- What is diabetes?
- How insulin works
- What's in a name?
- Symptoms of diabetes
- Insulin Dependent Diabetes Mellitus
- Non-insulin Dependent Diabetes Mellitus
- Gestational Diabetes Mellitus
Diabetes is a serious metabolic disorder that occurs when the body fails to produce enough insulin to stay healthy. After we eat a meal, food circulates throughout our body waiting for insulin to help our cells absorb it and convert it into energy. When we eat, the pancreas - a large gland behind our stomach - is supposed to automatically produce the right amount of insulin we need.
But in people with diabetes, either the pancreas doesn't produce insulin at all, or it doesn't produce enough. As a result, their cells do not get the fuel they need to keep their bodies healthy.
Insulin is a hormone secreted by the beta-cells in our
pancreas. Its job is to insure that our cells get the energy
they need to keep us going. As we digest our food, it is
broken down into substances - glucose, fat, and proteins -
which are absorbed into our bloodstream and circulate
throughout our body. Insulin molecules attach to special
spots on our cells, where they open channels into the cells.
Through this channel, our cells can absorb glucose and other
food molecules from our bloodstream. These molecules are
then burned by the cells to provide energy.
For people with diabetes, those channels don't get opened.
Glucose and other substances build up to a toxic level. In
defense, the body tries to spill excess glucose out through
the kidneys into the urine but this defense mechanism only
works to a point. Eventually the glucose level in our blood
builds so high that the kidneys can't get rid of it fast
enough and we begin to experience the effects of this
glucose toxicity.
The term diabetes mellitus comes from Greek words for "flow" and "honey". This name comes from two of the common symptoms that characterize this illness. Ancient physicians documented the fact that people with this illness were extremely thirsty and that they produced frequent, large amounts of urine almost as if the body had become a sieve.
It was also noted the urine produced was very sweet-smelling with a particular honey-like odor. Before the development of blood tests, the definitive diagnosis was made when the physician would taste the patient's urine. If it was sweet to the taste, diabetes mellitus was diagnosed.
More accurate diagnostic tests are now available and the
medical community has noted other symptoms which signal the
onset of this diabetes. Common symptoms include:
- Unusual thirst
- Frequent urination, especially at night
- Extreme hunger, even after eating
- Persistent tiredness or weakness
- Sudden, unexplained weight loss
- Blurred vision
- Irritability or forgetfulness
- Dry, itchy skin
- Sores or bruises that are slow to heal
- Persistent infections
Also referred to as Type I diabetes or IDDM. This type of
diabetes occurs when the insulin-producing beta cells in the
pancreas cease to function. People who develop this type of
diabetes require daily injections of insulin to replace the
substance that their pancreas no longer produces.
This type of diabetes was once called "juvenile-onset"
because it was thought that it only occurred in chilhood or
adolescence. Although onset is most common in childhood, it
is now known that onset can be delayed and can occur at any
time in a person's life. It is not unusual for patients in
their 40s to develop this type of diabetes and onset has
been documented among older patients as well.
People with this type of diabetes are susceptible to
diabetic ketoacidosis if insulin injections are skipped, or
if the body is severely stressed or ill. When a person has
no insulin in their blood, the body's cells become starved
for energy. To prevent the cells from starving to death, the
body breaks down fat for energy. Chemicals called ketones
are a by-product of this process and build quickly to toxic
levels. As ketone levels rise, the body tries to spill them
out by stimulating the kidneys to increase urine production.
The person becomes dehydrated, and in severe cases, has
difficulty breathing, lapses into coma, and may die.
Diabetic ketoacidos is prevented by taking regular insulin
injections.
It is currently thought that Type I diabetes may be caused
by an autoimmune reaction or by a viral infection but it is
not clear exactly how the process is triggered. It also
seems that there may be a genetic tendency to develop this
type of diabetes. There is no link between being overweight
and this type of diabetes.
Ten percent of people with diabetes have Insulin Dependent
Diabetes Mellitus.
Also referred to as Type II or NIDDM. This type of
diabetes is characterized by high blood sugar levels despite
the fact that the pancreas is producing insulin. In this
type of diabetes, the amount of insulin produced by the
pancreas is not adequate to meet the body's needs.
Some people with type II diabetes take insulin injections to
make up for the shortfall. Some people take oral medication
to stimulate the production of insulin. In other type II
diabetes, weight loss plays a key role in helping the body's
need for insulin return to a normal level.
There is a definite link between obesity and some kinds of
non-insulin dependent diabetes. Nearly 80 percent of people
with this type of diabetes are overweight. If we have eat
more food than our cells need for immediate energy, it's
stored in our cells as fat. As we become overweight, our
cells keep storing fat -- getting bigger and bigger like a
balloon until they can't store anymore without bursting. To
keep this from happening, our cells quit responding to
insulin and no longer absorb glucose and other substances
from our blood. That's when the onset of Type II diabetes
occurs.
As we lose weight and stored fat return to more normal
levels, our cells begin to process glucose again and the
diabetes may reverse itself. A weight loss of 15-20 pounds
is often enough to reduce an overweight person's need for
insulin or oral medication.
People with this type of diabetes are not susceptible to
diabetic ketoacidosis but are at risk from hyperglemic coma.
People with Type II diabetes are less likely to manage their
illness carefully because they don't consider it "as
serious" as insulin dependent diabetes, or are told by their
physicians that they have "borderline" diabetes and don't
require treatment. The truth is that any diabetes is serious
and should be carefully controlled whether the person takes
insulin or not.
There is a strong genetic tendency to develop this type of
diabetes although it is not directly inherited. It is
somewhat more common in females than in males. It is also
most common in adults, which is why it is sometimes referred
to as adult-onset diabetes. However, this type of diabetes
is sometimes found in children or adolescents. Ninety
percent of people with diabetes have Type II diabetes.
Some women develop diabetes during pregnancy. It is
believed that this is the result of hormones secreted by the
placenta which are essential for the baby's growth but which
cause insulin resistance in the mother's cells. This type of
diabetes is not only dangerous to the mother, but to the
unborn child as well. Gestational diabetes can cause
miscarriage, birth defects or complications during
delivery.
Typically, women with this type of diabetes require insulin
injections or oral medication during their pregnancy to
control their blood glucose levels although the diabetes
will usually disappear after childbirth. However, almost 40
percent of women who have gestational diabetes will develop
non-insulin dependent diabetes within five years of their
pregnancy.
It is recommended that all pregnant women - especially those
with a family history of diabetes - receive a glucose
tolerance test between the 24th and 28th weeks of pregnancy
to detect gestational diabetes in its early stages.
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