Insulin and Diabetes

The Pancreas and Insulin Production:

The pancreas is a very quiet little organ that sits behind the stomach and produces digestive enzymes and a couple of hormones called insulin and glucagon. Most people never think about their pancreas. It just does it's thing, pumping insulin into the blood when glucose is too high and glucagon when the glucose is too low.

Digestion and Energy:

When we take in food, our bodies break it down into materials that we need for our bodies to function. One of those materials is sugar in the form of glucose. Our cells use glucose for energy and our brains especially run on glucose. To get the glucose into the cells, the sugar travels into the bloodstream and triggers the pancreas to produce insulin. Insulin lets the sugar pass from the blood into the cells. When sugar is converted to energy, it's either used or stored until we need it.

The Rise and Fall of Blood Sugar:

Blood sugar is lower before a meal and then rises once we have eaten. Then, approximately 2 hours after the meal it returns to normal. Blood sugar is measured in milliliters per deciliter of blood. So the normal range for blood sugar in the person without diabetes usually falls between 70 and 110 milliters per deciliter or ml/dl.

A person is diagnosed with diabetes when their pancreas either doesn't produce any insulin at all or the insulin they do produce is ineffective.

Type 1 Diabetes: Type 1 diabetes occurs when the pancreas is attacked by the immune system. The insulin producing cells, also known as beta cells, are permanently destroyed. The pancreas no longer produces insulin. 10% of people diagnosed with diabetes have Type 1 and the majority of them are children or young adults when it strikes. There seems to be a genetic link to Type 1 diabetes, even though scientists believe that a viral infection may be the culprit.

The signs and symptoms of Type 1 happen swiftly.

Energy Crisis:

The insulin production drops off suddenly when the beta cells are destroyed and the person is very quickly in crisis. When there isn't any insulin, the sugar in the blood just keeps circulating and building. The cells don't get any fuel and the body tries to get rid of the excess sugar. It tries to dilute it by pulling water out of body. This causes excessive thirst and urination.

Diabetic Ketoacidosis:

The body becomes fatigued because the cells aren't getting the glucose they need for energy. The person may suffer a condition called diabetic ketoacidosis which means that the body starts to break down fats to make energy. This produces ketones which makes the blood increasingly acidic.This can cause a person to go into a diabetic coma and possibly even die. People with Type 1 diabetes must always take insulin for the rest of their lives in order to live with the disease.

Type 2 Diabetes:

Type 2 diabetes is different than Type 1. The pancreas still makes insulin, but the body develops resistance to insulin, so the cells don't respond to it, and they are unable to take up the sugar that is in the blood. Type 2 used to be almost exclusively an older person's disease, but with the rise in childhood obesity and obesity in general in our country, there are cases of Type 2 in children and young adults as well.

The Skinny on Type 2:

Obesity is the number one risk factor for developing Type 2 diabetes because fat cells do not absorb insulin as well as muscle cells do. Some scientists feel that because the pancreas has to work harder to pump increased levels of insulin into the blood to compensate for resistance, that the pancreas eventually wears itself out and can no longer keep up with the demand. Oral medications, combined with a low fat, high fiber diet and exercise is usually enough to control the symptoms of Type 2.

Type 1 Diabetes

What It Is:

Type 1 diabetes is a completely different disease than Type 2. Type 1 is an autoimmune disease of the insulin-producing beta cells of the pancreas. Scientists believe that it may be a virus that triggers the immune system to attack the cells and permanently destroy them. The pancreas can no longer make the insulin necessary to transport sugar from the blood into the other cells of the body for energy. Sugar builds up in the blood and over time can damage internal organs and blood vessels.

Insulin and Blood Sugar:

What does this mean to the person who is diagnosed? Someone who has Type 1 diabetes must take insulin everyday to survive. It becomes a delicate balance of finding the right amount of insulin necessary to keep the blood sugar level as close to normal as possible. The person with diabetes has to check their blood sugar levels often and then inject themselves with the correct amount of insulin to counteract the amount of sugar. This mimics the action of the pancreas.

Warning Signs for Type 1:

This can be an overwhelming process for the newly diagnosed person, especially since Type 1 diabetes typically strikes children and young adults, although adults age 40 and older, can get Type 1. The onset of the disease happens quickly. As the insulin stops being produced and the blood sugar rises, this causes hyperglycemia. Several warning signs appear. Increased thirst, increased urination, fatigue, weight loss and blurred vision are a few of the most noticeable signs of Type 1 diabetes.

