What is diabetes?
Diabetes is a complex metabolic condition that causes people to have high blood sugar, also called high blood glucose and hyperglycemia. This happens because the body’s way of converting glucose into energy is not functioning properly.
Glucose comes from both digested carbohydrates and stored sites in the body, primarily your liver. With the help of insulin, cells throughout the body are able to absorb this glucose to use as energy to fuel the body and brain.
When blood sugar is high (post-meal) insulin is released to signal cells to absorb sugar, reducing the concentration in the blood.Alternatively when blood sugar is low, the hormone glucagon acts antagonistically by signaling cells to release stored sugar to raise your blood sugar. This is tightly regulated to ensure your blood sugar levels are always between 70-110 mg/dl.
Diabetes develops when blood sugar remains elevated because the body doesn’t make enough insulin or it is not able to effectively use insulin. Without functional insulin, the levels of blood sugar are high but the body’s cells are starved of energy.
Type 1, type 2 and pre-diabetes
Both type 1 and type 2 diabetes are a result of the body lacking functional insulin. Type 2 diabetes accounts for around 90% of all adults with diabetes and tends to be associated with excess weight, physical inactivity, family history and certain ethnicities.
In type 1-diabetes, known as early-onset diabetes, insulin is not produced because the body’s immune system has attacked the cells that make it.
In type 2-diabetes, known as adult-onset diabetes, the body produces insulin however cells do not respond to it. This is called in insulin resistance, a condition linked to obesity, wherein the cells that normally absorb sugar are not using insulin properly. As a result, the pancreas has to produce more insulin to help the sugar enter cells to keep the blood sugar levels normal. Over time, the pancreas is overworked and loses its ability produce the required insulin causing blood sugar levels to slowly rise.
Prediabetes is a condition when blood glucose levels are rising but are not yet high enough to be diagnosed as diabetes. This means that this person is at an increased risk for developing type 2 diabetes, heart disease and stroke, but is in a position to prevent type 2 diabetes from developing.
Symptoms and risk factors
Symptoms in diabetes do not arise early in the disease but may include urinating more frequently, increased thirst, unexplained weight loss, headaches and tiredness.
Anyone age 45 and older should be tested for diabetes, especially if overweight or obese. People younger than 45 should consider testing if they are overweight or obese and have any of the following risk factors:
- physical inactivity
- family history of diabetes
- high blood pressure
- abnormal blood fats
- history of cardiovascular disease
- family background that is African American, Alaska Native, American Indian, Asian American, Hispanic or Pacific Islander American.
Screening and early detection is imperative in preventing and managing diabetes. Diabetes is diagnosed by a blood test from a healthcare provider and sent to a lab for analysis. Testing enables healthcare providers to:
- Identify cases of pre-diabetes to prevent or delay the onset of type 2-diabetes developing. Pre-diabetes is a reversible disease and if it is caught early enough can be completely prevented through diet and lifestyle change.
- Treat diabetes before serious complications arise. There is a substantial reduction in risk of complications when levels are regularly monitored. Monitoring levels is absolutely crucial to detect any early signs of complications so they can be caught and treated successfully.
As a result of persistent high blood sugar levels, damage can be done to the body’s nerves and blood vessels. This can lead to serious complications including heart disease, stroke, kidney disease, blindness and amputations. The best way to avoid these complications is to check blood levels regularly and make sure they are under control. The earlier a difference is noticed, the more likely the complications can be safely managed.
Herman WH et al. (2015). Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: A stimulation of the results of the Anglo-Danish-Dutch study of intensive treatment in people with screen-detected diabetes in primary care. Diabetes Journal.
Lazar MA (2005). How obesity causes diabetes: Not a tall tale. Science.
Harlan D (2014). Diagnosis of diabetes and prediabetes. National Institute of Diabetes and Digestive and Kidney Disease.
Seidell JC. (2000). Obesity, insulin resistance and diabetes – a worldwide epidemic. British Journal of Nutrition.