One thing I notice as a dietitian and diabetes educator is a simple truth. Whether you have had diabetes for 20 seconds or 20 years, you do not know or understand what exactly is going on with your body. If you do, you are few and far between. Your doctor may or may not have taken some time to explain the new diagnosis hanging on your neck, you may or may not have taken some time to utilize Doctor Google, OR you started taking medication/insulin without even batting an eyelash. No matter where you are now, I hope this article finds you and increases your understanding of the mountain you are currently facing, the big D.
Since I also carry a CDE credential I decided to sneak in some diabetes blogs. In this first diabetes blog I want to address the different types of diabetes, type 1, type 2, and gestational diabetes. Endocrinologists have decided there are some other types evolving, but for simplicity of this educational based post, let us stick to the basic three. I would like to insert a sarcastic moment at this point. Why do we name medical conditions in such a way no one really understands the true issue at hand? Might as well name the conditions dinosaur names, which would be just as lacking in information as to what the client or patient is now facing! Moving on.
Type 1, the insulin dependent diabetic.
You did nothing to cause this, the stats say you make up about 5% of diabetes cases, and you were hit in the face hard, fast, and young! This type of diabetes has been classified as an autoimmune disorder. For some reason or another, your body decided to attack itself. And in the case of the insulin dependent type 1 diabetic, the body destroyed the beta cells of the pancreas. So what? Well, hang tight with me and towards the end of the article I will explain just what those beta cells do for your body. Type 1 diabetic, as indicated by the name, have to take insulin to survive, “dependent”. Medications do not control the condition, only insulin controls the blood glucose (another word for sugar). The development of this type usually occurs under the age of 30, with some outlying cases of course. And can be diagnosed as young as baby/toddler years. Type 1 diabetes is a lot of why you see young children with insulin pumps, or pens, or even syringes and vials.
What a trial? Learning to manage your blood sugar at a young age. Trial for parents and children. Or if diagnosed a bit later, fumbling through a life or death condition while providing for the family. There are so many aspects of life which impact blood sugars, and a type 1 diabetic will experience it all. They have to fight the hard fight for a very long time. Insulin pumps help, but still. Can you imagine telling a teenage boy he has to manage his portion sizes? Or a teen girl her hormones are going to impact her blood sugar and there is little she can do other than dose insulin correctly? Can you imagine being at work on a forklift and realizing the stress you are going through is what is causing a massive high on your meter each day and you need to learn to cope because the amount of insulin you are burning through is difficult to purchase, even with insurance??? Makes me want to scream for you.
Type 2, the insulin resistant diabetic.
This type of diabetes is completely different from the what was just outlined. A type 2 diabetic is usually diagnosed a bit later in life, unfortunately, the truth now is the diagnosis is coming younger and younger. It use to be “over the age of 60” you are likely to develop type 2 diabetes, then “over the age of 50”, then 40, to now 30 years old and now even our kiddos.
Big deal you say, well let me draw the painful picture for you. Diabetes is not about the now version of self, rather, the ten to fifteen year and on version of you. The diabetes complication list is scary and long. Without proper management this PROGRESSIVE condition will bite you in the fanny!! The list begins with nerve damage and continues to heart attacks, blindness, and loss of limbs! And instead of having to fight the illness for 20-30 years as a 60 year old diagnosed, now you will have to fight it and its life altering complications for 40+ years!!! And working class folks, I don’t know about you, but health can really slow you down. I just do not have time for that, I have to provide for my family. So, now that you have a better understanding of the impact, back to the description of our current type.
As a type 2 diabetic you encompass about 95% of the current diagnosed individuals and there are what’s called modifiable and non-modifiable risk factors. See, many people will say, “oh it is in my family, so of course I have it.” Well let me put a stop to this all encompassing statement right now. Yes, if diabetes is in your family you have a genetic predisposition or likelihood to develop diabetes, BUT it does not mean you are absolutely destined to have diabetes OR it is the sole reason you developed the condition. See, you can have a genetic predisposition (non-modifiable risk factor), but you can manage the modifiable risk factors to prevent diabetes from presenting itself or at least delay the arrival to your life party. Yes, it is true. Part of this may be lifestyle. Pause. Do not shame yourself for living unhealthy, life hits and it hits hard. Coping mechanisms include all of the modifiable risk factors, and sometimes it is just too much to deal with one more aspect of life. But do realize your choices then could have impacted the now. For example, ask yourself the following questions, “Did you exercise? Did you manage your nutrition appropriately? Did you smoke? Did you drink too much?” All of these questions are the weapons in your tool belt now against diabetes and the ravishing complications (watch for future posts discussing this aspect).
