Your body spends a lot of energy on something called homeostasis. This is a constant internal state — an environment — that’s needed for optimal cellular function. For example, when you’re in a cold environment, your body tries to maintain a constant internal temperature so your cells can work properly.
Similarly, if your body temperature becomes too high, you start sweating so that some of that heat can be given off.
The same is true for blood sugar — the body has a dedicated biochemical mechanism that ensures that it stays within a normal range.
When this mechanism becomes abnormal, your blood sugar becomes either too high or too low, and in this article, we’ll discuss why this happens, what it means for your health, and how you can prevent it.
How is normal blood sugar maintained?
Your body maintains a normal blood sugar level using hormones, which are chemical molecules that act as messengers between your cells.
The two main hormones involved in blood sugar regulation are insulin and glucagon. Shortly after you eat a meal, your blood sugar concentration rises. Your body (specifically an organ called the pancreas) senses this increase in blood sugar and releases insulin.
The job of insulin is to help your cells utilize the sugar present in your blood. It does so by increasing the permeability of your cells to sugar and as they take it up, blood sugar levels return to normal.
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On the other hand, when you haven’t eaten for a while, your blood sugar starts to fall. The body responds to this in two ways:
- It reduces insulin secretion
- It increases glucagon secretion
Glucagon is the opposite of insulin. Its goal is to increase your blood sugar levels in times of fasting. It does this by making the liver break down glycogen, which is the storage form of sugar in the body. As glycogen is broken down and released into the blood, your sugar levels normalize.
Note: other hormones like cortisol and norepinephrine also influence blood sugar levels but are not as important as insulin and glucagon.
So what happens when this mechanism goes awry? Diabetes. Let’s discuss that now.
How does diabetes develop?
Diabetes is defined as a fasting plasma glucose level greater than 126 mg/dl or a random blood glucose level greater than 200 mg/dl. It's basically a condition where blood sugar levels are higher than they should be.
The two main types of diabetes are type 1 (insulin-dependent) and type 2 (insulin-independent) diabetes.
In type 1 diabetes, the body’s immune system turns against the insulin-producing cells in the pancreas and destroys them. As insulin production falls, blood sugar levels rise. Type 1 diabetes is called insulin-dependent because the body still has the ability to respond to insulin — it’s just not being produced.
In type 2 diabetes, the body loses its ability to respond to insulin (this is called insulin resistance). When cells stop responding to insulin, they can no longer take up sugar from the blood, causing blood sugar levels to rise.
This type is also called insulin-independent diabetes because there’s no problem with insulin production — the body has simply stopped responding to it.
You should know that one well-known reason for insulin resistance is obesity. As fat accumulates in the body, so do fatty acids. And fatty acids prevent body cells from responding to insulin. This is why one effective treatment for type 2 diabetes is weight loss.
How common is diabetes?
Around 1.6 million individuals are thought to suffer from type 1 diabetes in the US. Type 2 diabetes is more common and affects roughly 34 million in the US (with 7.3 million being undiagnosed).
Type 2 diabetes usually affects people after 40 years of age. However, it's increasingly affecting young people now. The longer you live with diabetes, the higher your chance of developing long-term complications, so let’s discuss them now.
Why is high blood sugar bad?
Long-term diabetes (and thus prolonged high blood sugar level) leads to a plethora of complications. As blood sugar increases, it spills into multiple organs causing damage.
When excess sugar accumulates in the lens of your eye, you can develop cataracts. Similarly, if excess sugar accumulates in blood vessels, it can reduce blood supply to multiple organs causing widespread damage (like blindness, foot gangrene, nerve dysfunction, and erectile dysfunction).
Diabetes is also famous for causing kidney damage over long periods. As excess sugar damages renal blood vessels, you can develop something called a nephrotic syndrome, where you start losing protein in the urine.
This can lead to abnormal blood clotting, increased risk of infection, and swelling. Diabetes is also a major cause of renal failure, where the kidneys completely shut down. This condition is fatal unless patients undergo renal transplantation or dialysis.
Finally, high blood sugar levels are a major risk factor for atherosclerosis. This is where abnormal blood lipids accumulate inside your blood vessels, reducing blood flow to major organs like the heart and brain. This is why patients with diabetes are at an increased risk for a heart attack.
High blood sugar levels have also been associated with dementia (where you lose cognitive skills), hearing impairment, and depression.
How can you prevent diabetes?
Type 1 diabetes isn’t really preventable since it occurs due to an abnormal immune system. But since type 2 diabetes develops due to obesity, anything that helps you maintain a healthy weight can prevent it. Steps you can take to prevent type 2 diabetes include:
- Reducing fat, sugar, and red meat intake. All of these can lead to weight gain and increase your risk of diabetes. It’s also a good idea to reduce the amount of calories you consume in general by eating smaller meals. Make sure your diet is well-balanced and contains lots of fruits and vegetables.
- Getting regular exercise. Exercise not only helps you shed weight (and thus reduce your risk of diabetes) but it also has a wide range of other health benefits. Exercising for 30 minutes daily is a good idea.
- Quitting cigarette smoke. Cigarette smoke not only increases your risk of diabetes but also predisposes you to a wide range of cancers!
*These statements have not been evaluated by the Food and Drug Administration. Any statements or products mentioned in this article is not intended to diagnose, treat, cure, or prevent any disease.