No outside cause

Unlike some diseases, diabetes is not caused by an outside agent. No bacteria or viruses carry it. You cannot "catch" it. In fact, scientists don't really know what triggers it. There are three types. In type 1, the most serious, the body stops making insulin because the immune system actually attacks and destroys the cells in the pancreas that make it. Scientists don't know why, but they believe there are genetic factors.

In type 2, either the pancreas slows down its insulin production or the body does not use its insulin well because the cells resist its action. Again, scientists do not know why this happens, but they do know that both genetic and environmental factors are at play. The third type, called "gestational," develops in some women when they are pregnant, and it usually goes away after the baby is born.

 

It's all about insulin

As you can see, insulin is central to the reality of diabetes. You probably know of insulin as the drug taken by diabetic people, but you may not know that insulin is a hormone in the human body that is produced by the pancreas and is designed to help glucose leave the bloodstream and enter the cells.

Glucose is produced in the  small intestines where it is converted from sugars

and carbohydrates, and absorbed into the bloodstream. It travels to the cells and becomes the source of the body's energy, but it needs help to enter the cells, and that's the job of insulin, which signals each cell to activate glucose transporters that pull the glucose through the cell walls. You could say that insulin is the key that unlocks the cell so glucose can enter and become energy.

When this process is working properly, the pancreas matches the glucose entering the bloodstream with the right amount of insulin. In type 2 diabetes, the pancreas may produce less and less insulin over time, so there isn't enough to unlock the cells, and the glucose cannot get in to generate energy. In another form of type 2 diabetes, cells build up a resistance to insulin. There may be enough, but it cannot unlock the cells to allow glucose to enter. So, more and more insulin is required, and it becomes harder for cells to get the energy they need. The glucose that cannot get into the cells builds up in the bloodstream, hence there is a high blood sugar level. Energy is being wasted, and the cells lack the energy to keep the body working.

 

Symptoms

When blood sugar is high, the kidneys,  which usually help the body reabsorb  

excess glucose, cannot handle all of it. So the body has to create urine to carry the glucose away. This draws fluid from the body and causes you to be thirsty and to urinate more often. Because there is less moisture available for other parts of the body, you become dehydrated, causing dry mouth and dry itchy skin.

The changing fluid level can also make the lenses of your eyes swell and change shape, blurring your vision. High blood sugar can affect blood flow, causing nerve damage, making it harder for sores and cuts to heal, and resulting in pain and numbness in the limbs.

Type 1 symptoms can include unplanned weight loss because your body cannot get the energy it needs from your food. Sometimes in type 1, the body, because it can't get the glucose it needs, may begin to burn fat, which produces ketones that can build to an alarming level in your blood and make you sick with nausea and vomiting.

 

Type 2 diabetes and its globalization

People in the early stages of type 2 diabetes may not experience any of these symptoms, but the disease is progressive, and the symptoms can develop as the disease progresses. This brings us to the statistics on diabetes. Ellen Gustafson, physician and hematologist, writes, "The abundance of cheap food with low nutritional value in the Western diet has wreaked havoc on our health; in America, one third of children and two thirds of adults are overweight or obese and are more likely to develop diabetes and cardiovascular disease."

Michael Pollan writes in The Omnivore's Dilemma, "Obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year."

The 2017 National Diabetes Statistics Report asserts that 30.3 million people (9.4 percent of the U.S. population) have diabetes. Of those, 23.1 million are diagnosed and 7.2 million are undiagnosed.

Furthermore, the same report estimates there are 84.1 million people (36.9 percent) with prediabetes. This is sometimes called "borderline" diabetes and is characterized by blood sugar levels higher than they should be but not in the diabetes range. The world health organization reported that 422 million people across the globe had diabetes as of 2014.

The incidence of type 2 diabetes rises as an economy develops. Thus, it is most prevalent in developed and developing countries. The International Diabetes Foundation puts the U.S. figure even higher than the National Diabetes Statistics Report, declaring that 10.75 percent of adults suffer from type 1 or type 2 diabetes, thus asserting that the U.S has the highest incidence of any of the developed countries.

 

Who will develop type 2 diabetes?

People are more likely to develop type 2 diabetes if -

 

There is also a higher incidence among African Americans, Alaska Natives, Native Americans, Asian Americans, Hispanic/Latino Americans, Native Hawaiians, and Pacific Islanders. (In the section that follows this article - titled "Diabetes taught me discipline and moderation" - you will find a list of the many actions you can take to impede or slow the progression of type 2 diabetes.)

