Diabetes refers to a group of conditions characterized
by a high level of blood glucose, commonly referred to as blood sugar. Too much sugar
in the blood can cause serious, sometimes life-threatening health problems.
There are two types of chronic diabetic conditions: type 1 diabetes and type 2 diabetes. Pregnant
women may acquire a transient form of the disease called “gestational diabetes”
which usually resolves after the birth of baby. Pre-diabetes is when the blood sugar
level is at the borderline: higher than normal, but lower than in diabetics. Prediabetes may
or may not progress to diabetes. During food digestion, carbohydrates – or
carb – break down into glucose which is carried by the bloodstream to various organs of the
body. Insulin is a hormone produced by beta cells of the pancreas and is necessary for
glucose intake by target cells. In healthy people, beta cells of the pancreas
produce insulin; insulin binds to its receptor on target cells and induces glucose intake. In type 1 diabetes, beta cells of the pancreas are destroyed by the immune system by mistake.
The reason why this happens is unclear, but genetic factors are believed to play a major
role. Insulin production is reduced; less insulin binds to its receptor on target cells;
less glucose is taken into the cells, more glucose stays in the blood. Type 1 is characterized
by early onset, symptoms commonly start suddenly and before the age of 20. Type 1 diabetes
is normally managed with insulin injection. Type 1 diabetics are therefore “insulin
dependent”. In type 2 diabetes, the pancreas produces
enough insulin but something goes wrong either with receptor binding or insulin signaling
inside the target cells. The cells are not responsive to insulin and therefore cannot
import glucose; glucose stays in the blood. In other words, type 2 diabetics are “insulin
resistant”. Here again, genetic factors predispose susceptibility to the disease,
but it is believed that lifestyle plays a very important role in type 2. Typically,
obesity, inactive lifestyle, and unhealthy diet are associated with higher risk of type
2 diabetes. Type 2 is characterized by adult onset; symptoms usually appear gradually and
start after the age of 30. Type 2 diabetes accounts for about 80 to 90% of all diabetics.
Management focuses on weight loss and includes a low-carb diet.