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Written By Tony Subia
Nov 29, 2021

Introduction: Navigating the Complexities of Diabetes Mellitus

Diabetes, a multifaceted health problem, extends beyond the commonly known Type 1 and Type 2, encompassing Type 3 (Alzheimer’s related) and Type 3c diabetes. Each type presents unique challenges and symptoms, ranging from excessive thirst and slow wound healing in Type 1, often linked to juvenile onset, to insulin resistance in Type 2, predominantly associated with obesity, aging, and lifestyle changes. Type 3 diabetes, tied to Alzheimer’s disease, highlights the increased risk of cognitive decline in those with Type 2 diabetes, while Type 3c stems from pancreatic damage, often mistaken for Type 2. Understanding these types is crucial for effective diabetes care, involving insulin injections, glucose monitoring, and, in severe cases, transplantation.

Managing diabetes mellitus involves more than just addressing high blood sugar levels; it requires a comprehensive approach encompassing lifestyle modifications, healthcare provider guidance, and monitoring potential complications like kidney disease, neuropathy, and cardiovascular issues. Prediabetes and obesity significantly elevate diabetes risk, underscoring the importance of a healthy lifestyle, controlled body weight, and medication like metformin. Recognizing the signs and symptoms of diabetes, understanding its causes, and implementing changes advised by healthcare providers are key to mitigating the health problems associated with this condition. This article delves into these aspects, aiming to empower individuals with knowledge and promote proactive health management.

What Are The Types of Diabetes?

Most people think there are two types of diabetes. In fact, there are actually 4.

Diabetes is a complex condition with several types, each with unique characteristics and causes. Diabetes can be categorized into Type 1, Type 2, and Type 3, and Type 3c diabetes.

Type 1 diabetes arises due to the body’s inability to produce insulin as a result of the immune system’s assault on insulin-producing cells. Typically, it manifests suddenly and is often diagnosed during childhood or adolescence, though it can emerge at any age. Risk factors are primarily associated with age and family history, with lifestyle choices playing no role in its development. Common symptoms include excessive thirst, frequent urination, fatigue, blurred vision, mood swings, increased hunger, numbness, and slow wound healing, and the condition can progress rapidly from mild to severe.

Type 2 diabetes differs in that the body still produces insulin but becomes increasingly resistant to its effects over time, hampering glucose absorption. This form of diabetes tends to develop gradually, often spanning several years. Risk factors encompass lifestyle choices (such as an unhealthy diet, lack of physical activity, and obesity), age, family history, high blood pressure, elevated triglyceride levels, low HDL cholesterol, and a history of gestational diabetes. Symptoms are akin to Type 1 diabetes but emerge more gradually and frequently remain undetected until complications arise. Type 2 diabetes typically surfaces later in adulthood.

Type 3 Diabetes (Alzheimer’s Related), sometimes referred to as Alzheimer’s disease in individuals with diabetes, underscores a strong connection between Type 2 diabetes and Alzheimer’s. Having Type 2 diabetes doubles the risk of developing Alzheimer’s, with other risk factors including a family history of the disease, poorly controlled blood pressure, obesity, and sleep apnea. Physiologically, high blood sugar levels contribute to inflammation, which in turn promotes the formation of amyloid plaques and tau tangles in the brain, hallmarks of Alzheimer’s. Insulin resistance further impedes blood flow and glucose utilization in the brain, negatively impacting cognitive function.

Type 3c diabetes is linked to damage to the pancreas, commonly resulting from conditions like chronic pancreatitis or cystic fibrosis, which impede insulin production. Additionally, it often involves a deficiency in pancreatic enzymes necessary for digestion. It accounts for 1% to 9% of all diabetes cases and can be misdiagnosed as Type 2. The amount of insulin production can vary, necessitating management through oral diabetes medications or insulin therapy.

What is Diabetes?

The most common types of diabetes are Type 1 and Type 2.

In Type 1 Diabetes, the body makes very little or no insulin at all and people with Type 1 Diabetes must take insulin every day. Type 1 Diabetes is “insulin dependent” and is most often diagnosed in infants and young children. That’s why Type 1 Diabetes has often been referred to as “juvenile diabetes”.

In Type-2 Diabetes, the body prevents insulin from working the way it should. The body may make some insulin but not enough. About 90% of people with diabetes have Type 2. This type of diabetes is called “insulin resistant” and happens in older adults, particularly those who are overweight.

What Causes Type 1 Diabetes?

