The Sugars

Over 9% of Americans suffer from diabetes. However, one quarter of these diabetics remain unaware of their diagnosis. Are you one of them?

Let's keep this short and sweet: the cause, diagnosis and treatment of type 2 diabetes.

 

Cause

Quite simply, overeating and inactivity lead to type 2 diabetes. Being overweight/obese is one of the leading risk factors for developing diabetes. 

Insulin allows cells to import glucose from the bloodstream. Insulin resistance--when cells stop responding to this signal to import sugar--is the first stage of the disease. The result is excessive sugar in the bloodstream, which is eventually wasted through the urine. Hence, the first symptoms of diabetes are excessive urination and thirst.

Why do these cells ignore insulin? If a ship were at maximum capacity, should the captain allow additional passengers to board? In the setting of caloric excess--someone being overweight or obese--it doesn't make sense for cells to import sugar when energy reserves are already maximized. In this sense, insulin resistance is a protective mechanism against excessive storage of energy, aka obesity.

 

Diagnosis

The hemoglobin A1C--or simply A1C--is a blood test measuring the average blood sugar over the past three months, the approximate lifespan of red blood cells in your body. Results are classified as Normal (5.6 and below), Prediabetes (5.7 to 6.4) or Diabetes (6.5 and above). The A1C is different than a simple fingerstick which measures the blood sugar at that exact moment in time.

 Red blood cells are coated in sugar proportionate to the amount of glucose floating in the blood stream. In the setting of insulin resistance, sugar is not imported into cells but rather remains in the blood, thereby elevating blood sugar.

Red blood cells are coated in sugar proportionate to the amount of glucose floating in the blood stream. In the setting of insulin resistance, sugar is not imported into cells but rather remains in the blood, thereby elevating blood sugar.

 

Treatment

Weight loss. The most effective treatment for diabetes is to reverse the cause: being overweight or obese. Eating a plant based diet and walking are the pillars of weight loss.

Non-insulin medications. There are a variety of oral and injectable medications to control blood sugar, by increasing sensitivity to insulin or decreasing glucose production in the liver. The first line treatment is metformin, which helps promote weight loss.

Insulin.  Pharmaceutical insulin functions just as your pancreas' insulin does: moves sugar from the bloodstream into cells. This achieves the goal of lowering blood sugar, but reinforces the primary problem: weight gain. Sugar previously wasted through the urine will be imported into cells and stored as fat. Insulin should be an absolute last resort treatment for uncontrolled blood sugar. Once insulin therapy is initiated, weight loss proves exceedingly difficult.