Chronic illnessDiabetes

What is diabetes?

Spoon full of sugar, with the logo of Chronic Buddy and this sentence : what is diabetes?

Chronic Buddy focuses a large part of its activities on diabetes, one of the most common chronic non-communicable diseases in the world: 425 million adults (1 in 11) and 1 million children are affected (IDF figures 2018). Many clichés and stereotypes are associated with the massive development of diabetes in the world, which reinforces discriminations and even inequalities that affect people living with diabetes. This article aims to deconstruct these stereotypes and to better understand this illness, which remains ultimately misunderstood by many people.

The different types of Diabetes

Diabetes is a disease characterized by a chronic increase in blood sugar levels, called hyperglycemia, whose long-term effects on the body can lead to serious complications. The disease occurs when the production of insulin, the hormone that regulates blood sugar levels produced by the pancreas, becomes insufficient or ineffective, depending on different causes. There are several types of diabetes, more or less prevalent in the population:

 

  • Type 2: this is the most common form of diabetes, accounting for about 90% of people with diabetes, mainly adults. It is characterized by a condition called “insulin resistance”, a normal phenomenon which come with age, but which can be aggravated by various risk factors: overweight and obesity, ethnicity, family history, but also lifestyle (sedentarism, unbalanced diet, stress, smoking…). Contrary to common belief, heredity is one of the main risk factors for type 2 diabetes, which varies between 40% and 70% in cases where both parents have the disease. Its treatment primarily involves the adoption of a healthy lifestyle (diet, physical activity) and, if necessary, oral medication or even insulin injections.

  • Type 1:  type 1 diabetes is an autoimmune disease, which means that it results from a dysfunction of the immune system that fights against insulin-producing cells in the pancreas. People with type 1 diabetes (8-9% of people with diabetes) no longer produce insulin: they are forced to get it on daily basis (by injection, or insulin pump) to keep their blood sugar under control, and could not live without it. The disease usually occurs as a child, teengager or young adults but can occur at any age, and its origin remains unknown. However, it is known that the combination of genetic and environmental factors (e.g. viruses, toxins, food (e.g. gluten, etc.)) play a role in the development of the disease, and also explain its heterogeneous geographical distribution. Currently, there is no way to prevent the onset of type 1 diabetes.
  • Monogenic diabetes: this rare form of diabetes (1-2% of cases) results from a mutation of a dominant gene and is mainly due to hereditary genetic predispositions: it generally affects 50% of individuals of the same family generation. This diabetes most often appears before the age of 25 but looks more like a type 2 than a type 1, which explains its name “Mody” (Maturity-Onset Diabetes of the Young). MODY’s treatment depends on the level of hyperglycemia: many people do not require drug treatment, but some must take oral antidiabetics or even insulin.
  • Gestational diabetes: this form of diabetes affects pregnant women during the second and third trimesters of pregnancy, although it can occur at any time. It results mainly from hormones production by the placenta that reduce the action of insulin, combined with other risk factors (age, overweight, family history). It is a temporary diabetes that disappears at the end of pregnancy, but increases the risk of developing type 2 diabetes later on for 50% of women.

  • Secondary diabetes:  secondary diabetes occurs as a result of medical complications, due to medication (e. g. corticosteroids), organ transplants (e. g. liver) or other diseases (hormonal disorders, pancreatic diseases, etc.).

Ending stereotypes

Understanding the different types of diabetes, their causes and implications aims to fights again some very popular and discriminatory stereotypes:

  • No, people with diabetes are not responsible for their disease: no one chooses to have diabetes, such as no one chooses to have cancer, a disability or anything else. It is important to remember that type 2 diabetes depends on a number of risk factors on which individuals have more or less impact, but no one ever “deserve” to have it.
  • No, it is not because you have eaten too much sugar that you have diabetes: recent studies suggest that there is a link between high consumption of sugary drinks and the risk of Type 2 diabetes. However, it is also important to remind that this type of diabetes is a result of a a conbination of different elements. Moreover, eating sugary food is not linked with other types of diabetes (type 1, gestational, monogenic, secondary), and some people who eat a lot of carbohydrates will never have this disease.
  • No,there is no “small” or “big” diabetes: the importance of diabetes is not measured by blood sugar levels, since the goal is to keep it under control. Complications of diabetes can have serious consequences. In all cases and whatever its type, this disease has many implications for everyday life that should not be minimized by judging of its “size”.
  • No, diabetes does not mean “death”: it is true that any chronic illness has a huge impact for people living with it. But this does not prevent them from living a normal, long, healthy and happy life, as long as they follow their treatments and the progression of their disease. Nor does it prevent them from enjoying themselves, with pastries or other sweet products (and they don’t need to be noticed!). Everyone can adapt to the disease’s inconvienients, which can be turn into positive results: you get to know amazing people, you develop many human qualities (adaptation, empathy…), and a balanced life!

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