As the obesity epidemic rises, so have diabetes cases with the CDC now reporting half of all Americans are either diabetic or pre-diabetic. The new report looked at cases in 2015 and found 30.3 million individuals had diabetes and close to three times that number were pre-diabetic.
A variety of factors have contributed to this. Less people smoking and substituting food, junk food becoming a main staple in our diet, high-fructose corn syrup in many of our food products, genetics, and of course, less exercise and activity.
What is diabetes/prediabetes?
Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly. When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function. They get absorbed in the small intestine and make it to the blood stream. In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in. Its similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter. Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.
As discussed below, one has diabetes if his fasting blood sugar is greater than 126 mg/dl. A non fasting blood sugar greater than 200 mg/dl will also define one as being diabetic.
Prediabetes is assessed if one’s blood sugar is between 100-126 mg/dl. (See Chart Below)
So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway. Insulin is the key to open the cells’ “doors” allowing sugar to enter. If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell. Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, by bringing in more water. The kidneys are going to want to dump the excess sugar, so to do so, one would urinate more, again causing thirst. So when a diabetic loses weight, urinates more frequently and becomes thirsty, the body is fighting the hyperglycemia (high blood sugar).
Complications of Diabetes
Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.
Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst. Moreover, high blood sugar weakens blood vessels.
Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar-laden blood isn’t the healthiest when kidneys, themselves, need nourishment.
Infections – pathogens love sugar. Its food for them. Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.
Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.
Dementia – as with the heart and other organs, the brain needs healthy blood and flow. Diabetes has been found to increase risk of Alzheimer’s as well.
Type I vs. Type II Diabetes
Type I Diabetes, previously called Insulin Dependent or Juvenile Diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need. Insulin has to be administered regularly.
Type II Diabetes, previously called Non-Insulin Dependent or Adult-Onset Diabetes, occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance. This is the fastest growing type of diabetes in both children and adults.
What is insulin resistance?
Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance. Its also been associated with an increase in heart disease.
Blood sugar numbers
If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic. Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl. If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.
Experts predict 1/3 of US Adults will be full on diabetic by the year 2050. Although genetics plays a big role, decreasing one’s sugar intake and maintaining an active lifestyle can help ward off diabetes.
Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.
For more information, visit http://www.diabetes.org/.
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician