Diabetes is a common but complex diagnosis. There are multiple types of diabetes, the most common being type 1 and type 2. We will focus on type 2 in this post.
When someone has type 2 diabetes, their body’s relationship to a hormone, called insulin, is out of balance.
Insulin is made by your pancreas, and it is a hormone your body uses to regulate the amount of sugar in your blood (also known as glucose, or energy, but we will simply call it ‘sugar’ from now on). When you eat food, that food is digested, and your body turns it into sugar. What you eat influences how much and how quickly the food turns into sugar, but we’ll save that for another post.
As sugar from your digesting food enters your bloodstream, your body senses the sugar and takes certain steps to get that sugar from your bloodstream into your cells, where it can be used. Sugar is useless in the bloodstream – it MUST be moved from the bloodstream into your cells to fuel you. How does your body move sugar into your cells? Insulin.
Literally! Insulin is a molecule that has a specific shape to perfectly fit into receptors on the surface of your cells. These receptors act as “locks” to the doors that allow sugar to go from your bloodstream to your cells. Only then can the sugar be used as energy.
(Shown above: insulin opening the locked gate on cells, allowing glucose/sugar in)
a. The locks on cells stop working as well, so the keys (insulin) can’t let the sugar into cells
b. There are not enough keys (insulin) to open the locks on cells, so sugar can’t get into cells
a. The locks on cells stop working as well
This phenomenon is called “insulin resistance.” The “locks” on cells are not sensing that insulin is present. They are resistant to being unlocked by the “key.” When this happens, the sugar in your bloodstream (which we get from food), is unable to get into cells, where it needs to go to be used as energy. The sugar builds up in the blood.
b. There are not enough keys (insulin) to open the locks
In type 2 diabetes, insulin resistance occurs (described above). Insulin is released when the body senses that there is sugar in the blood after a meal. However, because insulin resistance is occurring, sugar builds up in the blood with nowhere to go. The body senses that there is still too much sugar in the blood, and so it releases more and more insulin in response. The pancreas, which is the organ that makes and releases insulin, ends up working overtime. Eventually, the pancreas gets tired and cannot keep up with the body’s demand for more and more insulin as blood sugar remains high, meal after meal. This is often referred to as “pancreatic exhaustion.” When this happens, the pancreas stops working as well, and not enough insulin can be produced. The cycle continues in this way, with sugar building up in the blood and not being able to move into the cells.
Bodies are not built to have high amounts of sugar present in the bloodstream for long lengths of time. Individual sugar molecules attach to red blood cells when there is excess sugar in the blood.
(Shown above: excess sugar in the bloodstream)
(Shown above: excess sugar in the bloodstream attaches to red blood cells over time)
Why is this a problem? Well, sugar molecules are sharp, and can damage the delicate lining of the blood vessels as they flow through, leading to long-term complications.
If you have been diagnosed with diabetes, you will need to take a few extra steps in your healthcare routine. Your doctor will talk to you about medications and lifestyle changes.
Certain lifestyle and healthy habit changes can make a huge difference. Some examples include testing blood sugar, taking medications as prescribed, establishing appropriate exercise and activity habits, getting enough sleep, reducing stress, and healthy eating.
The American Association of Diabetes Educators (AADE) has outlined the AADE 7 Self-Care Behaviors™ for diabetes self-management. Good news – you don’t have to do it alone, the Brook app is here to help! You can read more here about how Brook supports the AADE 7 Self-Care behaviors.
Do you need support managing diabetes or know someone who does? Chat with us in your Brook app and see how we can help.
P.S. Concerned about your risk, or want to know symptoms to look out for? Check out the ADA web page to learn more.
on February 13th, 2020. Kelsea is a Registered Dietitian with her Master's degree in Nutrition from Bastyr University in Kenmore, WA, and is one of our Health Coaches.