What is Diabetes?

The Balance of Glucose and Insulin:

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you take in is digested and broken down to a simple sugar, known as glucose. The glucose then circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high.

There are two main types of full-blown diabetes. People with Type 1 diabetes are completely unable to produce insulin. People with Type 2 diabetes can produce insulin, but their cells don't respond to it. In either case, the glucose can't move into the cells and blood glucose levels can become high. Over time, these high glucose levels can cause serious complications.

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What is causes Diabetes?

Diabetes mellitus occurs when the pancreas doesn't make enough or any of the hormone insulin, or when the insulin produced doesn't work effectively. In diabetes, this causes the level of glucose in the blood to be too high.

In Type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.

It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:

• infection with a specific virus or bacteria;
• exposure to food-borne chemical toxins; and
• exposure as a very young infant to cow's milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body.

However, these are only hypotheses and are by no means proven causes.

Type 2 diabetes is believed to develop when:

• the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance. In response to this more insulin may be produced, and this over-production exhausts the insulin-manufacturing cells in the pancreas;
• there is simply insufficient insulin available; and
• the insulin that is available may be abnormal and therefore doesn't work properly.

The following risk factors increase the chances of someone developing Type 2 diabetes:

• Increasing age;
• obesity; and
• physical inactivity.

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How to treat the diabetes?

The major goal in treating diabetes is to minimize any elevation of blood sugar (glucose) without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is treated first with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, treatment with insulin is considered.

Adherence to a diabetic diet is an important aspect of controlling elevated blood sugar in patients with diabetes. The American Diabetes Association (ADA) has provided guidelines for a diabetic diet. The ADA diet is a balanced, nutritious diet that is low in fat, cholesterol, and simple sugars. The total daily calories are evenly divided into three meals. In the past two years, the ADA has lifted the absolute ban on simple sugars. Small amounts of simple sugars are allowed when consumed with a complex meal. For more, please read the Diabetic Diet article.

Weight reduction and exercise are important treatments for diabetes. Weight reduction and exercise increase the body's sensitivity to insulin, thus helping to control blood sugar elevations.

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