"We take the fear out of research and
health science communication."
Chris Atack, Atack Associates

What is diabetes?

Introduction

If you're reading this booklet, chances are you've been diagnosed with diabetes. Learning you have a disease is no fun. Maybe you're unsure what diabetes actually is, or what impact it will have on your lifestyle. This book will help you find the answers to those and other questions.

Here's some good news right up front: you can successfully manage your diabetes. Many, many people of all ages live full, active lives even though they have diabetes. You can learn to do the same.

The first thing you need to know is what diabetes is, and how it affects your body. To understand diabetes you'll need to know a few medical terms. At first these may seem confusing, but don't worry. As you learn a little more about the disease, the terms will start to make sense. If you forget what any of them mean, simply look them up in the glossary at the end of this booklet.

Diabetes, insulin and glucose

If you have diabetes, either your body isn't producing insulin at all, it's not producing enough, or it can't use insulin properly any more. Without insulin, your body can't process glucose -- a form of sugar found in the blood - and turn it into energy, as it should.

If that's about as clear as mud, read on! You need just a little more background.

Diabetes is actually quite simple to understand, once you learn about two chemicals the human body produces. These are called insulin and glucose. Let's start by taking a closer look at them.

In healthy people, insulin is produced by special cells in a small organ called the pancreas. Insulin does something very important. It lets your body move glucose - a kind of sugar - from your blood stream into your cells. There, glucose is converted into energy, and used to power your cells.

To use a simple analogy, if the cells in your body were cars, glucose is the fuel that makes them go. But to pump glucose into the cells, the body has to have insulin. Not only that, but the tiny 'pumps' on each cell wall have to be able to use the insulin to move glucose inside the cells where it's needed. When part of this process breaks down, the result is diabetes.

Depending on what part of the process is affected, the result can be either type 1 or type 2 diabetes. Let's look at these two different forms of the disease and see what causes them.

Type 1 diabetes

Insulin, as you've already learned, is produced by special cells in the pancreas, an organ located near the stomach. These cells are called beta cells, and their only job is to churn out insulin. Sometimes, for reasons scientists don't yet completely understand, the body's own immune system attacks and kills these cells. In rare cases, these cells die without any obvious cause.

Cause of type 1 diabetes

Whatever the reason, once the beta cells are dead, they do not grow back. That means the body can no longer produce any insulin at all. This condition is known as type 1 diabetes. It's also called Insulin Dependent Diabetes Mellitus (IDDM), because people with this form of diabetes need insulin shots at regular intervals to remain healthy. Because this form of diabetes usually occurs in younger people, type 1 diabetes is sometimes also called juvenile onset diabetes. In this book, to keep things clear, we'll call it type 1 diabetes

Treatment of type 1 diabetes

People with type 1 diabetes can't produce the insulin they need to 'pump' glucose into their cells. Without treatment, their blood becomes saturated with glucose. The body attempts to correct its chemical balance by increasing the amount of liquid in circulation. People with untreated type 1 diabetes become terribly thirsty and need to urinate often.

At the same time, they become very tired, their cells are literally running out of energy to function. The body desperately attempts to compensate by breaking down fat and protein for energy.

Until about 80 years ago, there was no way to help people with this form of the disease. Then, in the 1920s, scientists were able to produce insulin and inject it into patients with diabetes. What followed was a medical miracle. Patients who would otherwise have died began to get better. Soon, doctors realized insulin injections could let people with diabetes stay healthy.

Today, advances in medicine have made it possible for people with type 1 diabetes to live healthy, active lives. By keeping their glucose levels under good control and taking insulin, they can not only live normally but they can head off the long-term problems associated with diabetes.

Cause of type 2 diabetes

Type II diabetes is far more common than type I. Between 90 and 95 per cent of patients with diabetes have this form of the disease. Because it most often strikes people over 40, it is also known as Adult Onset Diabetes. Because people with type II diabetes don't usually need daily injections of insulin, this form of the disease is also known as Non-Insulin Dependent Diabetes Mellitus (NIDDM). In this book, we'll refer to it as type II diabetes.

People with type II diabetes are still able to produce insulin. Here's the problem: If you have this form of diabetes, your pancreas may not be producing enough insulin to meet your body's needs. Or, your body may not be using the insulin that's available as well as it should. Let's talk about these possibilities in turn.

The pancreas can only produce a limited amount of insulin. If your body's needs have increased, your pancreas may not be able to keep up with the extra demand. People who are overweight are have type II diabetes, because their insulin production simply can't keep up with the demands of their larger bodies.

Sometimes, the cells in the body can't use insulin as well as they once did. Either they need more insulin to pump glucose, or they don't react properly to insulin any more. Their ability to 'pump' glucose in response to insulin has broken down. This is called 'insulin resistance.'

Treatment of type II diabetes

Type II diabetes is most often treated by a combination of healthy eating and physical activity. Some people with this form of diabetes must also take drugs such as glucose reducers or insulin.

If you have type II diabetes, the first thing you have to do is develop healthy eating habits. This means you have to know what to eat, how much to eat, and also when you should eat. Healthy eating is vitally important for people with type II diabetes. It is the cornerstone of treatment. You'll find detailed advice on healthy eating in Chapter Five of this book.

It's important for everyone to get enough physical activity. It's even more important for people with type II diabetes. Physical activity helps your body work better and more efficiently. It also helps keep weight down, and protects you against cardiovascular problems (problems with your heart or circulatory system) which are often a complication of diabetes.

