
It's highly probable that someone you know has diabetes. With over 30 million Americans affected, it’s a widespread yet often misunderstood condition.
The term diabetes originates from the Greek word for "siphon"—a nod to the frequent and excessive urination associated with the disease. The word was introduced in the first century by the ancient doctor Aretaeus the Cappadocian, who famously (though incorrectly) explained that "great masses of flesh are liquefied into urine."
We now have a much clearer understanding of the illness, its causes, and the different forms it can take.
Diabetes is essentially a problem with hormones, specifically insulin. This hormone helps your body turn glucose (sugar) into energy. When you eat, your pancreas releases a small amount of insulin into the bloodstream. The insulin signals certain cells to absorb the glucose you just consumed, allowing the cells to use the sugar for energy.
At least, that’s how it’s meant to work. If you have diabetes, things don't quite go as planned.
Similar to rheumatoid arthritis or celiac disease, type 1 diabetes occurs when a person’s own immune system attacks them. In rheumatoid arthritis, it affects the joints; in celiac disease, it targets the intestines; and in type 1 diabetes, it’s the insulin-producing cells in the pancreas that are destroyed by the immune system.
Minor variations in blood sugar that wouldn’t faze a healthy system can cause significant issues in someone with type 1 diabetes. People with type 1 must vigilantly monitor their glucose levels and take insulin through injections, pens, ports, pumps, or inhalers, as blood sugar fluctuations—whether too low or too high—can lead to severe complications or even death.
Type 2 diabetes arises from a different problem at the other end of the process. A person with type 2 diabetes may have enough insulin at the start, but the issue lies in the body’s inability to process it. Glucose accumulates in the bloodstream, and the body begins needing more insulin to produce any effect.
Type 2 was once called adult-onset diabetes, and type 1 was known as juvenile diabetes. However, both children and adults can and do develop either type. While being overweight or obese increases the likelihood of developing diabetes, even those of normal weight can get it. To make things even more complex, researchers in Finland and Sweden recently identified five distinct subgroups of diabetes, each with unique features and risks for complications. Understanding which subgroup someone belongs to could lead to better treatment in the future.
And while we're debunking myths: The belief that diabetes is solely caused by eating too much sugar is a severe oversimplification. How you eat, of course, has an impact on your body, and a low-carb diet can help regulate blood sugar levels. However, diabetes can arise from various factors, including genetics, medications, and other health issues. (If you're on insulin, consult a doctor before starting a low-carb diet, as improperly managed blood sugar levels could drop too low.)
There isn’t a universal cure for diabetes yet—at least not one available. However, innovations like an artificial pancreas and other treatments targeting the immune system and pancreas cells are underway. For now, both types of diabetes are typically managed through medication, dietary changes, exercise, and frequent doctor visits.