Testing Blood Sugar:

Frequently testing blood sugar levels helps to let you know how much insulin you will need to keep your levels as near to normal as possible. The usual times to test are: before meals, before bedtime and maybe one to two hours after meals or a big snack. Also test before you exercise because exercise will lower blood sugar also, and you don't want your blood sugar to drop too low either. This is called hypoglycemia.

When and What to Eat:

For diabetes, when you eat is as important as what you eat. Eating meals that are approximately the same size and combination of carbohydrates and fats at the same time everyday helps to keep blood sugar regular and predictable. The best diet is one that is low in fat, low in salt and low in added sugars. Complex carbohydrates such as whole grains, fruits and vegetables are preferable over simple carbohydrates like sugary soft drinks and and candy.

Living a Healthy Life:

Until the 1920's, when insulin was first discovered, people usually died from Type 1 diabetes. Today with all the advances of medicine that are available, a person diagnosed with Type 1 diabetes can live a very normal, long life. There are many adjustments that need to made and skills that need to be learned, but these can be incorporated into a daily routine, and can become just as automatic as brushing your teeth. Working with your doctors and a nutritionist will give you the tools you need.

What is Pre-diabetes

A Diagnosis of Pre-diabetes:

What does this mean? It means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren't as high as they would be if you had Type 2 diabetes, the term "pre-diabetes" is used. Your doctor may also call this condition "impaired fasting glucose" or "impaired glucose tolerance. According to the Centers of Disease Control and Prevention, 41 million adult Americans between the ages of 40 and 74 have pre-diabetes.

Risk Factors:

The risk factors are the same for pre-diabetes as they are for Type 2 diabetes.

• Overweight or obese

• Sedentary lifestyle

• Family history

• Age

• Race - African Americans, Hispanics and American Indians are at greater risk for Type 2 diabetes

• A previous diagnosis of gestational diabetes

Signs and Symptoms of Pre-diabetes:

Very often there are no signs or symptoms for pre-diabetes. It is often discovered during a routine physical with basic screening for fasting blood glucose levels. The normal level is below 100 mg/dl. If it's 100 to 125 mg/dl, this indicates that you have impaired fasting glucose or pre-diabetes. Over 126 mg/dl most likely means a diagnosis of Type 2 diabetes.

Preventing Type 2:

Having pre-diabetes puts you at a higher risk for Type 2 diabetes in the future. But it doesn't have to mean that you will get Type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.

What Is Diabetes?

The Balance of Glucose and Insulin:

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you take in is digested and broken down to a simple sugar, known as glucose. The glucose then circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high.

There are two main types of full-blown diabetes. People with Type 1 diabetes are completely unable to produce insulin. People with Type 2 diabetes can produce insulin, but their cells don't respond to it. In either case, the glucose can't move into the cells and blood glucose levels can become high. Over time, these high glucose levels can cause serious complications.

Pre-Diabetes:

Pre-diabetes means that the cells in your body are becoming resistant to insulin or your pancreas is not producing as much insulin as required. Your blood glucose levels are higher than normal, but not high enough to be called diabetes. This is also known as "impaired fasting glucose" or "impaired glucose tolerance". A diagnosis of pre-diabetes is a warning sign that diabetes will develop later. The good news: You can prevent the development of Type 2 diabetes by losing weight, making changes in your diet and exercising.

• What is Pre-Diabetes?

Type 1 Diabetes:

A person with Type 1 diabetes can't make any insulin. Type 1 most often occurs before age 30, but may strike at any age. Type 1 can be caused by a genetic disorder. The origins of Type 1 are not fully understood, and there are several theories. But all of the possible causes still have the same end result: The pancreas produces very little or no insulin anymore. Frequent insulin injections are needed for Type 1.

• Type 1 Diabetes
• Insulin and Diabetes

Type 2 Diabetes:

A person with Type 2 diabetes has adequate insulin, but the cells have become resistant to it. Type 2 usually occurs in adults over 35 years old, but can affect anyone, including children. The National Institutes of Health state that 95 percent of all diabetes cases are Type 2. Why? It's a lifestyle disease, triggered by obesity, a lack of exercise, increased age and to some degree, genetic predisposition.

• Type 2 Diabetes
• Top 6 Risk Factors For Type 2 Diabetes

Gestational Diabetes:

Gestational diabetes (GD) affects about 4 percent of all pregnant women. It usually appears during the second trimester and disappears after the birth of the baby.

Like Type 1 and Type 2, your body can't use glucose effectively and blood glucose levels get too high. When GD is not controlled, complications can affect both you and your baby. Your doctor will help you work out a diet and exercise plan, and possibly medication. Having GD increases your risk for developing it again during future pregnancies and also raises your risk of Type 2 diabetes later in life.

• Risk Factors of GD
• Postpartum Follow-up Care for GD