Diabetes is a chronic health condition that affects how your body converts food into energy. If you have diabetes, your body either does not produce enough insulin or cannot use the insulin it produces the way it should. Over time, this can cause serious health problems such as heart, circulatory system, Alzheimer’s disease or cancer, vision loss, neuropathy and kidney disease. To date, there are three traditional types of diabetes: type 1, type 2 and gestational diabetes.
According to CDCDiabetes is one of the leading causes of death and disability in the country. In 2019, diabetes was the seventh leading cause of death in America and took more than 87,000 lives. Diabetes-related mortality increased by 17% in 2020 and 15% in 2021 compared to pre-pandemic levels in 2019. And many more people living with diabetes suffer from disease-related cardiovascular damage and other chronic diseases such as aging, vision loss and lower limb amputation.
There is no cure for diabetes, so self-control and a healthy lifestyle are necessary to reduce the effects of diabetes on the human body. As a physician specializing in endocrinology, diabetes, and metabolism, I help my patients understand and manage their diabetes. Read on to learn more — and to ensure your own health and the health of others, don’t miss it Sure signs that you already had COVID.
Type 1 diabetes is believed to be caused by an autoimmune reaction that attacks the body by mistake. If you have type 1 diabetes, your pancreas cannot produce the hormone insulin, which normally regulates sugar (glucose) levels. blood stream. Without insulin to remove excess glucose, levels increase, causing devastation in blood vessels. This is what causes all the vascular damage throughout the body.
Type 1 diabetes can be autoimmune or non-autoimmune. Autoimmune forms of diabetes can manifest in childhood, adolescence, or adulthood. Autoimmune diabetes in adults accounts for about 20% of cases in adults (meaning that 80% of cases are not autoimmune related).
The presence of certain antibodies in the blood is considered a marker of diabetes. These include glutamic acid decarboxylase (GAD) and pancreatic insulin-producing islet antibody (ICA) antibodies. When GAD-positive antibodies are seen in adult diabetes, it is a form of the disease called latent autoimmune diabetes in adults (“LADA” or “type 1.5 diabetes”). This type of diabetes is often misdiagnosed as type 2 diabetes because it occurs in adults. This misdiagnosis unfortunately leads to poor therapeutic choices, worsening glycemic control (blood sugar control) and can accelerate progression to fulminant type 1 insulin-deficient disease (a condition in which insulin-producing pancreatic beta cells are quickly and completely destroyed). The greatest onset of type 1 diabetes in early childhood involves autoimmune dysfunction, where antibodies attack and destroy insulin-producing cells
Some in the medical community now suspect that non-autoimmune forms of insulin-deficient diabetes (type 1) are actually autoimmune in nature, but include antibodies that have not yet been identified.
The main cause of type 2 diabetes is obesity. Type 2 diabetes is also called “insulin resistance” because it is not the lack of insulin that causes the blood sugar to rise, but the inability of the body’s cells – individual muscle and fat cells – to use it. The pancreas still produces insulin as it should, but insulin becomes dysfunctional because its cells “resist” it. This has the same negative effect as insulin deficiency. Sugar levels rise, leading to damage to blood vessels throughout the body. Moreover, compensatory hyperinsulinemia itself plays an important pathogenic role in chronic aging diseases, including heart disease, vascular disease, Alzheimer’s disease, and cancer.
Type 2 diabetes was once known as adult diabetes, but type 1 and type 2 diabetes can occur in childhood and adulthood. Type 2 is more common in the elderly, but an increase in the number of obese children has led to more cases of type 2 diabetes in younger people.
On the other hand, 20% of diabetes in adults is an autoimmune form (GAD antibody positive) of type 1 diabetes, the so-called latent adult diabetes or LADA.
A variant of type 2 diabetes is type 2 diabetes prone to ketosis. These people are usually older than adolescents or type 1 diabetics starting in childhood and are usually obese. This group is usually racially identified as black, Hispanic, Asian, or Indian. Ketosis or ketoacidosis is a characteristic initial manifestation of the disease, which requires treatment with insulin that can be subsequently controlled with oral medications. The pathogenic cause of type 2 diabetes prone to ketosis is unclear.
