It’s that post to break down what diabetes is all about…in a nutshell. Yes, it’s a repeat of a previous Time in Range post for the newer subscribers to this substack. Thank you for subscribing!

Diabetes 101

What’s diabetes, anyway? Let’s talk about the most common types:

1. Type 1 (insulin-dependent, or “juvenile,” or T1D)

2. Type 2 (non-insulin-dependent, or “adult-onset,” or T2D)

These different conditions are called "diabetes." Why? Because of their relation to the pancreas—the long, thin organ located behind your stomach. The pancreas plays a key part in the digestive process and metabolism, as it regulates sugar in the blood by secreting insulin (which lets cells change sugar into energy, which lowers blood sugar) and glucagon (which breaks down a substance in the liver, known as glycogen, to raise blood sugar). This process is complex within an individual body and it makes things like blood sugar levels difficult to predict accurately.

Diabetes is not a simple equation of insulin and food. If it were, blood sugars would be a lot easier to manage. The pancreas produces insulin, but that is only a small part of its function as a digestive organ. It’s involved in a strange sort of balancing act, trying to deal with whatever the body eats or doesn't (because all food is broken down into sugar eventually, unless it’s stored as fat) and produce substances that allow the body to continue to function. The functioning of the pancreas was a mystery until insulin was discovered in 1922. These substances keep blood sugar balanced—not too high and not too low-- just right for the body to go on its merry way and function without having to think too much about it.

People who have type 1 diabetes (T1D) must take insulin through multiple injections or a pump to survive and most likely have a pancreas that produces no insulin at all. Without insulin, sugar hangs around in the blood stream, unable to enter the cells to produce energy, and therefore produces high blood sugar.

T1D used to be called “juvenile” because it usually occurs in people under 30 years of age, although it can occur at any time during a person’s life. It is caused when the immune system attacks the insulin-producing beta cells of the pancreas. Why does this happen? That's the million dollar question, which is still unknown.

Type 1 Diabetes: Graham - JDRF

Type 2 (T2D) usually occurs in people over 40 years of age, hence the term “adult-onset,” and is usually hereditary. The pancreas does not produce enough insulin, or uses it ineffectively. People with T2D may be able to manage their condition with diet, exercise and/or medications, but some will also require insulin.

Diabetes affects all types of people. People with T1D like me are the minority, comprising about 10 percent of all people with diabetes, while T2D accounts for the other 90 percent of people with diabetes.

Are you a “diabetic?”

Part of this is a language issue. It matters. It gets lost in translation. In other words, the term “diabetic” is often used to describe both a child with T1D who requires insulin on a daily basis and an adult with T2D who must take medication and follow a diet. This is one of the main difficulties in defining the condition, and it can contribute to misconceptions. Diabetes Australia looks at it this way:

Evidence shows 1 in 2 people find the label unacceptable and 1 in 4 find it harmful. People with diabetes are free to use whatever words they wish. Other people – whether they are working in healthcare, media, research, industry or anywhere – have a responsibility to engage all people affected by diabetes in positive, constructive ways. Labelling a person as ‘diabetic’ runs the risk of causing offense or alienating that person. People are rarely offended by being referred to as a person. This is just one small part of why our language matters. It is so much more than whether we use the words ‘diabetic’ or ‘person with diabetes’. 1

And so there you have it!

Until next week…