A lot of attention has been focused on the increase of diabetes in the United States. According to the Centers for Disease Control and Prevention (CDC), 30.3 million Americans have diabetes (9.4 percent of the population), with an estimated 23.1 million people diagnosed with the disease, and 7.2 million cases undiagnosed. 84.1 million adults ages 18 years and older have prediabetes (33.9 percent of the adult population). Diabetes is expected to continue to grow over the next several decades.
DIABETES AND YOUR BODY
What exactly is diabetes? Diabetes is a medical condition in which your body struggles to metabolize sugar. The main chemical that metabolizes sugar in the bloodstream is insulin, which is produced by cells in the pancreas called beta cells. If your body either fails to produce enough insulin (type 1 diabetes) or becomes insulin-desensitized over time (type 2 diabetes), blood sugar levels will continue to rise. Higher-than-normal blood sugar levels can affect organs such as the kidneys, the eyes, the heart and the brain.
CAUSES AND RISK FACTORS
Type 1 Diabetes
People with type 1 diabetes tend to be younger, thinner and may have a family history of early development of the disease.
Despite the time, energy and true commitment that have gone into diabetes research, we still do not have an exact cause of type 1 diabetes, though there are several potential risk factors and theories.
The first possible cause for type 1 diabetes is genetics. The major reason genetics is considered a risk factor for developing type 1 diabetes is the relationship among family members who have type 1. Although the risk of inheriting type 1 diabetes from your parents is estimated to be only about 5 to 10 percent, the chance of having diabetes if your identical twin has the disease can be up to 50 percent. For this reason, researchers have proposed that contrary to being influenced by only one or two genes, there are likely many genes that contribute towards the development of type 1 diabetes.
A second, well-known potential cause of diabetes includes environmental factors. As mentions, there is approximately a 50-50 chance that if one identical twin has diabetes the other will have it as well. The reason the other 50 percent of twins don’t develop diabetes cannot be explained. Since identical twins share the same genetic makeup, there must be other environmental factors in play that may influence genetic factors.
A third possible cause of type 1 diabetes is exposure to viruses. Several viruses have been researched heavily and have been thought to be potential causes, including the coxsackievirus and Epstein-Barr, the virus that causes mononucleosis.
The theory behind this probably cause of type 1 diabetes is that while attacking the virus, the immune system created antibodies that confuse the virus with beta cells of the pancreas. Thus both the virus and the beta cells of the pancreas are attacked by the immune system and destroyed. This results in the development of type 1 diabetes, as the body starts producing less and less insulin while more beta cells are destroyed.
Type 2 Diabetes
People with type 2 diabetes tend to be overweight, and also can have a greater family history of diabetes. They have usually been older, but as the obesity epidemic in America grows, we are unfortunately seeing younger and younger patients develop type 2 diabetes. Some patients with type 2 diabetes are as young as six-years-old!
Type 2 diabetes is generally caused by what is known as insulin insensitivity. This condition usually occurs over a long period of time after your body begins desensitizing itself to insulin. This is the result of significantly elevated blood sugars over this period of time. As your body is exposed to more and more insulin, the receptors and subsequent downstream chemical pathways that are supposed to respond to insulin begin not responding as well. The outcome is that your body struggles to reduce blood sugar levels.
THE ROLE OF INSULIN
The way your body functions when you have diabetes has been very well studied and understood. The job of insulin is to reduce blood sugar levels and to prevent certain chemical reactions from taking place. After a meal, insulin is secreted by the pancreas to help reduce blood sugars. At the same time, insulin also functions to help the body store energy in the form of fat cells called lipids through a process known as lipogenesis. These fat cells function to store energy so, during times of hunger, energy can be burned from your fat cells to maintain metabolism.
When insulin is not functioning properly (either because it is no longer being secreted by your pancreas in adequate amounts, as in type 1 diabetes, or because your body has become desensitized to it, as in type 2 diabetes), these protective pathways no longer function properly. Consequently, after a meal blood sugar levels tend to rise.
Also, perhaps even more dangerous, is when insulin is no longer able to encourage the development of fat cells, resulting in an excessive breakdown of fat cells. This, in part, explains why people with type 1 diabetes (who do not produce enough insulin) tend to be thinner than those with type 2 diabetes (who still do produce insulin).
When this happens, fat cells are eventually burned into energy that results in the production of lactic acid. If this process continues unchecked, a life-threatening condition known as diabetic ketoacidosis can occur.
The treatment for diabetic ketoacidosis is to give continuous amounts of insulin through an IV to stop your body from breaking down fat cells and producing additional lactic acid.