If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin insensitivity or insulin resistance), or if the insulin itself is defective, then glucose will not be absorbed properly by the body cells that require it, and it will not be stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.
^ Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee D, Rosenson RS, Williams CD, Wilson PW, Kirkman MS (June 2010). "Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation". Diabetes Care. 33 (6): 1395–402. doi:10.2337/dc10-0555. PMC 2875463. PMID 20508233.
The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body. Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.
When 69-year-old Sandi, of Houston, was diagnosed with type 2 diabetes in 2007, she was confident she’d be able to manage the disease well. “I felt like, ‘I have this handled, it will be great,’” she recalls. Yet after the death of her best friend, five years ago, she started to experience anxiety and depression, and, she says, “it started manifesting more with my diabetes.”
The culprit in fungal infections of people with diabetes is often Candida albicans. This yeast-like fungus can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. These infections often occur in warm, moist folds of the skin. Problem areas are under the breasts, around the nails, between fingers and toes, in the corners of the mouth, under the foreskin (in uncircumcised men), and in the armpits and groin.
Low blood sugar (hypoglycemia) is common in people with type 1 and type 2 DM. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious effects such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases. Moderately low blood sugar may easily be mistaken for drunkenness; rapid breathing and sweating, cold, pale skin are characteristic of low blood sugar but not definitive. Mild to moderate cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon.
Diabetes can occur temporarily during pregnancy, and reports suggest that it occurs in 2% to 10% of all pregnancies. Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 35% to 60% of women with gestational diabetes will eventually develop type 2 diabetes over the next 10 to 20 years, especially in those who require insulin during pregnancy and those who remain overweight after their delivery. Women with gestational diabetes are usually asked to undergo an oral glucose tolerance test about six weeks after giving birth to determine if their diabetes has persisted beyond the pregnancy, or if any evidence (such as impaired glucose tolerance) is present that may be a clue to a risk for developing diabetes.
Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors, such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans. Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood.
People with type 2 diabetes have insulin resistance, which means the body cannot use insulin properly to help glucose get into the cells. In people with type 2 diabetes, insulin doesn’t work well in muscle, fat, and other tissues, so your pancreas (the organ that makes insulin) starts to put out a lot more of it to try and compensate. "This results in high insulin levels in the body,” says Fernando Ovalle, MD, director of the multidisciplinary diabetes clinic at the University of Alabama in Birmingham. This insulin level sends signals to the brain that your body is hungry.
Chronic pain can reflect injury that hasn’t completely healed. More often, it is caused by nerves that have become oversensitive or by a brain that is misreading the signals it receives. If acute pain goes on too long, nerves and brain can tire of the constant signals and just decide the injury is permanent. That’s why it’s important to treat acute pain seriously. For example, if you injure your foot or your back and don’t treat it promptly — with adequate rest, other first-aid measures, and seeing a doctor if the pain is severe or persists — mild pain can become severe, and acute pain can become chronic.
People with diabetes may also worry about trying new foods; traveling; diabetes complications; the toll the condition takes on their family; and healthcare costs, which are 2.3 times higher than for someone without diabetes. For Sandi, she worries about the cost of medication and, if her kidneys worsen, the possibility that she’ll have to go on dialysis. “That’s a really scary thought,” she says.
Acute pain is a lifesaver. Without it, we would have to watch out all the time to keep from injuring or killing ourselves accidentally. This is why people with diabetes are advised to check their feet visually or manually every day: If a person has peripheral neuropathy, particularly if it causes numbness in his feet, the acute pain nerves in his feet may not be working, and if they aren’t, they can’t warn him about injuries or other, normally painful foot problems.
It could have been confused for a sermon had he not been dressed in black-leather pants and cursed so much. And like many people, he’s not exactly aligned with Alcoholics Anonymous’s religious tone and bent, and so he has rewritten the 12 steps in more colloquial terms for anyone who wants to change, whether the addiction is to “eating badly or to bad jobs or to pornography.” Brand’s own 12 steps, projected on a slide, are:—Are you a bit fucked?
I just wanted to drop you a line and thank you for that post… My lab results at the beginning of the month were 230. After just this last week it’s down to 155. I think I’ll be in normal range within a month. Really miraculous… It’s really been a game changer for me already and I wanted you to know how much I appreciated the info and how much of a difference I think it will make in my life.
Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).
What are symptoms of type 2 diabetes in children? Type 2 diabetes is becoming increasingly common in children, and this is linked to a rise in obesity. However, the condition can be difficult to detect in children because it develops gradually. Symptoms, treatment, and prevention of type 2 diabetes are similar in children and adults. Learn more here. Read now