DIABETES
The different types of diabetes
Diabetes is a chronic disease that lasts a lifetime. The proper management of the disease by the patient himself, with the help of his doctor, should make it possible to avoid complications. Diabetes is responsible for poor health and premature death.
What is diabetes exactly?
Diabetes is a disorder of the assimilation, use and storage of sugars provided by food. This results in a high level of glucose in the blood (also called blood sugar): this is called hyperglycemia. It is caused by a lack or failure to use a hormone called insulin.
Note: normal blood sugar is less than 1.10 g / l on an empty stomach and less than 1.40 g / l after a meal. Diabetes is defined by fasting blood sugar above 1.26 g / l twice.
The role of insulin
Insulin, made by the pancreas, is permanently present in the blood. Its role is to maintain blood sugar around 1 g / l when the sugar intake is high. When the blood sugar level rises, for example after a meal, the pancreas produces more insulin to bring the blood sugar level back to normal.
If the insulin is insufficient or ineffective, sugar builds up in the blood and the blood sugar rises excessively (hyperglycemia).
Insulin in the non-diabetic person
- Released by the pancreas, insulin allows the cells to absorb glucose. To do this, it binds to a specific receptor in the cell which activates a surface protein whose role is the transport of glucose inwards;
- Via this activated transporter, glucose enters the cell where it is converted into energy;
- The blood glucose level (glycemia) thus remains stable.
Insulin in people with diabetes
- Insulin is produced in insufficient quantity (type 1 diabetes) or cannot bind to its receptor (type 2 diabetes) leaving the transporter inactive;
- Glucose does not enter the cell and remains in the bloodstream. The glucose level is not regulated.
Type 1 and type 2 diabetes: what differences?
Insulin-dependent type 1 diabetes
- Also called « lean » diabetes because one of the first symptoms is weight loss, or « juvenile » diabetes because it affects young people;
- It accounts for around 10% of cases and is compulsorily treated with insulin;
- It results from the disappearance of beta cells from the pancreas resulting in a total insulin deficiency;
- Symptoms are usually intense thirst, abundant urine, rapid weight loss;
- The only treatment is the supply of insulin: either in the form of injections (with a syringe or a pen), or with an insulin pump intended to administer insulin continuously.
Type 2 non-insulin dependent diabetes mellitus
- Also described as « fatty » diabetes or diabetes of maturity, since it often occurs around the age of 50 in overweight people;
- It accounts for around 90% of cases;
- Two abnormalities are responsible for hyperglycemia: either the pancreas still makes insulin but not enough, compared to blood sugar: this is insulinopenia; Either this insulin does a bad job, it’s insulin resistance;
- Painless, development can go unnoticed for a long time: it is estimated that it takes on average 5 to 10 years between the appearance of the first hyperglycaemia and the diagnosis;
- It is treated by diet, plus medications taken orally if necessary, and possibly insulin, after a few years of evolution.
HIGHLY EXPANDING TYPE 2 DIABETES
Type 2 diabetes is constantly evolving around the world.
According to the WHO, the number of type 2 diabetics in the world increased from 108 to 422 million between 1980 and 2014. This increase is due to several phenomena:
- Population growth and aging;
- The increase in prevalence at specific ages;
- The interaction of the two factors.