If healthy eating and physical activity aren't enough to control type II diabetes, you may have to take drugs as well, at least until glucose levels are brought under control.

Gestational diabetes

Gestational diabetes is a temporary form of diabetes, which only occurs in pregnant women, usually in or after the sixth month of pregnancy. It's caused by the hormonal and weight changes in the pregnant mother's body. It disappears after the mother gives birth. However, women who have had this form of diabetes have a higher risk of developing type II diabetes later in life.

Diagnosing gestational diabetes

This form of diabetes is usually diagnosed by having the mother drink a special high-glucose mixture. Doctors then monitor her blood glucose levels to see her reaction. If her insulin is not enough to bring levels down to healthy levels, she will be treated for gestational diabetes.

Treatment of gestational diabetes starts with a healthy diet and physical activity. If these measures are not enough to bring blood glucose to proper levels, the mother may also be given insulin injections for the rest of her pregnancy.

Chapter Two

Dealing with risk factors for diabetes

Certain things increase a person's chances of getting diabetes. These things are known as diabetes risk factors. Some of these risk factors, such as diet and exercise habits, can be changed. Other risk factors, such as age or ethnic background, can't be changed.

People who are at higher-than-normal risk of diabetes should make a special effort to get rid of all the risk factors they can. Of course, if you already have diabetes, changing your risk factors won't cure you. But making better lifestyle choices will help you manage your diabetes.

Risk factors you can't change

The things that put your at higher-than-average risk for diabetes include age, family history of diabetes and ethnic origin.

Age is a major risk factor for type II diabetes. Most cases occur in people 40 years of age or older.

Another major risk factor is family history. If a parent or a sibling (brother or sister) has diabetes, your chances of having it as well are higher.

Finally, your ethnic background affects your risk of diabetes. People of African-American or Hispanic-American origin are at higher risk for diabetes than people of other ethnic groups. Native Americans are at extremely high risk as well. In fact, this group has the highest rate of type II diabetes in the world.

Risk factors you can change

Obviously, none of us can change our age, or our family or ethnic backgrounds. What we can do is change risk factors that are under our control. This includes things such as weight, activity levels and certain medical conditions. Let's take a quick look at some of these.

Being overweight, being inactive, alcohol use, smoking

Being overweight is one of the of the worst risk factors for diabetes. Consider for a moment: the more you weigh, the more cells there are in your body. The more cells, the more insulin your pancreas has to produce. Less weight means less need for insulin. So, one simple way to protect yourself against diabetes is to make sure your weight is within normal range. Of course, this is easier said than done. In later chapters we'll look at tried-and-true ways to reduce weight through physical activity and better eating.

Inactivity - a couch-potato lifestyle - is another huge risk factor for diabetes, as well as for other serious health problems. Activity helps keep glucose at proper levels. It also helps keeps weight under control. It even helps the body use insulin more effectively. Taking up an active lifestyle is one of the best ways to reduce diabetes risk, and to manage the disease if you have it. We'll talk more about physical activity in Chapter 6.

Making unwise diet choices is also a risk factor for diabetes. Eating the wrong things in the wrong amounts can pack on extra weight and send glucose levels soaring, making it harder for the overworked pancreas to cope.

One of the least helpful dietary choices is alcohol. It contains huge numbers of calories and has virtually no nutritional value at all. Candies and processed desserts are also bad diet choices, for the same reason. In Chapter 5 you'll learn everything you need to know about healthy eating and drinking.

Smoking doesn't put you at greater risk for diabetes -- but it's one of the very worst things you can do if you have the disease. People with diabetes are already at higher risk for hypertension and cardiovascular problems. Smoking sends their risk skyrocketing. It also makes it harder to enjoy regular physical activity, one of the most important risk-reducers for people with diabetes. If you have diabetes, and you still smoke, one of the best things you can possibly do is quit. Now!

Stress and diabetes

Stress is a fact of life. We all have to cope with the day-to-day hassles of traffic jams, too-busy schedules, sick children and so on. We also have to deal with major stress-causing events from time to time. Job lay-offs, serious illnesses and other life-affecting events can send stress levels soaring. Even happy occasions such as weddings or overseas vacations can contribute to stress.

Stress can be unhealthy even for healthy people. It can be positively dangerous for people with diabetes because their bodies react to stress in a special way.

Blood glucose levels, diabetes care and stress

Stress releases a number of stress hormones or chemicals into the body. These hormones can cause blood glucose levels to soar. Without insulin to compensate, the result can be a dangerous 'spike' in blood glucose.

At the same time, stress can distract you from the vital task of managing your diabetes. When you're busy and stressed, it's all too easy to let your physical activity schedule slide, to skip a routine blood glucose check, or to be less careful with your food choices. The end result can be a loss of control of blood glucose levels.

How to handle stress safely

If you have diabetes, you have to take especially good care of yourself during stressful times. The key is to stick to your diabetes care routine, even if it seems extra hard. You'll be glad you did.

You also have to learn how to cope with stress effectively. There are many strategies for doing this. Physical activity is excellent for reducing stress levels. So are disciplines like yoga, tai chi and meditation.

If you need help in this area, talk to your doctor or diabetes care team. Ask them what you can do to cope with stress. If necessary, ask them to refer you to a specialist in this area.

  Back To Top Contact Us