Our bodies change the food we eat into glucose or sugar through a process of digestion. Sugar travels through the body in the blood. Some of this sugar is used for energy, as the bodys main fuel source, and some is stored in muscles and the liver for later use. Excess sugar is made into fat and stored throughout the body. Beta cells in the pancreas are responsible for producing the hormone insulin which allows sugar to be used for energy and for storage, unlocking cells throughout the body to allow glucose to enter as fuel. In diabetes, either the pancreas produces insufficient insulin or cells in the body are resistant to the insulin produced. Because of this, sugar remains in the blood, leading to high blood sugar levels. This sugar builds up and the excess is responsible for complications including diseases of the heart, eye, kidney, nerves and other organs. In Type 1 diabetes, previously called insulin-dependent diabetes mellitus or juvenile-onset diabetes, the bodys immune system destroys the beta cells located in the pancreas. The pancreas is unable to produce any insulin and the hormone must be delivered from outside of the body through an injection or a pump. This condition is most common among children and young adults but can occur at any age. Approximately 5-10% of all diagnosed cases of diabetes are Type 1. In Type 2 diabetes, previously called non-insulin-dependent diabetes mellitus or adult-onset diabetes, the usual cause of high sugar in the blood is due to insulin resistance. Cells do not respond to insulin and are unable to absorb glucose. Because the insulin is not able to be used, the pancreas continues to produce it at high rates and often Type 2 diabetics maintain a high level of insulin in their blood. Eventually, though, the pancreas is unable to meet the demand and gradually loses its ability to produce insulin. Type 2 diabetes accounts for 90-95% of all diagnosed cases. Gestational diabetes, diagnosed in some women during pregnancy, involves the inability to process glucose. After pregnancy, 5-10% of women are found to have Type 2 diabetes and 20-50% of those who have had gestational diabetes will develop Type 2 diabetes at some time in their lives. Pre-diabetes, formerly called borderline-diabetes, is a condition prior to diabetes where patients have marked metabolic difficulties. If not treated, these are likely to lead to Type 2 diabetes. There are 20.8 million diabetics in the United States, 7% of the overall population. Of these, approximately one-third are unaware they have the condition and are therefore untreated and at higher risk for complications. In addition, 41 million people are considered pre-diabetic. Diabetes is the sixth leading cause of death in the USA. The risk of death among people with diabetes is about twice that of people of similar age who do not have diabetes. Although there is no known cure at this time for Type 2 diabetes, research continues to focus on controlling the condition so that complications of the disease may be avoided and diabetics can live long and healthy lives. It is known that heredity plays a factor in Type 2 diabetes but there is a strong interplay of environmental factors, such as weight and inactivity too. The only known cure for Type 1 diabetes involves transplanting the pancreas so that the patient can again produce insulin. The surgery and its effects can be difficult and the immune system must be repressed to avoid rejection of these cells. Other research in this area involves transplanting the insulin-producing cells (islet cells) within the pancreas, developing an artificial pancreas or genetic manipulation by inserting normal human insulin genes into cells of the pancreas. A more recent advance in drug delivery systems means that short acting insulin is now available with an inhalation device rather than just by inection. |
