Find out the basics of diabetes, including how it affects your entire body, understand how diabetes is diagnosed, and discover the risk factors.
Uncover why itâs important to take care of yourself â today and for the future â and take the first steps toward managing your diabetes by making healthy choices in your everyday life.
IN THIS CHAPTER
Looking at the different types of diabetes Understanding how diabetes is diagnosed Seeing who else has diabetes Taking care of your diabetes means taking care of your whole body: from positive thinking in your brain to checking the bottoms of your feet for scrapes and cuts. Itâs a whole-body endeavor, and weâre here to take you on that journey as you discover what diabetes is, how to manage and treat it, and how to prevent complications down the road.
This chapter starts off with the basics of diabetes: what it is and how it affects your body. These are the Biology 101 facts that you can reference down the line. Itâs fascinating stuff (and you donât need a medical degree to understand it). Then we tell you who else has diabetes and what the contributing risk factors are. After all, youâre not the only one with diabetes. As of 2015, more than 30 million people in the United States had it, too.
What Exactly Is Diabetes?
You have diabetes, or perhaps someone you love has diabetes. Thatâs not an easy diagnosis to hear. But it doesnât have to be a scary unknown either. In fact, scientists know more about diabetes and have more tools at their disposal than ever before.
The following sections explain how diabetes affects your body. Itâs good to know whatâs happening before you dive into how to manage and treat diabetes.
Getting the lowdown on blood glucose
Diabetes is a disorder in which the amount of glucose, also called sugar, is too high in the blood. When you were diagnosed with type 2 diabetes, you were probably told that your blood glucose was sky high. But why would your blood glucose be high?
It all comes down to eating â that amazing topic that everyone likes to obsess about. When you eat food, your body breaks that food down into glucose, and then the glucose travels in your bloodstream to waiting cells. That glucose really wants to get out of your blood and into your cells because thatâs how you get energy. Thatâs the goal!
Insulin is a hormone that helps move glucose from your blood to inside your cells. However, people with type 2 diabetes donât make enough insulin or arenât as sensitive to that hormone. Therefore, the glucose gets trapped in the blood and canât get inside your cells. Then high blood glucose â diabetes â happens.
Glucose is just a simple form of carbohydrate. The simplest carbohydrates are sugars, and the simplest sugar is glucose. Itâs your bodyâs main source of energy, used to power everything from getting up in the morning to taking your dog for a walk. Is it blood glucose or blood sugar? Actually theyâre the same thing. Blood glucose is simple sugar. So, you may hear people say their âsugarsâ are too high or their blood glucose is too high. Blood glucose is the more technical term; sugar is the more colloquial term. We use
blood glucose, or simply
glucose, in this book.
The mighty hormone insulin
Youâve probably heard of insulin, and you may associate it with injections or an insulin pump. We usually think of that as the synthetic or man-made medication. But the hormone in your body is also insulin. And itâs one of the most important hormones for helping you metabolize your food and get energy.
Specialized beta cells in the pancreas make insulin. The pancreas, which is totally essential and underappreciated (until it stops working), is little, about 6 inches long, and sits right behind your stomach (see Figure 1-1).
The pancreas has islet cells that include both beta cells, which make insulin, and alpha cells, which make another hormone called glucagon. Both insulin and glucagon are important for metabolizing food.
Beta cells are the only cells that make insulin. In type 2 diabetes, several things are happening with those beta cells:
- The beta cells donât work well. They donât make as much insulin as theyâre supposed to.
- There may be fewer beta cells than usual.
- The beta cells that are making all the insulin get burned out (super tired) and eventually make less insulin. Itâs a cycle in which insulin production can get worse over time.
At the same time that beta cells are struggling in the pancreas, another crazy thing happens: Cells in your body become less sensitive to insulin. So, even though the insulin may be sitting right next to the glucose by a cell, saying, âHey, let us in!â your cell doesnât let them in. Instead, your cells need more insulin than ever before to let those glucose molecules inside. This is called insulin resistance or decreased insulin sensitivity.
Itâs a double whammy: Your pancreas makes less insulin, and yet you need more insulin than ever before. Itâs not a good combination.
If your body doesnât make enough insulin or if you have insulin resistance, your glucose canât get inside your cells and builds up in your blood. This is called high blood glucose. Itâs the key factor that defines diabetes.
Scientists are still trying to figure out why beta cells fail or die â and also why the body becomes less sensitive to insulin. If they can get to the bottom of those questions, weâre on our way toward a cure for type 2 diabetes.
In the meantime, scientists know that insulin sensitivity can be improved by exercise. Just a short bout of exercise can improve insulin sensitivity for up to 24 hours. Itâs another amazing effect of breaking a sweat besides burning calories.
Insulin is a hormone that helps your cells use glucose for energy. Itâs made by beta cells in the pancreas. People with type 2 diabetes may not make enough insulin or may not be as sensitive to insulin â or both.
Donât forget glucagon
Your pancreas makes another hormone, glucagon, which works together with insulin to turn food into energy (refer to Figure 1-1). Glucagon works very closely with the liver by stimulating glucose stored inside it. This is an essential step when you need extra energy and youâre not eating. For example, you might release glucagon when you exercise or if you need energy between meals. As you can see, itâs a delicate balance to get energy from the foods you eat, but also have access to energy whenever you need it.
High blood glucose is not good
The bottom line is that people with type 2 diabetes have too much glucose in their blood.
High blood glucose can create problems in the short term and long term. Itâs so important because it can make you feel crummy from time to time, but it can also cause dangerous complications down the road.
As blood glucose levels rise, your body tries to flush out extra glucose in your blood by filtering it through your kidneys and out...