What is diabetes?

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Obligatory disclaimer: I am not a medical doctor, and the content of this website was created for informational purposes only. Such content is not intended as a substitute for medical advice, treatment or diagnosis.

Over the past half year we’ve covered quite a number of topics. From starvation mode, metabolic damage, thermogenesis, the thermic effect of food, macronutrients and micronutrients to the likes of BMI, the satiety cascade and hormones such as ghrelin, leptin, glucagon and insulin, the time has come to talk about the Mighty-D: diabetes.

In this post we’ll go over what diabetes is, the different types diabetes comes in, its symptoms, and its relationship to insulin.

So what is diabetes?

Straight from the American Diabetes Association, diabetes melitus, a mix of greek and latin which means something along the lines of “constantly urinating honey”, is a a group of metabolic diseases characterized by hyperglycemia (high blood sugar). Such hyperglycemia may be due to problems with insulin secretion or action, but its long-term results are the damage, dysfunction and faillure or organs such as the eyes, kidneys, nerves, heart, and blood vessels.

In our posts on carbohydrates and the glycemic index we went over how carbohydrates are digested and how blood sugar levels fluctuate depending on how simple or complex carbohydrates are to digest. Since those topics are related to the contents of this post, you may want to check them out as a refresher.

What does high blood sugar levels actually mean? To begin with, it means that there is a high content of glucose in blood plasma. In terms of numerical values, however, the American Diabetes Association considers a blood glucose level higher than 200 mg/dl (milligram per decilitre) as hyperglycemia. The reason for that blood sugar value is that chronic levels between 180-216 mg/dl result in organ damage over time. Still, it is important to note that having blood sugar levels between 100-126 mg/dl puts you in the slightly hyperglycemic range while consistent blood sugar levels above 126 mg/dl are are considered a sign of diabetes. In other words, a little hyperglycemia can do a lot of harm in the long term. If we were to put the above values in a table it would look like this:

Blood sugar level in mg/dlBlood sugar level in mmolClassification
120-12610-12Slight hyperglicemia
greater than 126greater than 12Diabetes cutoff
greater than 200greater than 11.1Hyperglycemia

As stated previously, the hyperglycemia that comes along with diabetes is due to the beta-cells in the pancreas not producing enough insulin, the body not reacting to the insulin that is produced, or both. The majority of cases fall into two main, creatively named, categories: type 1 and type 2 diabetes. A third kind of diabetes can develop during pregnancy: gestational diabetes. Let’s take a closer look at all of them

Type 1 diabetes

In this type of diabetes, the cause of the disease is a deficiency in the production of insulin. This is due to the immune system destroying beta-cells, which are responsible for producing insulin, in the pancreas. It is also called juvenile diabetes because it usually starts in patients younger than 20 years old.

This kind of diabetes is relatively rare, with only about 5% percent of people with diabetes having this particular type. As far as we know, it cannot be prevented and patients must rely on insulin injections to control their blood sugar levels. At the same time, although exercise is a part of treatment, plenty of factors must be considered before engaging in any such activity.

Type 2 diabetes

Unlike type 1, type 2 diabetes is much more prevalent, and it is caused by a combination of resistance to insulin and a poor production of additional insulin to compensate for that resistance. It used to be called adult-onset diabetes since it appeared in adulthood, but given the increasing number of younger type 2 diabetes patients, that name’s become somewhat obsolete.

Type 2 diabetes can be caused by several factors like genetic predisposition, being overweight or obese, metabolic syndrome, malfunctioning beta-cells and excessive glucose production by the liver. Out of those factors we cannot easily control or repair our genetics, our beta-cells, or how well our liver works, so we must make do with the other factors in order to prevent the development of the disease.

The severity of type 2 diabetes can progress, regress, or remain unchanged, and the resulting hyperglycemia in each case will reflect the severity of the metabolic abnormality, and some individuals with type 2 diabetes may achieve a good glycemic control through weight-loss, exercise, or glucose lowering agents so that they do not require insulin injections.

Gestational diabetes

This kind of diabetes is similar to type 2 in that it is caused by insulin resistance, but it only happens during pregnancy. Althought there were no symptoms of diabetes prior to the pregnancy, high blood levels occur during it and some other complications might arise. Children born to mothers with gestational diabetes also have a higher likelyhood of becoming overweight or developing type 2 diabetes themselves.

Among risk factors for gestational diabetes we can find being overweight, a family history of type 2 diabetes, and polycystic ovarian syndrome. As prevention is key, maintaining a healthy weight and an active lifestyle prior to the pregnancy are encouraged.

Fortunately, most cases of gestational diabetes will resolve themselves after the baby is born.

Symptoms of diabetes

As the greek and latin we saw above implies, one of the key symptoms is frequent urination along with increased thirst and hunger. Other symptoms include tiredness, weight loss, blurred vision, headaches and itchy skin.

Among long-term complications we can find chronic kidney disease (nephropathy), foot ulcers (neuropathy), eye damage (through retinopathy), sexual dysfunction, and cardiovascular disease. Hypertension also tends to come along for the ride. Sounds fun, right?

As it tends to be the case, the longer the disease goes on without propper treatment, the worse things can get. Blindness and amputation may get most of the attention, but requiring dialysis due to diabetic kidney disease is nothing to scoff at.

In closing

So we’ve just gone over the very basics of diabetes. Considering previous posts in which we’ve covered carbohydrate digestion and hormones related to metabolic functions, we should now have a good idea of what diabetes is, in which types it comes in and some of the symptoms to look out for.

Next week we’ll cover metabolic syndrome, and the week after that we’ll tackle high blood pressure.

If you enjoyed this post, check out our page on Rebuttals to Fatlogic.

See you next week!

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