Diabetes
Question: What is diabetes?
Answer: There are two major types
of diabetes:
- Type 1 diabetes, which is usually diagnosed in
childhood. The body makes little or no insulin, and daily injections of
insulin are required to live. Without proper daily management, medical
emergencies can arise.
- Type 2 diabetes, which is far more common (about
90% of all diabetes cases) and usually occurs in adulthood. The pancreas
does not make enough insulin to keep blood glucose levels normal, often
because the body does not respond well to the insulin. Many people with
Type 2 diabetes do not even know they have it, although it is a serious
condition. Type 2 diabetes is becoming more common due to the growing
number of older Americans, increasing obesity, and a lack of exercise.
Without proper management, long-term health risks such as heart disease,
stroke, and kidney failure can occur.
Question: I understand that in type 2 diabetes the
cells are resistant to the effects of insulin, meaning blood sugar can't get
into them. How does this damage the rest of the body?
Answer: Insulin does allow sugar (glucose) in
the bloodstream to enter cells, but it also signals the liver to stop producing
more glucose. But in people with type 2 diabetes, the liver is also resistant
to the effect of insulin. This means that the liver keeps producing
glucose--thereby raising blood sugar levels, even when a person is fasting.
High blood sugar seems to damage
the pancreas by reducing its ability to produce insulin. Since a person with
type 2 diabetes is insulin-resistant, the pancreas produces more insulin than
normal to help get blood sugar into the cells. This leads to a vicious cycle of
high blood sugar causing less insulin production, which in turn leads to even
higher levels of blood sugar.
In addition, the excess blood
sugar outside the cells tends to stick to proteins in the bloodstream and on
cell membranes, altering their structure and damaging their ability to
function. These altered proteins can build up in the kidneys and blood vessels
and damage those organs.
High blood sugar also seems to
interfere with the ability of bacteria-fighting white blood cells to travel to
an infected area of the body. And enzymes in certain tissues (like in the eyes)
convert excess blood sugar into byproducts that can damage cells.
High blood sugar levels do not
cause all of the health problems experienced by people with type 2 diabetes.
Type 2 diabetes is often linked with other conditions--high cholesterol, high
blood pressure, and obesity--problems that boost the risk of heart attack or
kidney failure.
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