Diabetes: Why you get it, will you get it?

This is one of a series of columns about health issues written by staff members of ProMedica and Mercy Health Partners.

It can lead to blindness, kidney failure, and heart disease. It can also be delayed or, in many cases, completely avoided.

According to the Centers for Disease Control and Prevention, more than 23 million Americans have diabetes. To better understand the causes, symptoms, prevention, and treatment of this disease, let me start with the basics.

What is diabetes?

Diabetes is a disease characterized by high blood sugar. A more scientific word for sugar is “glucose.” The cause of this high blood glucose is what differentiates type 1 diabetes from type 2 diabetes.

But they are similar in root cause: the body’s ongoing struggle with insulin.

As you eat, your body breaks down food. Sugars and starches are broken down into glucose. Glucose is transported into your cells (where it becomes fuel) by insulin, a hormone produced by the pancreas. Think of insulin as a delivery truck.

Type 1 diabetes — previously called juvenile diabetes — is characterized by the body’s inability to make insulin (in other words, all the delivery trucks are broken down and there are no mechanics available). In type 1 diabetics, the immune system destroys beta cells — the body’s only producer of insulin. Type 1 diabetes is typically diagnosed in children and young adults, and insulin treatments help type 1 diabetics manage their condition.

Type 2 diabetes — previously called adult-onset diabetes — is characterized by the body’s inadequate production of insulin. In type 2 diabetics, the body either doesn’t make enough insulin or the cells simply don’t use it (they refuse to accept the truck’s delivery). Type 2 diabetes accounts for 90 to 95 percent of all cases of diabetes in the United States, and exercise and a healthy diet help type 2 diabetics manager their condition.

In both cases, a lack of insulin causes glucose to build up in the bloodstream. Why is this bad? Too much glucose in your bloodstream is called hyperglycemia, and its effects on blood vessels can be devastating in two ways:

• Damage to large blood vessels — responsible for heart disease and stroke.

• Damage to small blood vessels — responsible for kidney damage, nerve damage, and eye disease.

How do I know if I have diabetes?

Symptoms of diabetes don’t often indicate extreme danger, which is why so many cases of diabetes go undiagnosed. Symptoms are often attributed to tiredness or stress. Symptoms of type 1 and type 2 diabetes include:

• Extreme fatigue, irritability, and weight loss
• Frequent urination• Unusual thirst and hunger