“Person who can properly manage the diabetes is the person who lives with it day by day, month by month, year by year. It is the role of the healthcare professional to equip the patient (and often their family) with the tools to do this”- Professor Alberti.
Diabetes is a disease of high blood glucose (sugar). All food, especially carbohydrates, converts into glucose in the blood. Blood glucose stimulates the release of insulin from beta cells in the pancreas to maintain blood glucose levels between 80 to 120 mg%, and A1c less than 5.7%. Insulin acts as a conduit that allows the cells in the body to take in glucose and use it as energy. If insulin is not produced by the pancreas, Type 1 Diabetes (T1D) develops. If body cells cannot effectively use insulin to utilize glucose (called insulin resistance), Type 2 Diabetes (T2D) develops.
T1D affects children and young adults and is the result of an autoimmune process that suddenly destroys insulin-producing beta cells in the pancreas. These patients will need insulin for immediate therapy and then for the remainder of their lives. Without insulin, T1D patients develop ketoacidosis and fall into a coma, which is often fatal. In the long run, if T1D is not well controlled, patients will develop complications affecting the kidneys, the eyes and the nervous system. It is proven that complications in T1D are directly proportional to the control of diabetes. A normal and healthy life is possible by maintaining a desirable level of A1c.
Type 2 Diabetes occurs in adults. In these cases, the pancreas initially produces enough insulin but, due to insulin resistance, the blood glucose level is high. Over the years, the functioning of the beta cells in the pancreas also starts to decrease, resulting in reduced insulin production. T2D may be genetic, and is often related to lifestyle changes such as obesity and lack of regular exercise. It can go unnoticed and undiagnosed for years. These patients can often be managed with a proper diet and oral medicines but many eventually may need insulin. Association of T2D with cardiovascular risk factors (high blood pressure, high cholesterol and smoking) will often result in complications such as heart attack, stroke and poor circulation in legs. Control of risk factors is extremely important to prevent complications.