What is Diabetes?
Diabetes, also known as diabetes mellitus, is a term that is used to refer to a group of medical conditions that cause high sugar levels in the blood. When carbohydrates in foods such as breads, rice and fruits are ingested, they are broken down to their simple sugars such as glucose and fructose. These simple sugars are quickly taken up by the body for energy and enter the blood causing a rise in blood sugar levels. The body’s response is to signal to the pancreas gland to produce a hormone called insulin which causes the glucose to be stored in the liver for long term use. A type of cells called ‘β-cells’ (pronounced ‘beta cells’) are found within the pancreas and are responsible for insulin production. When the body loses the capacity to produce insulin or to respond effectively to insulin, the person is said to have diabetes. This causes high blood sugar levels and ineffective blood sugar regulation which can lead to a series of complications and diseases if not appropriately treated.
Diabetes is divided into two main types: type 1 and type 2 diabetes. The two types differ in the
way they develop, as well as their implications for health and treatment.
Type 1 Diabetes (T1D)
T1D is characterised by the destruction of β-cells and the inability of the body to respond to increased sugar levels in the blood. This is caused by the body’s immune system attacking itself, and specifically the β-cells. There is some evidence that this immune response can be triggered by environmental factors such as possible viral infections. This leads to insulin deficiency and as a result the body cannot remove sugar from the blood and into the body’s cells to be used later. The ability to respond to low sugar levels in the blood is also indirectly affected. T1D usually develops at a young age. It is partly inherited and is not a disease related to lifestyle.
Type 2 Diabetes (T2D)
T2D is characterised by insulin resistance. In other words, the cells in the body become unresponsive to insulin, even though insulin is being produced normally by β-cells. The β- cells then work on ‘over-drive’ in order to adequately respond to blood sugar peaks and this can ultimately lead to their dysfunction. Lifestyle choices such as a diet with excessive sugar content and lack of exercise as well as factors such as obesity and stress and can increase the chance of developing T2D, although genetic and other factors are also involved.
Why is Diabetes Bad?
In diabetes the body cannot function in a normal manner and some of the excess glucose that cannot be absorbed is excreted in urine. That means that although there is a lot of potential energy (glucose) in the blood, the body is not using it and this causes high blood sugar levels. Symptoms of diabetes can include frequent passing of urine, increased thirst, tiredness, weight loss, and blurred vision. High blood sugar levels over a long period of time can cause complications such as kidney disease, eyesight problems, high blood pressure, heart complications, dental problems, and more if the diabetes is not adequately treated.
T1D requires insulin as a form of treatment. This is usually in the form of injections or insulin pump therapy. Both of those methods require regular blood glucose monitoring to ensure the right amount of insulin is given. Another option for treating T1D, for selected patients, is transplantation of the whole pancreas gland, or transplantation of only the pancreatic ‘islet’ which contain the β-cells. The transplanted whole pancreas or islets can effectively cure diabetes by taking over the role of insulin production. However, the patient would need to receive drugs to prevent the body from rejecting the transplanted cells.
Treatment of T2D requires lifestyle changes, such as reducing sugar in the diet, in order to better control blood glucose. Often lifestyle changes are not enough and medication is needed. Various drugs exist to control the symptoms of T2D. These drugs work to increase the body’s sensitivity to insulin and also produce more insulin to meet the cells’ demands. Sometimes, in more severe cases, insulin injections can be used alongside medication.