We’ve all heard about diabetes. We’ve seen characters on TV and in the movies injecting themselves with insulin, we’ve seen them at risk of losing their lives when they can’t get hold of this vital drug. Maybe someone we know has the condition and has to follow a special diet, a particular lifestyle routine, take certain medications.
But how does diabetes really work and what causes it? And what is the difference between the often-heard terms “type 1 diabetes” and “type 2 diabetes”?
Diabetes: an Outline
To understand diabetes we need to understand how our bodies utilise the energy provided by the food we eat. Briefly, the process is this: we eat food, our digestive system converts the food into glucose (a type of sugar), glucose is transported around the body by the blood and our cells use it for energy and growth. But here’s the important thing, glucose cannot enter the cells without insulin.
Insulin is a hormone produced by the pancreas and if enough of it isn’t released when glucose is entering the bloodstream, or if the insulin that is released cannot do its job properly, then the blood sugar has nowhere to go and simply builds up in the blood until it is eventually excreted via the urine. One of the unfortunate consequences of this is that the cells don’t receive the vital fuel they need in order to function.
Types of Diabetes
So, it can be seen that problems arise in relation to blood sugar and cellular function if the body does not produce enough insulin to allow the glucose to pass into the cells. Problems will also arise even if the body is producing plenty of insulin if the cells, for whatever reason, stop responding properly to insulin. And this is where the differentiation of diabetes into type 1 and type 2 comes in.
Type 1 Diabetes
Type 1 diabetes, previously known as juvenile diabetes, is typically (but not always) found in individuals before the age 20 and accounts for around 10-15% of all diabetics. Type 1 diabetes is an autoimmune disease and is not related to a person’s weight or lifestyle. Indeed, during the onset of the disease many individuals with type 1 diabetes are not overweight and are otherwise healthy.
In type 1 diabetes the beta cells in the pancreas have been destroyed by an autoimmune reaction within the body and the pancreas is no longer able to produce insulin. Once this happens, sufferers of type 1 diabetes must take insulin for the rest of their lives in order for their cells to receive the fuel they need. Without insulin, type 1 diabetics will die.
Type 2 Diabetes
Type 2 diabetes is very different to type 1 and affects around 85% of all diabetics. Type 2 diabetics produce insulin but generally suffer from a condition known as insulin resistance. Often, sufferers of this type of diabetes are diagnosed after age 25 and typically are overweight and have been so for a long time.
Insulin resistance occurs when the cells no longer respond properly to insulin. While the exact cause of insulin resistance isn’t clear, the process is well understood. People who eat a lot of food produce more insulin than usual (to deal with the greater quantities of glucose). When cells are continually bathed in high levels of insulin they start to close down their insulin receptors in order to avoid the toxic effects an excess of this hormone produces.
As insulin resistance increases, a person will require more and more insulin to get enough glucose into their cells. Unfortunately, these increased levels of insulin speed the progress of insulin resistance even more and the sufferer enters a vicious circle.
While type 1 diabetes can only be treated by taking insulin, type 2 diabetes can respond successfully to weight loss, improved diet and increased exercise. Oral medication can also be prescribed for type 2 diabetes and in some cases insulin injections may eventually also be necessary.
To learn more about type 1 diabetes check out this video.