Diabetes: what it is and how to prevent it

Diabetes doesn’t appear overnight. The type 2 form — the most common one — develops over years, sometimes decades, before blood sugar levels finally move outside the normal range. The good news: you can noticeably slow its progress if you know what to look for and what to do.

What characterizes type 2 diabetes?

Type 2 diabetes differs significantly from type 1. In type 1, the problem is a lack of insulin — the body doesn’t produce enough of it. In type 2, insulin levels in the blood are normal or even above normal, but the body’s cells don’t respond to it properly.

The main characteristics of the disease:

• It usually appears after the age of 40.
• It occurs more often in women.
• It is often accompanied by obesity.
• There is a clear hereditary link.
• Insulin sensitivity is reduced — blood sugar responds sluggishly to insulin.
• A tendency toward hypoglycemia is very rare.
• It responds well to cutting back on food intake, especially when excess body weight is lost at the same time.

How does diabetes actually develop?

Insulin can only do its job in the body’s cells if the cells recognize it and let it work. This recognition mechanism is complex and can be impaired through heredity.

In addition, insulin’s activity in the body is under further control. Its antagonists include some hormones — glucagon, growth hormone, adrenal hormones — as well as certain metabolic products. In a normal body, this antagonism keeps insulin’s effect from becoming excessive. But in some diseases or special circumstances, the antagonism can go beyond the normal limit.

Insulin demand rises significantly with a lifestyle with little physical exertion, an abundant diet and obesity. It’s a simple truth: the less you move and the more you eat, the harder your pancreas has to work.

When insulin recognition is impaired and demand is high, the body helps itself by producing more insulin. This leads to the so-called hyperinsulinemia phase — a high level of insulin in the blood — in which, at least at first, blood sugar is still within the normal range. This phase is always present in the development of type 2 diabetes.

What does hyperinsulinemia bring with it?

As long as the pancreatic cells can produce plenty of insulin, diabetes doesn’t yet develop. Other pathological changes do, however: a tendency toward high blood pressure, circulatory problems, a greater predisposition to further obesity and faster progression of atherosclerosis.

So what actually happens? If the causes of hyperinsulinemia persist for a long time, they eventually exhaust the pancreatic cells that produce insulin — and that is when type 2 diabetes arrives. In this phase, when blood sugar is above the normal range, the risk of atherosclerosis remains very high.

That is why type 2 diabetes is often accompanied by hypertension and damage to the large blood vessels, which can end in leg gangrene, cerebral infarction and hemorrhage, as well as heart attack. Age is a contributing factor here.

Diabetes: what can you do yourself?

You can’t change heredity, and nobody escapes aging. But you can considerably delay the onset of type 2 diabetes and slow the progression of existing diabetes and cardiovascular disease.

Three things that really matter:

1. Be physically active. Regular movement improves insulin sensitivity — your cells respond better to insulin.
2. Maintain a normal body weight. If you are obese, even moving toward a normal weight one kilo at a time helps.
3. Limit your food intake. Overeating at the table is a direct risk factor — especially sweet and fatty foods.

Honestly: these three changes aren’t complicated. They’re just hard to keep up consistently. But with type 2 diabetes, consistency is what delivers results.

FAQ about diabetes

Is diabetes always hereditary?
There is a hereditary predisposition, but that doesn’t mean the disease will definitely develop. Lifestyle — movement, nutrition, body weight — strongly influences whether the predisposition becomes reality.

What is the difference between type 1 and type 2 diabetes?
In type 1, the body doesn’t produce enough insulin. In type 2, insulin levels are normal or higher, but the body’s cells don’t respond to it properly — so-called insulin resistance.

At what age does type 2 diabetes most commonly develop?
Usually after the age of 40, but because of lifestyle changes it is increasingly seen in younger adults as well.

Author: Dr. Jaan Kelk

Source: WHO – physical activity.

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