by Margaret Dedloff
Nearly 38 million people in the United States have diabetes, making it one of the most common chronic diseases, but what is it and what causes it? To understand what diabetes is, we first have to understand the function of the pancreas. The pancreas is an organ that produces enzymes that help with digestion and hormones that are sent all over the body. Two very important hormones produced by the pancreas are insulin and glucagon. These hormones help to maintain the blood sugar levels in our bodies. When we eat food, our body breaks the food down to its base components, one of which is sugar. Insulin helps to take sugar from the blood to be used in different bodily processes, like glycolysis which makes cellular energy (ATP). Glucagon raises your blood sugar levels when you haven’t eaten in a while (Figure 1).
Figure 1. When blood sugar (glucose) is high, the pancreas produces insulin, which helps to remove sugar from the bloodstream, resulting in decreased blood sugar. When blood sugar is low, the pancreas produces glucagon, which helps to raise blood sugar. Figure made by author in BioRender.
Diabetes is when your body either doesn’t make insulin or your cells don’t respond to insulin anymore. This means that there is too much sugar in your blood. Having too much sugar in your blood is called hyperglycemia, which can lead to serious damage to your body over time. Long-term hyperglycemia can cause kidney damage, vision loss, damage to nerves and blood vessels, and heart disease.
There are three different kinds of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. Type 1 diabetes is when your body does not make insulin, or does not make enough insulin. Scientists still don’t know the cause of type 1 diabetes, but it may be caused by an autoimmune reaction, meaning that the body is attacking itself. Type 2 diabetes is when your body doesn’t respond properly to insulin. This is called insulin resistance (Figure 2). While the exact cause of type 2 diabetes is unknown, high body weights and being inactive are important contributing factors. Type 1 diabetes usually develops earlier in life, while type 2 diabetes typically develops later in life, but can develop during childhood.
Figure 2. People with type 1 diabetes don’t make insulin, while people with type 2 diabetes can make insulin, but don’t respond to it. Figure made by author in BioRender.
The third type of diabetes is gestational diabetes. Gestational diabetes is a type of diabetes that can occur during pregnancy in people who don’t have diabetes. In the United States every year 2 to 10% of pregnant people will develop gestational diabetes. Gestational diabetes, like type 2 diabetes, is typically caused by insulin resistance. Gestational diabetes can lead to gestational hypertension and can cause an increased risk to the baby for being born earlier, being larger than 9 pounds, having low blood pressure, and developing type 2 diabetes later in life. The pregnant person is also at higher risk for developing type 2 diabetes if they are diagnosed with gestational diabetes.
While there isn’t any cure for any type of diabetes there are treatments. Healthy eating and being active can help improve symptoms for all types of diabetes. Treating type 1 diabetes requires monitoring blood sugar and taking insulin when necessary. Treatment for type 2 diabetes can be more varied. Type 2 diabetes can be managed with different oral medications as well as monitoring blood sugar and taking insulin when needed (Figure 3). Diabetes is a very serious chronic illness, but modern medicine and blood sugar management practices have made it so that people with diabetes can live normal lives!
Figure 3. Different treatments for diabetes, including (left to right) oral medications, blood sugar monitor, and insulin pens. Image source.
