Diabetes is perhaps one of the most misunderstood diseases in the world. Not only is there very little understanding of what is actually happening when people have the disease, but there’s also a lack of comprehension of what causes it. The problem is that few people with the disease know what is going on inside their bodies and, therefore, have few tools to deal with the problem. They become anxious and depressed, not knowing what to do.

Let’s start by talking about what diabetes is not. It’s not a disease caused by high blood sugar. High blood sugar is merely the effect of poor insulin action. Reducing the amount of sugar in the diet may help reduce spikes in blood glucose, but it will do little to improve the condition because it doesn’t address the root cause.

The fundamental problem in diabetes is the ability of the pancreas to secrete enough insulin to force sugar into the cells, keep the level of sugar in the blood at a healthy level. There are many reasons why cells won’t respond to insulin and take up sugar, but the most common cause is that their internal cellular mechanisms are gummed up with fat. Muscle cells engorged with fat, for instance, can’t take up sugar as well, forcing the pancreas to work harder to secrete more insulin.

Type 2 diabetes isn’t a disease which develops overnight. Instead, it results from pancreatic insufficiency – the inability of the pancreas’ beta cells to produce enough insulin – over the course of a decade or more. You can track the blood sugar levels of people with “prediabetes” in the run-up to full-blown diabetes, and see their fasting blood glucose slowly rise as the action of insulin become less effective.

Full-blown diabetes occurs when either the beta cells of the pancreas give up, or simply can’t keep up insulin production to offset the difficulty the body’s cells have taking up blood glucose. And at that point, problems start.

High blood sugar is extremely dangerous for the body. It can damage sensitive tissues in the body, leading to problems with the eyes, kidneys and lower extremities. Sufferers can use a diabetic sock to relieve some of the symptoms or take extra insulin, but high blood sugar levels must be brought down. It can ruin people’s mental health, as well as their physical well being, which is why the disease is so dangerous.


What Causes Diabetes?

There’s a debate in the literature about precisely what causes diabetes, although over the course of the last few decades the blame has shifted firmly from sugar to fat. In the early days, scientists at the Joslin Clinic believed that people with diabetes had to consume a high-fat diet to avoid excess sugar in the blood. But over time they realised that it was fatty foods themselves that were gumming up the works inside cells, preventing them from responding to insulin and taking up glucose from the blood.

Now the state of the art advice is to avoid processed, fatty and sugary foods, and focus on a diet centred around beans, whole grains and vegetables. The jury is still out on how to prevent diabetes, but many doctors report success with diets similar to the Mediterranean, high in unprocessed whole foods, and low in refined, oils, sugars and meat. People on these diets see both an improvement in their mental and physical health.

Here at Dr Julian we can support you through the psychological distress that can be caused by diabetes and have a number of diabetes expert counsellors and psychologists. Do check them out through app.dr-julian.com

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