[Diabetes Pt.1] Diabetes; Known or Unknown?

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Read part 2 of this article: Is Diabetes Manageable?

Diabetes has risen in rank to one of the most known diseases. This gained popularity however does not come with enough knowledge about it. For a starter, diabetes is of two main forms;

Diabetes mellitus, caused by insulin issues and Diabetes insipidus, caused by vasopressin problems. In 2017, the International Diabetes Federation (IDF) published that there were 518,400 cases of Diabetes in adults which makes about 3.6% of the total world population. In the same year, the World Health Organization (WHO) compiled data that indicated that Diabetes mellitus contribute 2.71% of total deaths.

Read part 3 of this article: Lab Investigations in Diabetes

Photo credit: Alisha Kleinhammes

The more common nature of Diabetes mellitus and its greater fatality have so influenced the use of the word Diabetes such that most people and articles use it when they are actually referring to just Diabetes mellitus. The usage of diabetes as a word will be employed by this article and subsequent parts with reference to Diabetes mellitus. Even for this form of diabetes, there are two types; Type I and II Diabetes mellitus – DM1 & DM2 respectively.

Back to basics: When one takes a carbohydrate meal (most of our foods contain carbohydrates), it is digested (broken down) into glucose which is then absorbed into the blood stream to be finally incorporated into cells for energy production. After absorption, the initial high level of blood glucose signals the pancreas to release insulin. Insulin (a hormone) then spearheads the incorporation of the glucose into the cells for use. Without insulin, the glucose remains in the blood stream and cannot enter the cells. Meanwhile, metabolism (processes that lead to energy production and release) happen in the cells. If glucose cannot enter the cells for use for energy, how do you maintain life?

In DM1, the individual cannot produce insulin either sufficiently or at all. Let’s say you order pizza, the delivery gets to your door, and you cannot find the key to open the door. How do you get your pizza? Insulin acts as the key that opens the door on the cells for glucose to enter. Usually, DM1 is congenital (if a baby is born without pancreas or has a defective pancreas). There are instances however when DM1 can be induced either by infection or surgical removal of the pancreas.

How about this? What if you find the key but the lock on the door doesn’t fit with the key (supposing there has been a disruption in the lock), will the door open? Certainly not! This is basically what happens in DM2. Here, the door on the cells don’t respond well to the insulin. One research speculates that this has to do with dysfunction in cell signaling and regulation. So even if insulin is released by the pancreas, chunk of the glucose still remains in the blood stream. DM2 is usually an acquired disease and therefore preventable; because of this reason, subsequent parts of this article focus more on DM2.

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