Even though the exact cause is unknown, In Type 1 Diabetes, cells from the body’s immune system attack the insulin making beta cells of the pancreas without symptoms or pain over a period of months or years, the beta cells are killed. As a result, the body does not have enough insulin.

Normally, Insulin helps the cells of the body take sugar out of the blood, cells use the sugar as fuel. Without insulin, sugar builds up in the blood. This can harm blood vessels. It can also cause heart disease, blindness and kidney failure. To keep these things from happening, people with Type 1 Diabetes take insulin several times daily. Most people with Type 1 Diabetes are diagnosed around the age of 12.

What Causes Type 2 Diabetes?

In Type 2 Diabetes, the body either does not make enough insulin or is not able to use it properly.

Type 2 Diabetes usually begins with insulin resistance. This is when the cells can’t use insulin properly. As explained earlier, insulin is a hormone made within the “Endocrine Function of The Pancreas”, a gland behind the stomach and near the small intestines.

Special cells in the pancreas called “Beta cells” make the insulin the body constantly checks how much sugar is in the bloodstream. When blood sugar levels rise beyond a certain point, the body signals the Endocrine portion of the pancreas to release insulin. Insulin helps the cells use sugar.

The diagnosis of Type 2 Diabetes is when not enough insulin is available, either because the pancreas can no longer keep up with the demand or because the body can’t use the insulin that is produced.

Let’s take a closer look…

Cell walls have little locks called Receptors. Insulin fits into those locks like a key. When insulin opens the locks, sugar is allowed to enter the cells.

When the body is not able to make enough insulin, blood sugar is locked out of the cells. Sometimes the locks change in shape, then the insulin can no longer fit into them. Either way, blood sugar is locked out of the cell. It stays in the bloodstream, and the levels can become too high, causing “hyperglycemia” which can lead to the symptoms of diabetes.

When cells cannot get sugar, they no longer have the fuel they need. The pancreas tries to make up for this by working harder. At first, the pancreas keeps up by making more insulin. In time, the pancreas is unable to continue doing this, which is when the symptoms of diabetes begin to occur.

As a result of these changes, your physician may discuss starting a diabetes care plan with you.

Diabetes Care Plans Can Include The Following

> Taking injections of insulin or diabetes medicines.

> Eating a carefully planned diet.

> Exercising regularly.

> Controlling blood pressure and cholesterol.

> Possibly taking aspirin daily..

Some Common Signs and Symptoms of Diabetes

> Urinating often.

> Being thirsty more often than usual.

> Being hungry more often than usual.

> Unusual weight loss without trying.

> Being tired more often than usual.

> Blurry vision.

> Wounds that won’t heal or heal very slowly.

> Numb or tingling hands or feet.

> Having very dry skin.

> Frequent infections.

The symptoms of Type 1 Diabetes can have a faster onset and be more dramatic, whereas the symptoms of Type 2 Diabetes can be more difficult to detect. High blood sugar also called “Hyperglycemia” can happen if you:

> Skip a dose of insulin or diabetes pills.

> Eat more than usual.

> Are less active than usual.

> Are under stress or sick are taking certain medications.

The best way to avoid high blood sugar is to follow your diabetes care plan. Ask your diabetes care team when it is appropriate to call their office with your blood sugar results.

What is Low Blood Sugar?

Signs and symptoms of low blood sugar can include:

> Feeling nervous, shaky, light-headed and anxiety.

> Unusual sweating,

> Becoming sleepy and lethargic.

> Feeling confused or disoriented.

Things That Can Cause Low Blood Sugar

> Taking certain medications. Check with you family doctor.

> Eating too few carbohydrates,

> Skipping meals too often.

> Becoming more physically active than usual.

> Taking too much insulin or diabetes pills.

If You Think You Have Low Blood Sugar

> Have your blood sugar level checked right away.

> Discuss the results with your physician.

Most blood sugar (glucose) comes from carbohydrates which sugars and starches found in grains, beans, vegetables, fruit, milk products, honey, and sugar itself.

If you do not have diabetes and are feeling the signs and unpleasant effects of a sudden drop in blood sugar, eat foods or drinks that contain carbohydrates.

If you have been diagnosed with diabetes, hypoglycemia can strike suddenly and must be treated urgently before the symptoms become worse. Eat or drink foods or drinks high in carbohydrates that can be quickly digested to counter the symptoms. It is important to consume foods and drinks with at least 15 to 20 grams of sugar or carbohydrates which can include the following:

> 1/2 cup of fruit juice.

> 1/2 cup of non diet soda pop.

