What is diabetes? You can’t see it, you usually can’t feel it
So what is diabetes? It’s a complex disease that affects your entire body, and it takes healthcare professionals years to learn about its ins and outs. Once you’ve been diagnosed, though, you won’t want to take that long to learn how to take care of yourself. And luckily, you don’t have to—you can easily bone up on the basics and prepare yourself for battling your condition right here and now. In fact, education is a cornerstone of care. The more you know about diabetes, the better you’ll be able to use all the tools at your disposal to keep blood sugar in check and avoid complications that can compromise your enjoyment of life.
Start Damage Control Immediately
Think about what happens when you spill honey: It gets on your fingers, sticks to everything you touch, and generally gums up your entire kitchen counter. Now imagine a honey spill taking place inside your bloodstream—which is essentially what high blood sugar is. What happens? Cells, proteins, and fats get stickier, slowing circulation, holding back tissue repair, and encouraging material to adhere to your artery walls, where it causes clots and weak spots. In short, excess blood sugar gums up your entire body and sets the stage for all kinds of damage.
You’d never leave spilled honey on your countertop. Likewise, you should clean up blood sugar as quickly and thoroughly as possible because the “stickiness” only gets worse. Doing so can make you feel better right off the bat. And even if you have no symptoms of diabetes, taking this action will start to reduce your risk of problems including damage to artery walls, which makes them more likely to snag blood clots and plaque that can cause heart attack, stroke, and high blood pressure. These complications wreak all kinds of havoc, including impaired healing, infections, lack of sensation that can lead to injury (especially in the feet, loss of vision, swollen ankles, fatigue, sexual dysfunction—the list is long Fortunately, learning about your condition can help you clean up the excess blood sugar and halt this parade of problems. Imagine a honey spill.
Why Glucose Matters
Glucose, also known as blood sugar, is the major source of energy powering your bloodstream brain, muscles, and tissues – all your body’s functions. In fact, glucose is one of nature’s great dynamos, providing an almost universal energy source for living things. Scientists know down to the molecule how it’s made and what it does, but, that’s what interestingly, they’ve never been able to create it in a lab. Only plants can make glucose through the magic mix of sunlight, water, and other elements and pass this energy along to other creatures through the food chain.
When you eat, your body breaks down the food into smaller, simpler components that move through the small intestine and into the bloodstream. Once in the blood, these nutrients are carried to cells throughout the body.
Different foods break down into different types of nutrients. Protein breaks down into amino acids, which are often used to build or repair tissue. Fat breaks down into fatty acids, which are mostly stored as energy reserves. Carbohydrates (including everything from bread and pasta to fruits and vegetables) mainly break down into glucose, which is used almost immediately for energy. In order to feel your best, you need enough glucose powering your cells at all times.
With diabetes, however the glucose in your blood doesn’t make it into your cells. The cells are deprived of energy, which explains why fatigue is one of the hallmarks of diabetes. And since the glucose can’t enter cells, it builds up in the blood. In the short I term, excess glucose essentially soaks up water from the bloodstream, creating a par adoxical condition in which you need to urinate more often, while feeling parched with thirst. Too much glucose can also hinder the immune systems infection-fighting white blood cells, making you more vulnerable to illness. Over the long haul, persistently high blood sugar can lead to serious complications, such as damaged nerves, kidneys, eyes, blood vessels, liver, and heart.
A Wild Blood-Sugar Ride
Blood sugar fluctuates normally throughout the day, rising after you eat a meal. In people who don’t have diabetes, these fluctuations stay within a span (measured in units of milligrams of glucose per deciliter of blood) that ranges from about 70 to 140 mg/dL (or 3.9 to 7.8 mmol/L). When you have diabetes, though, the patterns become more erratic:
> Blood-sugar levels spike to mountainous heights (rather than gentle hills) after meals.
> Levels drop more slowly as the body metabolizes the food you’ve eaten.
> Blood-sugar levels are, on average, higher than what is considered to be normal and healthy
> The less you control your diabetes, the more likely your blood sugar is to swing wildly between highs and lows or simply stay high all the time
Insulin’s Inside Job
Glucose may inflict the damage done by diabetes, but it isn’t really to blame. Instead, the real troublemaker is the hormone insulin, manufactured by the pancreas. Insulin’s job is to “unlock” cells so that glucose can enter. As glucose leaves the bloodstream and enters cells, blood-sugar levels fall. When that happens, insulin levels also plum met so that blood sugar doesn’t get too low—a condition called hypoglycemia. When you have diabetes, the delicate dance of glucose and insulin is thrown out of step, either because the pancreas has trouble manufacturing insulin in the first place or because the body’s cells have difficulty letting insulin do its job. The term that describes this latter condition is insulin resistance. —a critical breakdown in the body’s ability to utilize insulin properly. Insulin resistance is the underlying cause of the vast majority of diabetes cases.
