, exercise, and medication. 

Gestational Diabetes: This type of diabetes only occurs in women during pregnancy. Some risk factors include being overweight prior to pregnancy, gaining excess weight early in the pregnancy, having a family history of diabetes, or previously giving birth to a large baby. The symptoms and treatments are similar to that of Type 2 Diabetes. For most women, gestational diabetes subsides after pregnancy, but increases your risk of developing Type 2 Diabetes later in life. Also, you are at an increased risk for Gestational Diabetes if you have subsequent pregnancies.

Pre-Diabetes: This is actually not Diabetes, but what I like to think of as a second chance. Pre-Diabetes is diagnosed when an individual has a fasting blood sugar between 100-125 mg/dL. Think of Pre-Diabetes as the point before the point of no return. You can use diet and exercise to improve your blood sugar control and prevent the onset of Type 2 Diabetes.

Random Fact: Blood sugars greater than 200 mg/dL is toxic and can actually kill your cells – especially brain cells. That is why it is imperative that individuals are tested early on and attempt to have good blood sugar control after diagnosis.