Let’s Discuss: Diabetes
Most people have heard of the term “diabetes.” We’ll dive deeper into 4 different types of diabetes and how they affect the digestion and absorption of nutrients in the body. Let’s look at the similarities and differences to better our understanding of these pancreatic disorders.
Type 1 Diabetes
People diagnosed with type 1 diabetes have a chronic insulin deficiency - the pancreas cannot produce insulin, a hormone needed to stabilize glucose levels in the blood. Once carbohydrates and sugars are digested into glucose it cannot be absorbed into the cells to use as energy without insulin. This glucose (sugar) stays in the bloodstream which raises the body’s blood sugar level. The cells in charge of producing insulin (beta cells) in the pancreas are destroyed. This inability to produce insulin leads to high blood sugar levels which can cause excessive urination, thirst and hunger, weight loss, dehydration and electrolyte imbalances. If blood sugar levels become too high, diabetic ketoacidosis could occur causing a buildup of acids called ketones in the blood and urine. Diabetic ketoacidosis can be fatal if left untreated. Insulin is administered through injections into the skin or through an insulin pump to lower or balance blood sugar levels after eating. People diagnosed with type 1 diabetes may also have an autoimmune disease known as Celiac disease, simply understood as a gluten allergy where the body cannot digest or absorb gluten which results in an inflammatory immune response. Damage to the heart, kidneys, nerves, vascular system, eyes, legs and feet can occur.
Type 2 Diabetes
Genetic, environmental, and metabolic factors all play a role in the development of type 2 diabetes. Ethnicity, family history, and genetics along with obesity, sedentary lifestyle, and high calorie/low nutrient diet are all risk factors of type 2 diabetes. Both insulin resistance and beta cell dysfunction in the pancreas can cause type 2 diabetes. Once diagnosed with type 2 diabetes, there are many different ways to manage the disease including: eating a balanced diet, regular exercise, monitoring blood sugar levels, and medications.
Gestational Diabetes
Gestational diabetes is a serious pregnancy complication involving high blood sugar levels throughout pregnancy which can increase the mother’s risk for developing type 2 diabetes after birth. Beta cell dysfunction also occurs in gestational diabetes. The following risk factors of gestational diabetes are also linked to beta cell dysfunction: overweight/obesity, excessive weight gain during pregnancy, western diet – high in calories, fats, carbohydrates and low in fiber, ethnicity, genetics, advanced maternal age, family history, and other diseases of insulin resistance, such as polycystic ovarian syndrome (PCOS).
Diabetes Insipidus
Diabetes insipidus is characterized by a decrease in the antidiuretic hormone known as arginine vasopressin (AVP). This hormone helps to control the fluid balance in the body and when the production of this AVP is decreased, polyuria can occur. Polyuria will cause a person to excrete large volumes of diluted urine. Polydipsia may occur with that, which is an excessive thirst. Diabetes insipidus can lead to dehydration as it imbalances electrolyte levels in the body. Diabetes insipidus can also occur during gestation and resolve itself within 4-6 weeks.
References:
Disability and Diabetes Prevention. Centers for Disease Control. Accessed December 17, 2023. https://www.cdc.gov/ncbddd/disabilityandhealth/features/disability-and-diabetes-prevention.html
Raymond, J. & Morrow K. Krause and Mahan's Food & the Nutrition Care Process.16th ed. Elsevier; 2023.
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Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Martín C. Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences. 2020; 21(17):6275. https://doi.org/10.3390/ijms21176275
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Weiner, A., & Vuguin, P. (2020). Diabetes Insipidus. Pediatrics in review, 41(2), 96–99. https://doi.org/10.1542/pir.2018-0337