Scientists are still struggling to understand exactly what goes wrong to cause insulin resistance. It’s possible, they suggest, that insulin resistance occurs when problems develop in the normal chain of chemical reactions that must occur to permit glucose to be transported through cell membranes. Or maybe, they speculate, an intricate system of proteins in cells, sometimes called the metabolic switch, loses its ability to sense the presence of insulin and react accordingly.
Even if the biology is still a bit mysterious, however, it’s important to remember that the factors known to raise the risk of diabetes are fairly well understood.
Insulin isn’t the only hormone that can affect blood-sugar levels. A number of others, sometimes called insulin antagonists, have the opposite effect of insulin. These include:
Glucagon. Produced in the pancreas along with insulin, it blocks insulin’s ability to lower blood sugar by causing the liver to release stored glucose when the body requires it.
Epinephrine. Also called adrenaline, this so-called stress hormone is released when the body perceives danger. Epinephrine raises blood sugar in order to make more energy available to muscles.
Cortisol. Another stress hormone, it can also raise blood-sugar levels.
Growth hormone. Produced by the pituitary gland in the brain, it makes cells less sensitive to insulin.
Your Pancreas: Small but Mighty
The pancreas is a fist-size organ that resembles an overgrown tadpole. It lies just behind and below the stomach. In its tail,” cells known as beta cells (which are clustered in clumps called the islets of Langerhans) produce insulin and release it when needed. Other cells, called acinar cells, secrete enzymes that help break down proteins, carbohydrates, and fats. Normally, the pancreas acts as a kind of glucose meter, closely monitoring levels in the blood and releasing insulin in spurts to mirror glucose levels. It also helps regulate a process in which the liver stores glucose as glycogen and then releases it back into the bloodstream to raise glucose levels when they fall too low. Certain diabetes drugs work to improve the function of the pancreas.
Major Symptoms of Diabetes
You may be among the countless people who suspect they have diabetes but have avoided making an appointment to be checked. You’re certainly not alone: Denial is an all-too-common response to the subtle symptoms that characterize diabetes type 1 or 2.
Symptoms or not the American Diabetes Association recommends that everyone be tested for diabetes every three years after age 45—or more often if they face such risk factors as a family history of the disease. Whatever you do, don’t ignore these symptoms; they’re a signal that you should make a doctor’s appointment ASAP.
When cells can’t get glucose and are deprived of energy, you can suffer from both physical and mental fatigue. The brain, in fact, is a glutton for glucose using far more glucose for its weight than do other types of tissue. Mental fatigue can make you fuzzy-headed and emotionally brittle, while physical fatigue can make your muscles feel weak.
Frequent bathroom breaks
When the body is awash in blood sugar, the kidneys, which recirculate nutrients and filter out waste products, are among the first to know. When overwhelmed by glucose, they try to flush the excess out of your system by boosting urine production, especially after blood-sugar levels reach or exceed about 10 mmol/L or 180 mg/dL.
As urine is excreted, you lose fluid. To urge you to replace it, the body triggers a persistent thirst.
The irony of diabetes is that although your body is overflowing with nutritional energy, your cells are starving. Deprived of sustenance, they tell the body’s appetite system to send a call for more food, which only creates more glucose that can’t be properly used.
Diabetes can degrade your eyesight in two seemingly contradictory ways. In one, lack of body fluid due to loss of urine can dry out the eyes, constricting the lens and distorting vision. In the other, excess blood sugar can cause the lens to swell, also creating distortion. Both of these effects are temporary, although diabetes can cause other complications that may eventually result in serious visual impairment and even blindness.
Having too much glucose in your blood makes immune-system cells less effective at attacking viruses and bacteria that cause infection. To make matters worse, some of these invaders actually feed on glucose, making it easier for them to multiply and become an even bigger threat. This can result in frequent upper respiratory illnesses like colds and flu, as well as urinary tract infections, gum disease, and, in women, vaginal yeast infections.
Tingling hands and feet
High blood sugar can damage nerves, a condition that may first become noticeable in the touch-sensitive extremities as a tingling or burning sensation. Damage caused by excess blood sugar can also affect nerves in the digestive tract, provoking nausea, diarrhea, or constipation.