You might know diabetes has something to do with insulin and sugar. But none of it is sweet.
Diabetes itself is not a deadly condition, but it can lead to other complications that can be.
Limb loss is also a risk.
When blood sugar levels are too high, the blood thickens and cannot travel to the limbs as it should.
Blood sugar levels are regulated by insulin.
What does insulin do?
Insulin is a hormone produced by the pancreas.
The body uses insulin to convert sugar into energy.
“Carbohydrates are what break down into blood sugar,” said Carlie Hansen, University Health Dietician and Diabetes Educator. “Carbohydrates is the fancy way to say sugar.”
That’s not to say, however, that all carbs are bad.
“That’s literally what the brain is using to function. It’s the gasoline of the body,” Hansen said.
Without enough insulin or with insufficient insulin, blood sugar levels in the body get too high.
Sugars are not broken down into energy.
“When your sugar levels are too high, then you’re not really able to use all of that sugar as energy,” said Dr. Maria Escobar Vasco, Endocrinologist with UT Health San Antonio. “You’re just accumulating that extra sugar in your bloodstream, which is what causes the complications of diabetes.”
When the body can’t convert sugar into energy, it has to store the excess somewhere.
That storage comes in the form of fat.
“On top of that, your liver, it’s always producing sugar,” Escobar Vasco said. “Extra sugar that’s just dumping into your bloodstream.”
Insulin tells the body when to release that sugar.
It’s one more job the hormone won’t do well if the body doesn’t have a strong insulin supply.
Plus, when excess sugar is stored as fat, excess fat can damage the liver.
Signs of diabetes include:
- feeling sluggish
- having difficulty concentrating
- frequent urination
- frequent thirst
How diabetes is treated
Adding more insulin to the body through injections used to be the main treatment for diabetes patients, but that changed.
While injections are still used, different types of medications now target different problems.
Some medications focus on making the pancreas produce more efficient insulin.
Others aim to make fatty tissue use sugar as energy rather than store it, while another type of medication tells the liver to stop producing sugar.
Lifestyle changes are also crucial for managing Type 2 diabetes.
The less sugar a person consumes, the easier it is to control sugar levels.
Plus, exercise.
“Every time you’re exercising, you’re using energy,” Escobar Vasco said. “And so you’re taking some of that sugar, some of those fatty deposits to mobilize energy and help the sugars as well.”
Type 1 and Type 2
Lack of insulin or an insufficient supply is the leading cause of Type 2 diabetes, which can largely be managed through diet and exercise.
Type 1 diabetes, however, is an auto-immune disease.
“This means that the immune system, which should be hunting down germs and viruses and other bad guys, gets confused and attacks your own cells instead,” said Jonathan Rosen, Director of Research with JDRF.
A patient’s own body attacks its insulin.
“So these patients typically will have barely any insulin production at the beginning,” Escobar Vasco said. “And eventually, they’ll completely stop producing insulin.”
Type 1 patients must rely on insulin injections.
A Type 1 patient, Natalia Pierre-Louis, takes 3 to 5 injections daily.
“Three meals and then the one that I take once a day, and then if I have a snack that’s kind of carby or to correct the blood sugar that’s too high,” she said.
Pierre-Louis said it feels like she’s intoxicated if her blood sugar levels get too low.
“That’s the best way to describe somebody that doesn’t have diabetes,” she said. “Like you almost don’t have control of your own body if you become hypoglycemic.”
“Doesn’t matter how healthy I am,” Pierre-Louis added. “Whether it’s eating, exercising, no matter what I do, I’m going to be dependent on insulin.”
Family history and genetics play a big role in Type 2 diabetes.
“I have patients that come to me, and they’ve done everything that they can to avoid diabetes. And now they’re 70, for example, and they’re starting to have issues with the sugars,” Escobar-Vasco said. “And so they’re like, ‘what did I do wrong?’ Well, unfortunately, nothing. You did everything right. But it was in your genes, so it was coming.”
Even if you have the genetic makeup for diabetes, there are still ways to manage it.
“Absolutely,” Hansen said. “It’s 100% manageable with diet.”
Diabetes by the numbers
Hansen said there is a range of carbohydrates recommended for every meal.
For women, 45-60 grams of carbohydrates per meal is recommended, whereas men should try for 60-75 grams of carbohydrates per meal.
A healthy range of sugar levels, without eating or drinking anything 6 hours before a test, is 70-999 mg/dL.
A sugar level of 100-125 mg/dL is considered borderline diabetic, while 126 or higher signals diabetes.
There’s also a blood sugar measurement called A1C.
“I have a lot of patients that tell me, ‘Oh, my sugar is a little high because I just had a soda,’ but the A1C gives me an average of a three-month journey of your body,” Escobar Vasco said.
And A1C measurement of 5.6 or lower means the body has controlled sugar levels for three months.