What is diabetes?
Diabetes is defined as having too much sugar in the blood stream. There are
two major types of diabetes, type1 and type 2. There are some management
differences, especially with medications. But management of
cholesterol and blood pressure are all important factors in the treatment of
diabetes, whether it’s type 1 or type2. Diabetes is a “risk equivalent” for
heart disease. That means that someone with diabetes who has never had a heart
attack, has a similar risk for a heart attack as someone without diabetes who
has had a heart attack. Therefore recommended values for cholesterol and blood
pressure are tighter for people with diabetes than for non-diabetics who have
the same risk factors.
Type 1 diabetes
Type 1 diabetes accounts for only about 5-10% of diabetes. It is the result
of an autoimmune process that destroys the cells in the pancreas that make
insulin. Insulin is needed to move sugar from the blood stream into body cells,
where the sugar can be used for energy. When there is not any insulin produced,
sugar is ‘trapped’ in the blood stream, and cannot be used for energy. Type 1
diabetes is always treated with insulin. Insulin cannot be given as a pill, so
it is injected, inhaled, or administered through an insulin pump.
Type 2 diabetes
90-95% of diabetes is type 2 diabetes. There are multiple processes related
to sugar metabolism and fat metabolism that become disordered in type 2
diabetes. Insulin resistance is at the core of these disorders. Insulin
resistance is a term referring to a decreased sensitivity of body cells to
insulin. Body cells don’t respond well to insulin signals to move sugar into
cells; the pancreas responds by producing more insulin to get the job done.
Eventually the pancreas cannot keep up with the increased demand for insulin, it
begins producing less insulin and blood sugar levels in the blood stream start
to rise. Additionally, the liver further increases the amount of sugar in the
blood by releasing too much stored sugar into the blood stream.
Healthy eating and adequate activity are the corner stones of treatment for
type 2 diabetes. Some people with type 2 diabetes can control their disease
without medications. Many people with type 2 diabetes need medication, or
multiple medications, to control blood sugars, blood pressure and blood lipids.
Find out if you are at risk for type 2 diabetes.