Ep 85 Diabetes

Contributors: Mariah Rossi and Dr. Emran

Dr. Emran talks about Diabetes, a disease that affects over 50% of adult Americans. Diabetes is caused by high blood sugar, also called glucose. Sugar is important for many organs in the body including the brain, liver, and metabolism.

There are different types of Diabetes: Type 1, Type 2, Gestational Diabetes, and Borderline Diabetes. He also talks about treatment options and the importance of checking blood sugar.

The Pancreas produces insulin to help metabolize sugar that we eat into an energy source for the rest of the body. In Type 1 diabetes, the pancreas can’t make insulin, so the sugar builds up in the blood and is never used by the body properly. The sugar in the blood is toxic and can exceed 400 or 500. Those with Type 1 Diabetes are often diagnosed as children or teenagers. People with Type 1 diabetes require insulin injections because there are no pills that can produce insulin. One of these is an insulin pump that monitors the blood sugar levels and gives insulin at the same time. It is very effective and helps people take control of their blood sugar.

Type 2 Diabetes is the most common and found in people who are overweight or obese. Unlike Type 1, the body does have insulin, but it is insulin resistant. This causes a chronic problem as the body cannot metabolize the amount of sugar in it. To manage this, people are usually given an oral medication called Metformin. It serves two purposes: working on the liver and on the rest of the body. It does this by shutting off the liver’s ability to make sugar, called gluconeogenesis. Gluconeogenesis raises blood sugar levels during the night. If people have high blood sugar during the day and it increases at night, the body is overwhelmed.

For the rest of the body, Metformin is an insulin sensitizer which means it makes insulin more efficiently in the intestine, muscles, brain, and kidneys. Most people just need one medication to treat Type 2 Diabetes. If Metformin doesn’t work, they can switch to another medication that targets the Pancreas, or injectable medications which tend to be a little more expensive. A major part of Type 2 Diabetes requires a lifestyle change, which means people have to monitor their diet so they avoid eating too much sugar.

Gestational Diabetes occurs in pregnant women. Growing babies love sugar and if a mother eats too much sugar, the baby becomes very large. This may lead to a c-section since the baby cannot be safely delivered naturally. An Endocrinologist can help the mother monitor her diet so that she is not consuming too much sugar. After the baby is born, the mother will no longer have Gestational Diabetes, but she is 8 times more likely to develop it later.

Finally, Borderline Diabetes or Pre-diabetes is a term that many doctors will explain to patients. These people usually have high blood sugar, but not high enough to be called Diabetic or start medication. Those with Diabetes have a blood sugar of 126+, so those with borderline usually range between 100-125. Sometimes this is detected after a person has breakfast or lunch because the sugar in their food causes their blood sugar to rise. Some people are diagnosed with it at a health fair or pre-employment physical and they have no symptoms. The best thing is to monitor the blood sugar over months and modifies the diet to avoid needing prescription medications for diabetes.

Diabetes can lead to severe problems if it is not treated properly. Because blood sugar is a sweet poison, it damages the body in different ways. It can affect the heart, causing blood clots and strokes. It can damage nerves causing Neuropathy, which leads to permanent numbness in the hands or feet. This is harmful because people are unaware of when they have an infection, splinter, or injury and by the time the infection is detected, it has already eaten away the bone. Often, limbs must be amputated and many people will lose their toe, foot, or leg. People can also suffer from blindness because sugar destroys the retina in the eye.

Those with diabetes must treat the problem very seriously. There are many ways to manage it. People should regularly check their blood sugar levels and consult their doctors.

 

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