Another factor contributing to the development of type 2 diabetes is the consumption of “non-nutritional” dietary supplements (e.g., artificial sweeteners). These substances cause oxidative stress in the liver and then in the pancreas, resulting in excessive insulin secretion and resistance to that insulin in muscles, liver and fat cells. As mentioned above, childhood insulin-mediated diabetes is often considered a type 1 disease, although the presence or absence of insulin deficiency independent of autoimmunity also distinguishes type 1 diabetes from type 2 diabetes.
Prolonged type 2 diabetes eventually leads to depleted destruction of insulin-producing pancreatic beta cells with declining insulin levels. When this happens, the disease develops into a non-autoimmune form of type 1 diabetes (insulin-deficient), sometimes called type 1 1/2 diabetes. When this happens, the person will need to start taking insulin injections because their body no longer produces its own insulin.
Another form of insulin-resistant diabetes or type 2 diabetes is known as steroid-induced diabetes – an unexpected increase in blood sugar associated with steroid use.
This can happen with prolonged steroid use and is one of the reasons why prescribed courses of steroid medications are generally short and rapidly declining. Such marked increases in blood glucose levels can occur in people with or without diabetes. The most characteristic is insulin resistance of skeletal muscles with spikes in blood sugar that occur after meals. Muscles do not take in sugar as they should. Steroid-induced diabetes is more similar to type 2 diabetes than Species 1. In both steroid-induced diabetes and type 2 diabetes, your cells do not respond properly to insulin. In type 1 diabetes, the pancreas does not make insulin.
Gestational diabetes is a type of diabetes that can develop during pregnancy in women who do not yet have diabetes. Gestational diabetes occurs when your body becomes resistant to the action of insulin during pregnancy. Insulin is a hormone produced by your pancreas that lets blood sugar into cells in your body to be used as energy.
Both hormones produced by the placenta (progesterone and human placental lactogen) promote insulin resistance. The placenta also produces a hormone called corticotropin-releasing hormone (CRH) which increases cortisol production during pregnancy. It also antagonizes the action of insulin. In addition, excessive weight gain and poor dietary choices during pregnancy promote insulin resistance.
Having gestational diabetes can also increase the risk of high blood pressure during pregnancydue to compensatory hyperinsulinemia induced by insulin resistance, promoting arterial vasoconstriction and renal-mediated salt retention.
The concept of type 3 diabetes has recently been coined in relation to the component of insulin resistance in the pathogenesis (developmental course) of Alzheimer’s disease. Type 3 diabetes occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning. Some researchers believe that insulin deficiency is central to the cognitive decline of Alzheimer’s disease.
Diabetes mellitus (MODY) is a group of inherited subtypes of diabetes that are passed from parent to child through genes. Symptoms usually begin in older childhood or younger adulthood, before the age of 30. This group is characterized by abnormally high blood sugar levels – blood sugar is caused by reduced insulin production. The severity depends on a certain genetic diversity and can vary from asymptomatic to severe. MODY, unlike type 1 and 2 diabetes, accounts for only 1-2% of diabetes prevalence.
Anyone who feels constant dry mouth, excessive thirst, frequent excessive urination, dizziness, unintentional weight loss, or blurred vision should have their blood glucose levels checked immediately. Your doctor should do blood tests that include endogenous insulin levels (the best test is a C-peptide level). If this level is low or moderate, a GAD antibody test should be performed.
If pre-diabetes or insulin-resistant diabetes is diagnosed, the best course of action is weight loss, developing an exercise plan that includes at least 30 minutes of walking or other movements most days of the week, smoking cessation (if applicable), limiting alcohol, following Mediterranean diet (there are many forms of it that can be adapted to any ethnic preference) and find ways to reduce stress. Learning what makes a healthy, balanced diet (which includes not only the Mediterranean but also a low glycemic index diet and limiting processed and “non-food” food additives) is a great first step toward better health and can help prevent the onset or progression of type 2 diabetes. And to protect your life and the lives of others, don’t visit any of this 35 places where you will most likely get COVID.
Dr. Brian Fertig, MD, FACE, is the founder and president of the Center for Diabetes and Osteoporosis in Piscataway, NJ, works as an associate professor at Robert Wood Johnson Medical School and as chairman of the Department of Diabetes and Endocrinology at Hackensack Meridian Health, JFK University Medical Center. He is also the author of “Metabolism and medicine“a two – volume series detailing the scientific approach to disease prediction and prevention.