Part II – Development of Disease

Metabolism of Sugar and Pathogenesis

Glucose is derived from the sugar and starch breakdown as well as being manufactured by liver and muscle cells. Glucose is transported throughout the body via the circulatory system and is metabolized within cells for the production of energy.

Insulin is a hormone that is manufactured in the pancreas by beta cells. In response to a rise in blood sugar, the pancreas releases insulin into the bloodstream. The insulin then transports glucose molecules to receptors on the cell membranes and signals them to open and allow the energy substrate (glucose) to enter. When energy is provided in excess of need, insulin aids in fat storage.

When cells start becoming insulin resistant, it takes more of the hormone to get the cells to open. Prediabetes generally begins when body cells start becoming resistant to the effects of insulin, requiring increased amounts in order to keep blood glucose from becoming elevated.

Type 2 diabetes tends to develop slowly, taking many years to develop into a full-blown disease. It begins when body cells stop responding to insulin’s open-up-for-glucose signal. The body responds by manufacturing more and more insulin in an effort to force blood sugar into the resistant cells. Eventually, the pancreatic beta cells become exhausted and begin to fail.

The resulting combination of insufficient insulin glucose and intolerant cells creates abnormally high blood sugar and leads to a diagnosis of type 2 diabetes. At this point, medication, diet/lifestyle changes or both are required in order to control blood sugar and prevent serious complications.

Risk Factors for Developing Type 2 Diabetes

Conditions which increase your risk include:

  • Diagnosis of prediabetes
  • Age 45 or older
  • Family history of the disease
  • Overweight
  • Physically inactive
  • High blood pressure
  • Low HDL (good cholesterol) and/or high triglycerides
  • Smoking

Smokers are roughly 50 percent more likely to develop diabetes and heavy smokers sustain even higher risk. Additionally, the toxins contained in tobacco smoke greatly increase risk for heart disease, particularly when blood sugar is also elevated.

Over time, uncontrolled blood sugar can lead to serious complications, especially with your cardiovascular system, eyes, kidneys, nerves, gums and teeth. Diabetes is the leading cause of kidney disease and blindness. Diabetes frequently results in kidney failure, stroke, foot amputation or death.

Persons with diabetes have more than double the risk for heart disease and stroke. Their risk of heart attack is the same as someone who has already had their first heart attack.

Fortunately, a protective diet and lifestyle are powerfully preventive even in the face of genetic predisposition. The saying goes, “The genes load the gun, but lifestyle pulls the trigger.” Healthy choices can keep weight and blood pressure under control, improve insulin sensitivity, promote optimal blood lipid profiles (high HDL, low LDL cholesterol, low triglycerides) and help maintain optimal functioning of our cardiovascular and other organ systems.

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