Last post we looked at how the body uses insulin to convert glucose to energy. Now let's look at what happens when things go wrong.
Type 2 Diabetes: Part II
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Insulin becomes less effective
When you're diabetic, your body still breaks down carbohydrates into glucose. The problem is that the cells fail to respond to insulin. In a normal body, cells are closed systems that rely on chemical 'signals' to allow molecules to pass in and out. Insulin is the signal that lets the body know a glucose molecule is safe to enter.
When a cell fails to respond to that signal, not only does that cell lose out on that source of energy, but now glucose levels begin building in the blood. This is called hyperglycaemia.
Hyperglycaemia
When your blood sugar rises, your kidneys try to filter out the excess through urine. This works in the short-term but as the diseases progresses the kidneys become overworked, and the increased need to urinate means you're often feeling thirsty. That half-litre of Evian you crave may be good hydration, or it may be a sign that your kidneys are working harder than they need to.
It's not only the kidneys; after a while the pancreas starts to tire out. That fine-tuning we discussed in Part I becomes a constant struggle to balance insulin levels to blood glucose, and eventually the body produces less and less insulin.
Dehydration
If you're noticing an increased need to urinate, particularly at night, you should think about diabetes testing. Not only are you losing vital elements through constant water loss, you're at the risk of increased headaches as well as tiredness or lethargy from the reduced glucose available to the body's cells. You'll also notice your skin becoming dry and itchy as less water is available to keep your skin moist.
Feeling hungry
The loss of energy eventually makes you seek out some calories; it can't be helped. One of the biggest risk factors for Type 2 Diabetes is obesity; fat molecules in the blood interfere with function of insulin, and you wind up eating more to make up for the shortfall in energy. Obesity isn't the only risk factor though...
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What are the biggest risk factors besides weight?
Fat distribution: If you store fat mainly in the abdomen, or are classically 'pear-shaped', you run a greater risk of Type 2 diabetes than someone with fat stored in the hips or thighs. For men with a waist circumference above 40 inches or women with a waist over 35 inches, that risk rises.
Inactivity: Using glucose for energy also keeps your body's cells more insulin-sensitive. Long walks to lose weight, or HIIT if you want to increase your cardiovascular fitness.
Family history: Unfortunately for you, if your parents or siblings have diabetes, there's every likelihood you may have it too. Part of it may be because of your Race or ethnicity: Although it's unclear why, certain people including Afro-Caribbean, Middle-Eastern and South Asian communities are often at greater risk. The rich, fabulous sweets may however be a factor!
Age: After 45, we tend to slow down and take less exercise, put on a little weight and lose muscle mass and tone. Plus, as our taste buds change we start developing a liking for warmer, richer foods and flavour combinations that are probably a lot less healthy than that salad we used to crave.
Well, diabetes doesn't sound so dangerous...
Left uncontrolled, diabetes can eventually lead to...
Heart disease: High blood sugar actually damages the arterial walls and the blood vessels of your heart, putting you at risk of stroke, high blood pressure and build-up of fatty deposits along your ever-narrowing artery walls.
Nerve damage: Also called neuropathy, you may feel loss of pain or pressure sensation (and not realise that Lego you stepped on that morning has now worked its way into your foot). It may affect your ability to sweat, resulting in dry, cracked skin that's vulnerable to splitting and infection. The reason that's bad is because you may also develop Poor wound healing: where a simple cut can take weeks or months to heal, again leaving your open wound vulnerable to infection.
As an unwanted bonus it's possible for diabetes to affect the the nerves that control digestion, causing problems with nausea, vomiting, diarrhoea or constipation. For men, erectile dysfunction may be rearing it's ugly head.
Kidney disease: The continuous strain on the kidneys will eventually wear them out, resulting in poorer quality blood and even slower healing if you suffer a cut. Eventually, kidney disease and dialysis.
Eye damage: Cataracts, glaucoma, and damage to the tiny the blood vessels of the retina, potentially leading to blindness.
I'm worried! What should I do?
If you think you may be diabetic, have a family history of diabetes or risk, the first thing to do is to see a professional!
There is a wealth of information out there on the internet and most of it is useful, but it may not fully apply to you or your circumstances. As with all medical advice, it needs context for you as the individual your are. While many websites offer good generalised advice, some sites or forums are actually quite misleading and in some cases may cause you more harm by promoting an unhelpful diet or supplement that is completely inappropriate for you.
So now you now a little more about how diabetes is caused, and the effects it can have on you. In our final part, we'll discuss how to go about getting a diagnosis, professionals who can offer assistance and useful items to keep in the home.