Diabetes: what is it and what can I do?

Diabetes mellitus is the name given to a set of chronic, metabolic diseases that affect the way our body uses food to produce its necessary energy for life. More specifically, diabetes is a disorder in the metabolism of carbohydrates (i.e. sugars and starch), and it also affects the metabolism of fats and proteins. This disorder leads to hyperglycemia (i.e. elevated blood glucose), and when this hyperglycemia lasts for a long time can severely damage various parts of the body. But, how much ¨long time¨ is actual too long and can be responsible for the development of diabetes? The answer to this question depends on numerous variables-characteristics of each body, such as genetic predisposition, dietary and nutritional habits, age, sex, lifestyle, physical activity habits etc.

How many forms of diabetes exist?

There are two main forms of diabetes mellitus:

• type 1 (insulin-dependent or juvenile) and

• type 2 (non-insulin-dependent or adult).

There are also secondary forms of diabetes, caused by conditions such as pancreatic disease, pregnancy (gestational diabetes), hormonal and genetic problems, and the administration of certain medications. Only the specialized endocrinologist can distinguish and comment for these secondary forms of diabetes mellitus.

Diabetes type I

Type 1 diabetes mellitus happens when the pancreas is damaged and produces minimum or no insulin. Insulin is the hormone that transports glucose into cells to be used as energy (i.e. fuel for life) and as storage in the form of glycogen. Glucose is the final molecule that comes from the breakdown of food (mainly carbohydrates) into its components. In addition, insulin stimulates protein synthesis and the storage of free fatty acids in fat depots. When pancreas produces little or no insulin, the body’s tissues have less access to glucose and they do not receive sufficient amounts of essential nutrients for the required energy and storage. Type 1 diabetes usually develops before the age of 30, it is also called juvenile diabetes and it requires controlled insulin administration for life. Recent research supports that Type 1 diabetes is considered an autoimmune disease triggered by stress events and with a genetic background.

Diabetes type II

People develop diabetes type II when their pancreas secrete insulin, but it is either too little or insufficient. In diabetes type II, the insulin receptors that control the transport of glucose into the cells do not work at their optimum (i.e. insulin resistance) or may be reduced in number. Diabetes Type II is the most common form of diabetes, is considered a diet-dependent disease and usually develops in adults over 40 years of age. Diabetes type II is a chronic, complex disease and, although there is a genetic predisposition and susceptibility to type 2 diabetes, environmental factors such as exercise and nutritional habits play a key role in the onset and outcome of the disease. Diabetes type II is a common consequence of obesity.

What are the symptoms of diabetes?

The symptoms of diabetes may differ among patients and between type I and type II diabetes mellitus. Patients with diabetes type I often report rapidly developing symptoms while patients with diabetes type II usually develop symptoms gradually which may appear many years after the actual onset of the disease. Some of the symptoms of type 1 and type 2 diabetes include the following:

• Sudden weight loss
• Frequent diuresis
• Higher hunger than usual
• Excessive thirst
• Blurred vision and fatigue
• Dry, itchy skin
• Slow-healing cuts or sores
• More infections than normal

Long-term diabetes-related health problems

Although diabetes type I is quickly identified and controlled with the correct amount of everyday insulin administration, this does not happen with diabetes type II. The high glucose levels may exist during long periods without any obvious symptom. This de-regulation can damage small and large blood vessels and nerves, and reduce the body’s ability to fight infections. When diabetes type I or type II is not correctly controlled patients are more likely to experience the following serious health complications.

Stroke: Causes a neurological deficit, leading to numbness, weakness, difficulty speaking, coordinating or walking.

Eye disease: Blind spots or even total blindness may occur.

Heart disease: Myocardial infarction or congestive heart failure may occur.

Nephropathy: Kidney failure may occur.

Circulation problems: Ulcers may develop that do not heal easily. In advanced cases, gangrene can develop which can even lead to amputations.

Patients with diabetes should be checked regularly for symptoms of these complications, and it is very important to remember that many of these complications can be reduced or delayed with good blood glucose control and adequate prevention.

Prevention of diabetes

Prevention is the best treatment and diabetes mellitus is not an exception. Although diabetes type I can not be prevented, due to the etiology of this type of diabetes (i.e. genetic predisposition and autoimmunity), the diabetes type II is 100% preventable. To prevent the onset of diabetes type II, we must firstly address the risk factors that we can influence. There are 2 crucial risk factors that all of us can affect from early in life.

• Our lifestyle and

• our eating habits.

Diabetes type II has a stronger environmental influence on its onset. That is why it belongs to the category of food-dependent, complex diseases. There are many myths that blame sugar and sweets as the sole components leading to diabetes. However, diabetes type II occurrence, and subsequently its efficient prevention, is based on our entire eating and lifestyle behavior which goes far beyond sweets. Plant (dietary) fiber, systematic exercise, adequate water, targeted nutrition based on our genetic sensitivities are the basics that will help us balance any genetic predisposition to diabetes type II and gain quality of life for more years. Proper training by an experienced nutritionist-dietitian, as early as possible in our lives, guarantees our correct and targeted nutritional education that will favor and strengthen not only prevention but also improves the treatment, when diabetes type II has already been developed.

It is never too late to start prevention! Start today.

Diabetes most important references: 

1. Centers for Disease Control and Prevention (CDC) – https://www.cdc.gov/diabetes/basics/diabetes.html

2. Diabetes Symptoms and causes Mayo Clinic – https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444

3. Diabetes Overview Complications American Diabetes Association (ADA) – https://www.diabetes.org/diabetes/complications

4. Long-term complications of diabetes MedlinePlus – https://medlineplus.gov/ency/patientinstructions/000327.htm