Dr. Vikas Namdeo Desale explains what is Diabetes

What is diabetes?

Diabetes is a disease in which blood sugar/glucose levels go high. Blood glucose comes from food, which is the body's energy source. The body has a mechanism to absorb, manage and store glucose. The mechanism primarily involves two hormones produced by an organ inside the abdomen called the pancreas. When this mechanism is disturbed, the utilization and storage of glucose are affected, and the blood sugar/glucose levels rise.

The management of glucose in the body

The body manages glucose in the blood through two hormones – insulin and glucagon. The hormone levels rise and fall to keep blood sugar in a normal range. When you eat, your blood sugar levels increase. As a result, the pancreas releases insulin. The insulin binds to cells, the gates transporting sugar into cells open, and glucose gets absorbed. Excess sugar is stored in organs like the liver.

When blood sugar levels are too low, insulin levels fall, and the pancreas releases glucagon. Glucagon releases the glucose stored in the liver and other places, and as a result, blood sugar levels increase.

What happens in diabetes?

In diabetes, the mechanism mentioned above is disturbed – either the insulin levels are very low, and hence glucose can’t be absorbed into cells, or the cells do not recognize the insulin binding to them; therefore, the gates transporting sugar into cells do not open. In both situations, the sugar accumulates in the blood, and there is an increase in blood sugar levels.

Who is at risk?

Diabetes has both genetic and lifestyle factors working together. When exposed to unhealthy lifestyles, those with a genetic susceptibility are at risk of diabetes. Some risk factors include obesity, a family history of diabetes, low birth weight, and diabetes during pregnancy.

Types of diabetes

There are two types of diabetes – type 1 diabetes and type 2 diabetes. Type 1 diabetes is a condition where there is insufficient insulin. In type 2 diabetes, the cells do not recognize insulin. In both cases, the sugar remains in the blood, increasing blood sugar levels.

Management

If the diabetes is because of a deficiency of insulin (type 1 diabetes), insulin is given as an injection. If the cells are not recognizing insulin (type 2 diabetes), it is treated with pills. In both cases, lifestyle changes are equally important as medicines.

Complications

When the sugar remains in the blood for a long time, it starts damaging the blood vessels affecting the blood supply to organs. Besides, the unused sugar also accumulates in tissues, and tissues are burdened, and they also become good places for germs to grow. Eventually, complications develop.

Diabetes patients are at risk of complications like kidney disease, heart disease, vision problems, nerve problems like pain or loss of sensation, and frequent infections. The complications happen when blood glucose levels remain uncontrolled for an extended period.

In conclusion, diabetes disturbs the body’s mechanism of handling glucose. The good news is that it can be managed with medicines and lifestyle changes.

References:

NIH. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
Kaiser Permanente. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=uf6060
Banday MZ, Sameer AS, Nissar S. Pathophysiology of diabetes: An overview. Avicenna J Med. 2020 Oct 13;10(4):174-188.
CDC. https://www.cdc.gov/diabetes/basics/diabetes.html

 

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