The Disease Process of Diabetes: How Does It Start?

There are two main types of diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas produces no insulin or very little insulin. Because it is most commonly diagnosed in children it used to be called "juvenile diabetes."

Type 2 diabetes is a disease in which the body either resists the blood sugar-controlling influence of insulin or doesn't produce enough insulin. It used to be known as "adult onset diabetes" but this is a misnomer as many children are now diagnosed with type 2.

In our world, diabetes has become something of an epidemic.

How Does It Start?

For both type 1 and type 2 sufferers, lack of insulin or resistance of the cells to accept insulin results in diabetes.

For type 1, the pancreas is either not manufacturing insulin, or not manufacturing enough insulin to process the glucose levels in the blood. These patients must test their blood multiple times each day, and try to match their insulin dosages to their blood sugar needs, in order to keep blood glucose levels down and damage caused by elevated levels to a minimum.

Type 2 sufferers have a somewhat different scenario. Cells in the body require insulin, which they use to accept glucose. Glucose is necessary for metabolism within these cells.

For someone with type 2 diabetes, the body's cells become desensitized to insulin, a process called insulin resistance, and they stop accepting it, causing glucose levels to rise. This leads the pancreas to work even harder, producing more insulin. Finally, the pancreas wears out, and stops producing the levels of insulin necessary to process the glucose in the bloodstream.

The insulin desensitization process may be the result of inherited traits or may result from a diet high in fat and sugar. In either case, a poor diet and sedentary lifestyle will exacerbate the condition.

What Happens Next?

These continually high glucose levels in the bloodstream cause damage to many of the body's systems. This damage includes:

• Damage to the cellular linings in the blood vessels, leading to plaque formation and rigidity of these vessels, which in turn leads to increased blood pressure;
• Damage to the nervous system, most notably causing peripheral neuropathy, a disorder that results in pain in the extremities;
• Kidney damage, as the increased blood pressure and damaged blood vessels weaken the ability of the kidneys to remove waste products from the blood;
• Liver damage, caused by damage to the millions of blood vessel within the liver, which limits their ability to transport waste products into the liver and nutrients out;
• Eye damage, in the form of diabetic retinopathy. The blood vessels in the eyes are extremely susceptible to damage from elevated sugar levels.

What Can Be Done?

Prevention of diabetes is possible. A healthy diet, minimizing fats and sugars, exercise and maintaining a healthy weight will all go a long way to preventing the onset of this disease.

In the case of someone who has been diagnosed as pre-diabetic these same efforts, followed rigorously, can prevent the onset of diabetes.

Sources: Harvard School of Public Health, National Diabetes Information Clearinghouse
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