 

About type 1

On the other hand, type 1 diabetes is a more serious and life-threatening condition. It is usually diagnosed in children and young adults, and has been known in the past as juvenile diabetes. Only 5 percent of people with diabetes have this form of the disease. Because the immune system destroys the cells in the pancreas that produce insulin, there is little or no insulin in the body available to do its necessary work.

People with type 1 diabetes require lifelong insulin therapy. The insulin cannot be taken orally because stomach enzymes will break it down, so it has to be taken by injection or with an insulin pump. There are many different types of insulin: short-acting, rapid-acting, intermediate-acting, and long-acting, and the therapy is tailored to the person. However, some of the same practices that help people with type 2 are also good for people with type 1, such as monitoring blood sugar, eating healthy foods, exercising regularly, maintaining a healthy weight, and paying close attention to carb and sugar intake.

 

Treatment

As stated above, the treatment program for people with type 1 diabetes is regular infusions of insulin. On the other hand, people with type 2 may be able to keep it under control with diet and exercise. Those who cannot will need medication, which may be insulin or more likely will be an oral drug.

The drugs for type 2 diabetes work in various and different ways to bring blood sugar to normal levels, such as increasing insulin production by the pancreas, decreasing the amount of sugar absorbed by the intestines, improving how the body uses insulin, or other actions. Some oral medications combine more than one of these actions.

 

Conclusion - simple, but difficult

Though type 1 diabetes is a serious and difficult disease requiring constant attention and effort, the easier-to-manage type 2 diabetes is the bigger threat across the world. A study published in 2011 by the American Diabetes Association reported, "Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Fueled by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles, the epidemic has grown in parallel with the worldwide rise in obesity. Asia's large population and rapid economic development have made it an epicenter of the epidemic."

Though the disease is progressing rapidly in Asia, it is still the U.S. that has the highest incidence of type 2 diabetes. And the healthy response is quite simple and also quite difficult. Eat a better diet, get more exercise, and lose weight. These are three ways almost all of us could enhance our lives and thus reduce the chance that we might develop type 2 diabetes, or, if we have it, improve our ability to slow its progress. And these are things that many contemporary Americans find hard to do.

• Find ways to be more active each day - at least 30 minutes, 5 days a week.
• Walk. This is something you can do almost anywhere at any time. See if you can find walking maps for your community.
• Ride a bike, swim, and even dance.
• Turn up the music and jam while doing household chores.
• Use work-out videos.
• Deliver messages in person to your co-workers instead of sending e-mails.
• Take the stairs at your office, not the elevator.
• Take a walk to catch up with friends rather than having lunch or using phone or e-mail.
• March in place while you watch TV.
• Walk in the mall if your streets are too busy or are unsafe.
• Get off the bus one stop early and walk the rest of the way home or to work.

• Reduce portion size as a way of controlling the amount of food you eat.
• Drink a large glass of water 10 minutes before your meal so you feel less hungry.
• Keep meat, chicken, turkey, and fish portions to about 3 ounces.
• Share one dessert.
• Use teaspoons and salad forks (small utensils) to help you take smaller bites and eat less.
• Make less food look like more by serving your meal on a smaller plate.
• Eat slowly. It takes 20 minutes for your stomach to send a signal to your brain that you are full.
• Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
• Try filling your plate with these ratios: 1/4 protein, 1/4 grains, 1/2 vegetables and fruit.

• Grow some of your own vegetables or shop at your local farmers market for fresh, local food.
• Make a list of foods you need to buy before you go to the store. Resist impulse buys, which are often processed and loaded with sugar.
• Eat a healthy snack or meal before shopping for food. Do not shop on an empty stomach.
• Buy a mix of vegetables when you go food shopping.
• Compare food labels on packages, and choose the foods that are lower in saturated fats, trans fats, cholesterol, calories, salt, and added sugars.
• If you cannot grow, find or afford fresh produce, buy frozen and low- sodium canned vegetables. They may cost less and keep longer than fresh ones.
• Stir-fry, broil, or bake.
• Cook with less oil and butter. Try using non-stick spray or low-salt broth.
• Cook with smaller amounts of cured meats (smoked ham, turkey and bacon). They are high in salt.
• Cook with a mix of herbs and spices instead of salt.
• Try different recipes for baking or broiling meat, chicken, and fish.
• Try not to snack while cooking or cleaning the kitchen.

What to eat

When you snack

 

"I am a type-2 diabetic, and they took me off medication simply because I ate right and exercised. Diabetes is not like a cancer, where you go in for chemo and radiation. You can change a lot through a basic changing of habits." 

Sherri Shepherd , comedienne, author, and TV personality.

Changing habits