Diabetes (or also known as “high blood sugar” disease)

Did you know that one of the diseases I study is type 2 diabetes? Type 2 diabetes falls within the general diabetes category, however, is not the only type of diabetes that humans get. Other types of diabetes include:

• Type 1 diabetes (this is an autoimmune disease – a condition where your immune system mistakenly attacks your body),
• Gestational diabetes (diabetes you get during pregnancy, which could sometimes also be type 2 diabetes during pregnancy),
• Monogenic diabetes, or diabetes that is caused by a single gene defect or mutation (type 1 and type 2 are polygenic (poly=many, genic=genetic or related to genes), which they are related to a change, or defect, in multiple genes). Neonatal diabetes mellitus (NDM) and maturity-onset diabetes of the young (MODY) are the two main forms of monogenic diabetes. NDM occurs in newborns and young infants. MODY is much more common than NDM and usually first occurs in adolescence or early adulthood.

Today we’re going to go over type 2 diabetes, because it’s the most common type of diabetes, but we’ll cover other types of diabetes in later Science Sunday posts. We’re still in the middle of Heart Health Month, and I’m not sure if you are aware, but type 2 diabetes is a risk factor for heart disease. In fact, among people with diabetes, the most common causes of death are heart disease and stroke.
There are other conditions that can result from having diabetes, though. They include:

• kidney disease
• eye problems
• dental disease
• nerve damage
• foot problems
• heart disease
• stroke

Perhaps you’ve read all of this and thought to yourself, okay, that’s great, but I still don’t really understand what diabetes is! Well, the National Institute of Diabetes and Digestive and Kidney Disease has a great way to describe it, so I’m going to summarize their explanation here! Diabetes is a disease that happens when your blood sugar is too high. The sugar in your blood is your main source of energy and comes from the food you eat. Insulin, a hormone made by an organ in your body called the pancreas, helps the sugar from food get into your cells so that it can be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. When that happens, the sugar stays in your blood and doesn’t reach your cells. Over time, that large amount of sugar can cause health problems, among them, type 2 diabetes.

Phew! That was a lot! So, how do we prevent diabetes?? Is diabetes genetic? More importantly, if I get diabetes, can I reverse it and no longer have diabetes??

Yikes, that’s a lot too! Let’s start with whether diabetes is genetic. I mentioned that type 2 diabetes is a polygenic disease. While the concept of genetics is complicated, the short version of this is that while you may “carry” some genes that increase your risk for type 2 diabetes, having those genes alone does not alone mean that you will get diabetes. Type 2 diabetes also depends on other things. Here are some things that may increase your risk for type 2 diabetes (this means that each on its own cannot cause diabetes, but can increase your risk overall for type 2 diabetes):

• are overweight or obese
• are age 45 or older
• have a family history of diabetes
• are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino (our research suggests being of Mexican background may increase your risk for type 2 diabetes by about 30%!) , Native Hawaiian, or Pacific Islander
• have high blood pressure
• have a low level of HDL (“good”) cholesterol, or a high level of triglycerides
• have a history of gestational diabetes or gave birth to a baby weighing 9 pounds or more
• are not physically active
• have a history of heart disease or stroke
• have depression
• have polycystic ovary syndrome, also called PCOS
• have acanthosis nigricans—dark, thick, and velvety skin around your neck or armpits

Remember, none of the factors above can cause diabetes on their own. Type 2 diabetes is also known as a “complex” disease, which means that sometimes, multiple things have to happen (the perfect storm of risk factors) in order for a person to develop type 2 diabetes.

So what can you do to prevent it?
To help prevent diabetes, the best things you can do are maintain a healthy weight, eat a healthy diet, and be more physically active! Definitely talk to your primary care doctor about managing the other things on the list above if any require medical treatment. Managing these things can help prevent type 2 diabetes. Also talk to your primary care doctor about any medications that may increase your risk for type 2 diabetes as well.

Finally, if you have diabetes, can you reverse it or cure it??
That’s a loaded question and the answer will vary depending on who you ask. It’s important to know that there is no cure for type 2 diabetes. Recent scientific studies suggest that it’s possible to “reverse it”. That’s a bold claim considering, but what can happen is that through diet changes and weight loss, you may be able to reach and hold blood sugar at normal levels, without medication. This, however, may not mean you’re completely cured. It’s very important to recognize and know that type 2 diabetes is an ongoing disease.
For additional information, check out the info pages for the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, American Diabetes Association, the Centers for Disease Control, and the National Heart Lung and Blood Institute.

Sources for today’s post:
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
https://www.nature.com/articles/s41598-018-35707-7
https://www.ncbi.nlm.nih.gov/pubmed/31857443
https://www.nhlbi.nih.gov/health/educational/healthdisp/pdf/tipsheets/What-Is-Diabetes.pdf