> Two tablespoons of raisins.

> A tablespoon of honey.

> 1 cup of milk.

> A few pieces of hard candies.

> Several wheat or saltine crackers.

> A tablespoon of sugar.

Once your blood sugar returns to normal, eat a meal or snack. This can help keep low blood sugar from coming back. Always check with your diabetes care team for instructions on how to best treat low blood sugar.

What is Blood Sugar Testing? And Why is It Important?

Checking your blood sugar yourself is one of the best ways to be sure your diabetes is under control.

> If your insulin or other diabetes medicine is working.

> If your insulin or other diabetes medicine is working.

> How physical activity and the foods you eat affect your blood sugar.

> You’ll usually feel better and have more energy when your blood sugar stays at or near normal.

> Managing your blood sugar can also reduce your risk of developing problems from diabetes.

> Use an approved blood sugar monitor.

It’s important to write down your blood sugar levels so that you can keep track of what makes them go up or down. If you are often out of the desired range, it might be time to change your diabetes care plan. Working with your doctor will help you to better understand your numbers.

What is An A1C Test?

The A1C test measures your estimated average blood sugar level over the past 2 to 3 months. It shows you how well you’re controlling your blood sugar levels. Lowering your A1C to below 7% reduces your risk of problems from diabetes.

It is recommended that you get an A1C test at least two times a year if your blood sugar is under control.If not under control consistently, get tested every few months.

Your Diabetes Care should come from a team put together by your doctor. Your diabetes care team may include an eye doctor, a dietician, and other specialists recommended by your family physician.

How Is Diabetes Related To The Pancreas?

Diabetes is a chronic disease. It is caused when the “Endocrine Function” of the pancreas either does not produce enough insulin, or none at all. Insulin is a hormone which functions like a key that permits sugar (glucose) from the food we eat to pass from the bloodstream into the body’s cells. Once sugar (glucose) reaches the inside of each cell it is converted to energy for immediate use by the cells or the sugar is stored in the liver for future use.

Simply, if the Endocrine Portion of the Pancreas does not produce any, or enough insulin, it leads to excessively raised levels of sugar in the bloodstream known as “hyperglycemia” which characterizes diabetes. The insufficient production of insulin or the resistance to the actions of insulin will result in a form of diabetes.

You can look at this way. Insulin lowers blood sugar levels by helping sugar move from the  bloodstream into the body’s cells. In addition to insulin, there is also another hormone made by the pancreas called Glucagon that tells the liver to release stored sugar if your blood sugar gets too low, or if you have not eaten for many hours. Low blood sugar is called “Hypoglycemia“versus “Hyperglycemia” which is high blood sugar.

Therefore, the hormones of insulin and glucagon are designed to work as a team to efficiently maintain healthy levels of blood sugars. If the system breaks down, the result can lead to “Diabetes”. One of its primary action is to stimulate the beta cells in the pancreas to produce insulin when your blood sugar is too high. It also helps to lower the amount of sugar made by the liver.

Diabetes cannot yet be cured, but it can be managed. This article gives you some important tips on how to help manage diabetes.

Conclusion: Addressing the Diverse Challenges in Diabetes Management

The multifaceted nature of diabetes, including gestational diabetes and its various risk factors, underscores the need for personalized care and preventive strategies. Family history plays a crucial role in the risk of type development, with certain ethnic groups, such as Asian American, African, and Hispanic populations, facing a higher risk. These groups must be vigilant about the causes of type 2 diabetes, particularly considering the additional risks associated with obesity and high BMI. Complications such as nerve damage, retinopathy, and the severe condition of diabetic ketoacidosis, often aggravated by factors like high blood sugar levels and polycystic ovary syndrome, further highlight the need for early detection through a blood test and ongoing glucose tolerance monitoring. The American Diabetes Association emphasizes the importance of understanding these risks to prevent serious outcomes, including heart attack and amputation, which are more prevalent among certain ethnicities like Pacific Islanders.

In conclusion, diabetes management requires an all-encompassing approach, taking into account individual risk factors and the unique challenges faced by various ethnic groups. Regular monitoring through blood tests, understanding the signs such as blurred vision, and adhering to guidelines set by the American Diabetes Association are vital. Addressing lifestyle factors, recognizing family history, and being aware of conditions like gestational diabetes are key in reducing the overall risk and preventing severe complications. By adopting a proactive and informed approach towards diabetes management, individuals can significantly lower their chances of developing serious health issues, ensuring a better quality of life.