A common aspect regarding type 2 diabetics diagnosis story includes, not quite feeling yourself. Noticing a few of the signs and symptoms, but not knowing what they could possibly mean, going to the doctor and finding yourself completely shocked at the words coming out of their mouth, “you have type 2 diabetes”. Common early signs of diabetes include: frequent urination, frequent thirst, frequent hunger, fatigue, unexplained weight loss or gain, slow healing, excess sleep, difficulty sleeping, and blurred vision. All of which can be confused with the fast paced lifestyle most of us maintain.
With type 2 diabetes, you are insulin resistant, which means the pancreas beta cells still produce insulin, but your body has developed a resistance to what you make. How? Well what happens when you are overworked and underpaid? YOU QUIT. Well, your beta cells have been worked hard and are continuing to work extremely hard to keep up with the blood sugar. Eventually they begin to die off, no longer making the same amount of insulin you once did. A type 2 diabetic can progress to the need of insulin, this is when all the beta cells have died off and you are no longer making your own insulin.
Why does your body become insulin resistant you ask? Many factors contribute to this, but one to address would be fat cell size. When you gain weight you do not get more fat cells, your fat cell size increases. Once the fat cells reach a certain size, varies for everyone, they begin to produce “stuff” which blocks the action of insulin. Not all fat does, certain fat cells do. Particularly in the middle, your abdomen. See the extra rolls/inches you see on the outside are a representation of what is going on inside the body. The fat surrounding your organs is biologically active, producing hormones and plenty of other health harming items. So a common, but not always the case story, I gained weight, then I got diabetes. Well Bob is 400lbs and he doesn’t have diabetes, how do you explain that lady? Simple, he does not have the genetic predisposition you do, insert the likelihood to develop. Maybe Bob is more likely to have a different life altering illness? Who knows where his genetic predisposition is leading him.
The third type of diabetes I would like to discuss includes, gestational diabetes.
Gestational is very similar to type 2 diabetes in the aspect it is a form of insulin resistance. The major difference is the insulin resistance causing aspect, the placenta. So once the baby is born and placenta leaves the picture, boom. Diabetes gone. BUT you are not out of the woods sister Sue. If you developed gestational diabetes you far more likely to develop type 2 diabetes in the upcoming years. And it is not a great distant future type deal either.
Remember the beta cells and pancreas?
Let me explain this pretty simply as well. Every time you eat, whatever it may be, if it contain carbohydrates, your body will break it down to glucose. Glucose is the gasoline in the tank of the engine known as the human body. Every single cell in the body needs glucose to survive. Well in the digestion process, the glucose molecules are absorbed into the blood in the small intestine. Once in the blood, glucose molecules must move to their final destination, the inside of the cell. Well the glucose does not just walk up to the cell, say hi and move on in! The cell has a membrane which protects it from all the junk which passes by in the blood stream, and believe me, there is plenty of bad stuff floating on by the cells.
In order for the glucose to get inside the cell, insulin has to open the gates of the cell. Once insulin opens the gates of the cell, the glucose can move to its final destination rather than lingering in the blood stream, causing issues. Well, if there is no insulin, there are no open gates. If there are no gates opening, the glucose (sugar) remains in the blood stream, not feeding the cells as it should. Insulin is made in the beta cells of the pancreas, so if the cells are destroyed or dying off, boom, no insulin. No insulin, blood sugar rises, insert diabetes once blood glucose/sugar hits a certain number.
I hope you have found this post educational. The purpose behind doing these type of posts is to inform those who may not be informed. Diabetes cannot be cured. Diabetes CAN be managed and controlled. The stories you hear of lost limbs, blindness, and other issues are the repercussions of uncontrolled diabetes. Controlling diabetes can be one heck of a task, especially alone. Subscribe to the blog for more super informative diabetes snippets! Difference between pre diabetes and diabetes, nutrition, blood sugar monitoring, medication, insulin, complications, all to come! Want even more than these tiny snippets? Email me to set up an appointment, near or far we can meet your needs. Not ready to commit to an appointment, how about joining the Foodie Club portion of this site for helpful recipes and tips!
Lydia Sartain, MS, RD, LD, CDE