Diabetes is a hot button issue in our society. It can be accompanied by fear, panic and almost always plenty of misunderstanding. For instance, many people are unaware that there are two types of diabetes with different causes, thus different ways of treating them. People are also sometimes misled to believe that eating any sugar or being fat is a contributing cause of diabetes – simply not true. In the next two posts, I will attempt to correct some of these misunderstandings. First…
Here is a quick primer to dispel some of the myths around diabetes.
Diabetes, officially known as diabetes mellitus, which breaks down etymologically as “sweet urine.” Fun fact, they at one time a test for diabetes included tasting someone’s urine. As a doctor, I can say I am glad we have other ways to test for diabetes in contemporary times. The name makes sense, though, since in both types of diabetes mellitus there are high levels of glucose (sugar) in the blood, which then is passed through the kidneys into the urine when it gets too high.
The reasons behind WHY there are high blood glucose levels are what help us determine which type of diabetes a person is working with.
First, some basics. Glucose is the basic form of energy that every cell in our body uses for energy, and the brain prefers to use glucose for energy above anything else, like fatty acids. Glucose is found in every type of food aside from fat and animal protein. It is a very important thing for our bodies to have. It is so important, in fact, that our body has a way to create glucose when we need it.
Our liver can store excess glucose as glycogen and when we have not eaten in a while, for example, when we are asleep, our liver releases some of the glycogen so that our glucose does not get too low. Our bodies like things to stay in certain ranges, not too high, and not too low. Now, for the pancreas, which is a very important part of the glucose regulation process.
The pancreas is an organ that is located on the left side of our abdomen toward the bottom of our rib cage.
It has cells in it, beta islet cells, that produce insulin. Insulin is a hormone that basically provides a key to the cells to let glucose in. Without the key, the glucose cannot get into the cell and the cell doesn’t have energy. If this lasts too long, the body basically starts to starve, even though there is plenty of glucose around. This is the situation in diabetes of both types.
The first type, type 1 diabetes mellitus (DM1) is caused by an autoimmune reaction to the pancreas.
Essentially, the body decides that the beta islet cells are invaders and starts to kill them off! As you can imagine, without those important cells, there is little to no insulin being made. Without the insulin, the glucose does not have a way to get into the cells and the cells start to starve. DM1 is typically diagnosed in children, but it can also be discovered in adults.
In this case, the person will find that they are hungry and thirsty all of the time. They will also find themselves urinating a lot, because their body is trying to get rid of all that extra glucose. They often start to lose significant amounts of weight. If this situation is left untreated it can cause coma and death. Fortunately, it is often caught, and adequate treatment is available. Treatment involves injecting insulin, replacing what the body is not making itself. It is a lifelong condition to manage, and can be a big challenge, but many type 1 diabetics live long, healthy lives.
The second type, type 2 diabetes mellitus (DM2), is caused by a resistance of the cells to insulin.
In this situation, the pancreas is generally working well, but when it tries to use the key to get the glucose into the cells, the lock has been changed. It takes more keys to get the right fit, so insulin and glucose levels can slowly rise over time as the body tries to compensate. It can take years, or even decades for the body to stop being able to compensate well and let glucose levels stay high. This is why the majority of people are diagnosed with DM2 as adults.
Initial treatment often includes lifestyle changes, particularly exercise to increase the body’s sensitivity to insulin.
Also, many people are instructed to lose weight, but research does not back weight loss itself as curative or helpful in the long term for type 2 diabetics. Thin people can also get DM2, and everyone can support the control blood glucose levels through behavior changes and/or medication.
Pre-diabetes is a condition that has become popular to diagnose. What it generally means is that the person’s blood glucose is higher than what is considered normal, but not in the official diabetic range. Pre-diabetes does not mean that one will automatically become diabetic. It does, however, provide an opportunity to focus on behavior changes that will support healthy glucose regulation in the body. Again, in conventional medical scenarios, people are often told to lose weight to manage the situation.
With these important (if a little dry) basics under our belt, we can move on to action! In my next post, I will talk about 5 options to help with glucose control that do not have a weight loss focus. If you’re interested in coming to talk to me about how we can work together to manage your blood glucose levels, please do not hesitate to reach out!/?php // If comments are open or we have at least one comment, load up the comment template //if ( comments_open() || '0' != get_comments_number() ) : // comments_template(); //endif; //?>