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The Sugar Highway

In honour of World Diabetes Day (14 Nov), we decided to shed light on a condition that affects millions to increase awareness of symptoms and highlight preventative measures.

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Diabetes is a serious condition that causes high blood glucose levels in 1 in 14 people in the UK. Glucose is a simple sugar used to provide energy in the body. This sugar is accessed when carbohydrates, found in food and drinks, are broken down. As the sugar enters a person's bloodstream, the body’s maintenance response (homeostasis) kicks in to maintain a balanced sugar level. This ensures we don’t have too much or too little sugar for bodily functions. Insulin, the main protagonist in this process, is a hormone produced by pancreatic beta cells. As the pancreas senses sugar, insulin facilitates the use of glucose by cells and handles the conversion of excess sugar into glycogen to be stored for later use.

So what happens with diabetics? There are two main scenarios. When insulin is either ineffective at its job or not sufficiently produced in the bloodstream this is known as Type 2 diabetes (T2D). When insulin is not produced at all this is considered to be Type 1 diabetes (T1D). This leads to an accumulation of sugar in the bloodstream that causes a range of symptoms (such as frequent urination, extreme thirst, abnormal fatigue, genital thrush or blurred vision). Over time, diabetes can severely impact organs like the heart, kidneys, eyes and feet.

Aside from how each form of diabetes occurs, the cause for each type is unique. So far, answers for the cause of T1D are limited. However, T2D has been associated with age, ethnicity, weight and diet. Initially, research groups have argued that there is a higher risk of T2D in black people compared to their white counterparts. However, in a 2017 study, the disparity in risk was not significant after researchers accounted for additional factors like socioeconomic backgrounds, behaviour and psychosocial factors during young adulthood (1). Thus arguing that there is no unique genetic link between diabetes and black people but rather, comes down to additional risk factors such as lifestyle, BMI and blood pressure.

T1D and T2D can also be distinguished from each other by how quickly the symptoms develop. Symptoms manifest faster in the case of T1D, whereas T2D cases show a characteristic slower symptom development (which explains T2D is often diagnosed later than T1D). Differing symptom manifestation is accompanied by differing management. T1D requires a daily dose of insulin to manage and monitor sugar levels. Whereas management of T2D has varying regimes including medication, lifestyle improvements, changes in diet, exercise and, in some cases, insulin doses.

Diabetes is currently considered a lifelong condition but mass amounts of research is being done with the hopes to find a cure someday. So far, scientists are working on weight management research that puts T2D into remission, returning blood sugar levels to normalcy. In remission, diabetes is not 'gone' but becomes somewhat dormant. It is very important to do regular check-ups when under this treatment. For T1D, scientists are developing treatments called immunotherapies which seek to disrupt the immune system’s attack on beta cells in the pancreas.

Is diabetes preventable? For cases like T1D and other rarer types of diabetes, risk is typically genetic. For T2D, there are ways to reduce the hereditary or general risk of it by eating healthy, eating in moderation, being more active and maintaining a healthy weight. The journey towards a cure may seem long but with dedicated and highly specialised scientists behind the cause, it can be expected that progress will be made.

There is no doubt that a diabetes diagnosis is life-altering. Despite this, be assured that with individually created routines, treatment and a positive outlook, life can still be lived a diabetic. They are everyday people with everyday worries and dreams but are simply on a different sugar highway they drive for the rest of their lives.

World Diabetes Day: 14 November 2019.

(1) Bancks M.P., Kershaw K., Carson A.P., Gordon-Larsen P, Schreiner P.J, Carnethon M.R. (2017) Association of Modifiable Risk Factors in Young Adulthood With Racial Disparity in Incident Type 2 Diabetes During Middle Adulthood. JAMA. 318(24):2457–2465. doi:10.1001/jama.2017.19546

Get more details here:

Breaking down Diabetes, Diabetes UK (YouTube)

By Lela Pea, Editor

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