Diabetes- Understanding the Myths and the Facts to know

In this Blog we will discuss about

• What is Diabetes & types of Diabetes.
• How does Human body maintain healthy Glucose Level
• How does Medicines/Insulin control Diabetes

What is Diabetes & Types of Diabetes?

Diabetes is a chronic medical condition that affects how your body processes blood sugar (glucose). Glucose is an important source of energy for your body's cells, but to use it properly, your body needs insulin—a hormone produced by the pancreas.

There are three main types of diabetes:

1. Type 1 Diabetes – An autoimmune condition where the immune system attacks insulin-producing cells in the pancreas. People with type 1 diabetes must take insulin because their bodies cannot produce it. It usually develops in childhood or early adulthood.

2. Type 2 Diabetes – The most common type, where the body either doesn’t produce enough insulin or becomes resistant to it. It is often linked to obesity, poor diet, and lack of exercise but can also have genetic factors. It can sometimes be managed with lifestyle changes, medication, or insulin.

3. Gestational Diabetes – Occurs during pregnancy when hormonal changes cause insulin resistance. It usually resolves after childbirth, but it increases the risk of developing type 2 diabetes later.

Symptoms of Diabetes:

• Frequent urination
• Excessive thirst and hunger
• Fatigue
• Blurred vision
• Slow healing of wounds
• Unexplained weight loss (especially in type 1 diabetes)

Long-term Complications:

If left untreated or poorly managed, diabetes can lead to serious complications like heart disease, kidney damage, nerve damage, and vision problems.

How does Human body maintain healthy Glucose Level?

The human body maintains glucose levels through a complex balance of hormones, mainly insulin and glucagon, which are produced by the pancreas. This process ensures that blood sugar stays within a healthy range (typically 70-140 mg/dL). Here’s how it works:

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1. After Eating (High Blood Sugar) – Insulin Lowers Glucose

When you eat, carbohydrates break down into glucose, which enters the bloodstream, increasing blood sugar levels. The body responds by:

• Pancreas releases insulin → Helps cells absorb glucose for energy or storage.
• Glucose enters muscle, fat, and liver cells → Used for immediate energy or stored as glycogen in the liver.
• Excess glucose converts to fat → Stored for long-term energy.

🡺 Result: Blood sugar levels decrease back to normal.

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2. Between Meals or Fasting (Low Blood Sugar) – Glucagon Raises Glucose

When you haven’t eaten for a while, blood sugar drops. The body responds by:

• Pancreas releases glucagon → Signals the liver to release stored glucose.
• Liver converts glycogen to glucose (glycogenolysis) → Releases it into the bloodstream.
• Liver makes new glucose from proteins & fats (gluconeogenesis) → Provides energy when glycogen is low.

🡺 Result: Blood sugar levels rise back to normal.

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3. During Exercise

• Muscles use stored glycogen for quick energy.
• If glycogen runs out, the liver starts breaking down fats and proteins into glucose.
• Insulin levels drop, and glucagon increases to keep blood sugar stable.

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4. In Stress or Emergency (Fight-or-Flight Response)

• Adrenal glands release adrenaline & cortisol → Signals the liver to release more glucose.
• Blood sugar rises to provide immediate energy.

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5. In Diabetes (Impaired Glucose Regulation)

• Type 1 Diabetes: The body doesn’t produce insulin, so blood sugar stays high unless insulin is injected.
• Type 2 Diabetes: Cells become resistant to insulin, leading to high blood sugar.
• Hypoglycemia (Low Blood Sugar): Can occur if too much insulin is released or if a person doesn’t eat enough.

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Key Takeaways

✅ Insulin ↓ blood sugar by storing glucose.
✅ Glucagon ↑ blood sugar by releasing stored glucose.
✅ The liver plays a big role in storing and releasing glucose.
✅ The brain relies on glucose, so stable levels are crucial.

How does Medicines/Insulin control Diabetes

Diabetes medications work in different ways depending on the type of diabetes and the drug class. Here’s a general breakdown of how they function in the human body:

For Type 1 Diabetes (Insulin-Dependent)

Since the body doesn’t produce insulin, the main treatment is insulin therapy, which helps:

• Lower blood sugar by allowing glucose to enter cells for energy.
• Prevent excessive sugar buildup in the bloodstream.
• Mimic the natural insulin response of the pancreas.

Types of insulin:

1. Rapid-acting (e.g., Lispro, Aspart) – Works quickly to manage post-meal glucose spikes.
2. Short-acting (e.g., Regular insulin) – Covers meals eaten within 30-60 minutes.
3. Intermediate-acting (e.g., NPH insulin) – Provides longer-lasting glucose control.
4. Long-acting (e.g., Glargine, Detemir) – Maintains stable glucose levels throughout the day.

For Type 2 Diabetes (Insulin Resistance)

Type 2 diabetes medications work by:

1. Increasing Insulin Production
• Sulfonylureas (e.g., Glipizide, Glyburide) stimulate the pancreas to release more insulin.
• Meglitinides (e.g., Repaglinide) work similarly but with a shorter effect.
2. Reducing Sugar Production in the Liver
• Biguanides (e.g., Metformin) decrease glucose production in the liver and improve insulin sensitivity.
3. Improving Insulin Sensitivity
• Thiazolidinediones (TZDs) (e.g., Pioglitazone) make the body’s cells more responsive to insulin.
4. Blocking Sugar Absorption in the Intestine
• Alpha-glucosidase inhibitors (e.g., Acarbose) slow carbohydrate breakdown, reducing post-meal sugar spikes.
5. Promoting Sugar Excretion via Urine
• SGLT2 inhibitors (e.g., Empagliflozin, Dapagliflozin) help the kidneys remove excess glucose through urine.
6. Mimicking Gut Hormones to Control Blood Sugar
• GLP-1 receptor agonists (e.g., Liraglutide, Semaglutide) increase insulin release, reduce glucagon, and slow digestion.
• DPP-4 inhibitors (e.g., Sitagliptin) prolong the effect of natural gut hormones that regulate insulin and glucose levels.

For Gestational Diabetes

• Often managed with insulin if diet and exercise aren’t enough.
• Some doctors prescribe Metformin or Glyburide to help control blood sugar levels.

Each type of medication has different effects, and doctors choose treatments based on a patient’s specific needs.

*** Also read blog about diabetes management tips for those who already diabetic and those are in pre-diabetes condition.  "A wise approach for diabetes management"