This is the first of the myths of diabetes which have been plaguing attempts to raise awareness of the disease.
Yes, there are several types of diabetes. Type 1 and Type 2 diabetes are the most common forms, and the only forms which will be discussed in any detail on Medimise. They are both serious diseases which will ultimately be the cause of death for many individuals.
One of the reason why some people feel that a case of diabetes may be mild is because it is the early stages of type 2 diabetes. A person in the early stages of diabetes may not have any outward symptoms at all, they will feel fine, generally be active, alert and healthy.
However, the same processes are still at play inside their body, which is the continued decline in the ability to utilise blood sugar for energy. Most cases of type 2 diabetes will eventually see a person needed insulin injections to survive. Diabates is a degenerative disease which means that the beta cells of the pancreas which release insulin are being slowly destroyed in most cases. Only if you manage to control your diabetes by maintaining a healthy body weight and regular exercise will you avert the eventual decline of the pancreas.
If blood sugar levels are not managed eventually the pancreas will no longer be able to release insulin which will result in rapid weight loss as the body breaks down fats and proteins for energy.
All the time that blood sugar levels are high microvascular and macrovascular damage is also occurring, which means the small blood vessels in the eyes and nervous system and the larger blood vessels of the heart slowly deteriorates.
This damage is irreversible and can occur for years, sometimes for over a decade, before a person is diagnosed with type 2 diabetes. The whole time they feel fine while their body is being destroyed. Once a person starts medication they may just be taking some tablets to control blood sugar levels and also be advised to follow a healthy diet and lifestyle. For this reason they do not feel unwell and will tell people that they just have mild diabetes.
Type 1 diabetes is a different story. Before insulin was discovered in the 1920’s by Dr. Frederick Grant Banting and Dr. Charles Best type 1 diabetes killed within weeks. Type 1 diabetes is when the pancreas completely stops producing insulin. This means that there is nothing to stop the production of glucagon, which is the hormone which breaks down fat and protein for energy.
When fat and muscle is broken down a diabetic will use ketones for energy. As the brain does not need insulin to take up glocose it can still function. However, the glucose derived from the breakdown of TAGs (energy stored in fat cells in the form of glycerols and fatty acids) still causes blood sugar levels to rise as the glucose cannot be removed from the blood by insulin.
However, more serious than this is that the breakdown of ketones raises the acidity of the blood. When the level of acidity rises too much a condition called ketoacidosis occurs, which his essential acid poisoning of the blood. This is fatal. It will cause both vomiting and also excessive urine as the body tries to expel both the acids and the glucose (diabetics tend to urinate more as this is one way for them to release glucose from the blood). Soon dehydration sets in. However, kidney failure and multiple organ failure may occur due to acid poisoning.
Somebody will type 2 diabetes will rarely develop ketoacidosis as even a small amount of insulin will aid the removal of ketones from the blood.
So, the recap, someone with type 2 diabetes may be feeling fine and may be controlling their blood sugars with a course of tablets and improvements to their lifestyle. However, over time more damage is likely to occur which can lead to complications as the disease advances.
With early diagnosis and careful management a person with diabetes can now live a long and active life. But for many it is a great burden, both mentally and physically.