What is Diabetes?
Diabetes is a metabolic disorder that results from the body’s inability to produce enough insulin or effectively utilize it. Insulin is a hormone produced by the pancreas that plays a vital role in regulating blood sugar levels. When the body lacks insulin or becomes resistant to its effects, glucose accumulates in the blood, leading to hyperglycemia.
Type of Diabetes
There are two primary types of diabetes:
a) Type 1 Diabetes: Also known as insulin-dependent diabetes, Type 1 diabetes occurs when the immune system attacks and destroys insulin-producing beta cells in the pancreas. As a result, the body cannot produce insulin, leading to uncontrolled blood sugar levels.
b) Type 2 Diabetes: Type 2 diabetes is the most common form, accounting for around 90% of all diabetes cases. In this type, the body either doesn’t produce enough insulin or becomes resistant to its effects, causing elevated blood sugar levels.
Type 1 Diabetes Pathogenesis
Type 1 diabetes has a strong genetic component, and individuals with certain human leukocyte antigen (HLA) genotypes have an increased susceptibility to the disease. Environmental factors also play a role, as viral infections and other triggers can initiate an autoimmune response against the beta cells.
Once triggered, the immune system starts attacking the beta cells, mistaking them for foreign invaders. As the beta cells are progressively destroyed, insulin production decreases, leading to insulin deficiency.
Onset and Symptoms
The onset of Type 1 diabetes is usually abrupt, and patients may present with symptoms such as excessive thirst, frequent urination, weight loss, and fatigue. Early diagnosis is essential to prevent life-threatening complications like diabetic ketoacidosis.
Type 2 Diabetes Pathogenesis
1. Insulin Resistance
Type 2 diabetes typically begins with insulin resistance, where the body’s cells become less responsive to insulin’s action. This forces the pancreas to produce more insulin to compensate for the resistance.
2. Beta Cell Dysfunction
As the disease progresses, beta cells may start to malfunction, reducing insulin production. Consequently, the combination of insulin resistance and beta cell dysfunction leads to elevated blood sugar levels.
3. Lifestyle Factors
Several lifestyle factors contribute to the development of Type 2 diabetes, including sedentary behavior, unhealthy dietary habits (e.g., high sugar and refined carbohydrate intake), obesity, and lack of physical activity.
Type 1 Diabetes Risk Factors
- Family history of Type 1 diabetes
- Presence of specific HLA genotypes
- Exposure to certain viruses (e.g., enteroviruses)
Type 2 Diabetes Risk Factors
- Family history of Type 2 diabetes
- Sedentary lifestyle
- Poor dietary habits
- Obesity or overweight
- Aging (as insulin sensitivity decreases with age)
Complications of Diabetes
- Hypoglycemia (low blood sugar)
- Diabetic ketoacidosis (DKA) in Type 1 diabetes
- Cardiovascular diseases
- Diabetic nephropathy (kidney damage)
- Diabetic retinopathy (eye damage)
- Neuropathy (nerve damage)
Prevention and Management
1. Lifestyle Modifications
- Maintaining a healthy diet
- Regular physical activity
- Weight management
2. Medication and Insulin Therapy
- Type 1 diabetes: Insulin replacement therapy
- Type 2 diabetes: Oral medications and/or insulin therapy
3. Monitoring Blood Sugar Levels
- Regular blood glucose monitoring
- HbA1c testing to assess long-term blood sugar control