1. FOUR (not one) TYPES OF DIABETES
Though Type 2 Diabetes accounts for almost 90% of the Diabetes cases diagnosed each year across the globe; Pre-diabetes, Type 1 Diabetes, and Gestational Diabetes are the three other types of Diabetes. All four types exhibit several common signs and symptoms and also some distinct traits –
- Pre-Diabetes or Metabolic Syndrome:
Body begins to show the first signs of impaired glucose tolerance. Body is still producing Insulin, but can’t use it properly, given the insulin resistance, that would have been built over the preceding years. The blood glucose levels are elevated just beyond the normal range, but don’t yet feature in the diabetes range. Nevertheless, if risk factors of Type 2 Diabetes are in place, be assured that you are on your way to getting a full blown Diabetes soon. This stage, if diagnosed early enough, should ring alarm bells to bring in immediate and drastic lifestyle changes including rigorous physical exercise, appropriate diet and weight reduction so that type 2 diabetes can be staved off.
- Type 1 diabetes:
It is an autoimmune disease in which the immune system, by mistake, attacks its own insulin-producing cells, β cells in pancreas. The autoimmune attack occurs over time and by the time the patients first presents, 80-90% of β cells would have been already destroyed. In most cases, over 90% of the cells are dead, leading to no or very little insulin. The incidence of this type is around 5-10% of all diagnosed diabetes patients around the Globe with the most frequent age of onset between 10 and 14. For the early onset and complete dependence on external Insulin supplements for a lifetime, this crippling disease is also called as “Juvenile Diabetes” or “Insulin-Dependent Diabetes Mellitus” (IDDM).
Type 1 can set in some adults over 25 and is sometimes called as “slow-onset type 1” or “latent autoimmune diabetes in adulthood” (LADA) or “type 1.5 diabetes”. To distinguish this from type 2 diabetes, a key test employed is to detect the level of certain antibodies (ICA and GAD) that attack the β cells in Type 1 Diabetes.
- Type 2 diabetes:
Insulin resistance is the show stopper for Type 2 diabetes or “Non-Insulin Dependent Diabetes Mellitus” (NIDDM) or “Adult-Onset Diabetes”. Though occasionally it can occur in children and adolescents (visualize morbid obesity), the commonest age bracket is post 30, with the strike rate going up steeply with advancing age.
- Gestational diabetes:
Certain Pregnancy-related hormones interfere with the function of insulin and some women develop hyperglycemic states during late pregnancy, which if not managed adequately, can have deleterious impact on the mother and the fetus. In addition, women who recover from gestational diabetes, post child birth, have considerably higher incidence of Type 2 diabetes, later on in life, than compared to normal women.
2. TOO HIGH GLUCOSE OUTSIDE CELLS
Given the current milieu of over-consumption, the average amount of glucose inputs (carbohydrates) being fed into our bodies far exceed the normal digestible and storable limits. Low physical activity, in addition, compounds this hyperglycemic states by blocking the outlet to burn this surplus glucose.
In normal conditions, liver stores the surplus glucose as glycogen; however, once the storage capacity is full, glucose spills over into the blood and also gets converted into fat and stored across body. Obesity sets in and with fat stores across the body triggering marked Insulin resistance, the stage is truly set for Type 2 Diabetes.
Insulin resistance is the crux of Type 2 Diabetes. The insulin receptors aren’t very receptive to Insulin anymore. Beta cells in Pancreas are pushed to their limits to keep on producing high amounts of Insulin to surmount the resistance. However, the resultant high Insulin levels would only augment the Insulin resistance which further squeezes beta cells to produce more Insulin. As you see, there is a vicious cycle in operation and very soon the Pancreas gets burnt out and Type 2 Diabetes begins to resemble Type 1 Diabetes.
Compromised Insulin function during states of Insulin resistance (early Type-2 Diabetes) combined with inadequate Insulin in the latter stages (overworked beta cells in late Type-2 Diabetes) or absence of Insulin (Type-1 Diabetes) compounds this hyperglycemic state by letting even more glucose float in the bloodstream instead of aiding its absorption by the cells and leads to persistent hyperglycemia or Diabetes. The high blood glucose leads to extensive cellular and microvascular damages in kidneys, liver, heart, nerves and eyes before it is excreted out of the body in urine. Imagine this happening on a daily basis, and over say 5-10 years, the organ damage will truly become irreversible.
3. TOO LITTLE GLUCOSE INSIDE CELLS –
Insulin resistance emasculates Insulin from pushing Glucose into the cells. This lowers the ready availability of Glucose inside cells. Glucose is a key precursor to ATP (fuel) inside cells. This explains the persistent fatigue, increased hunger (polyphagia) through the day for most Diabetics.
Make no mistake; the elevated blood Glucose is only a symptom and not the disease. The disease is Insulin resistance and high Insulin levels. The solution is to strike at the heart of the problem, the glucose input stage (err, Eating) to break the Insulin resistance, reduce Insulin levels, restore pancreas function or give it a break from producing Insulin and let it rejuvenate. This is curing or reversing Diabetes and we’ll talk about the solution in detail later on.