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Diabetes Basics: Understanding the disease

Diabetes is a disease that currently affects over one million people across Australia, and the numbers are on the rise. However, although diabetes is so widespread, many of us don’t have a good basic understanding of the disease or how to manage it.

Even if you don’t have diabetes yourself, you are likely to know someone who does, and it's good to be familiar with the basics. This two-part guide explains the basics of diabetes and diabetes management in easy-to-understand terms.

For the second part of the guide click on the link for Diabetes Basics: Management and treatment at the end of the article.

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What is diabetes?

The diabetic condition is one in which the body doesn’t produce or properly use insulin and therefore cannot let glucose (converted from carbohydrates) into the cells for energy.

Carbohydrates are the body's primary source of energy. Although the body can use protein, fats and carbohydrates for energy, it is the carbohydrates that trigger a more dramatic insulin release and response. Here's what happens to carbohydrates in your body if you don't have diabetes:

  • When you eat a food containing carbohydrates, the carbohydrates are converted to glucose and released into the bloodstream.
  • The glucose then wants to get into the body’s cells to give them energy. However, the glucose cannot just enter the cells – it needs a "key" to unlock the cell "door", and insulin carries that key.
  • Therefore, when glucose levels in the bloodstream get high enough, the pancreas releases some insulin to go and unlock the cells so that the glucose can get in and give energy to the cells. 

If you do have diabetes, the process fails at one of two points.

  • In Type 1 diabetes, the pancreas does not produce enough insulin.
  • In Type 2 diabetes, the cell’s keyholes are not the right shape for the insulin keys.

Either way, glucose cannot enter the cells and so remains in the blood stream.

What is hyperglycemia?

When glucose remains in the blood stream, glucose levels get too high; this is called hyperglycemia - also known as high blood-glucose (sugar).

The body tries to combat hyperglycemia by pulling water out of the body’s cells and sending it into the bloodstream. In the bloodstream, the water dilutes the high glucose and then excretes it in the urine. This produces symptoms of frequent urination, continual thirst, and tiredness. At the same time, the cells remain starving for glucose and send signals to the body to eat more food. People with diabetes are thus often very hungry.

Checking your blood sugar count regularly and then treating high blood-glucose early can help you detect and avoid hyperglycemia.

If you don't treat hyperglycemia quickly, a serious condition called ketoacidosis can occur. This occurs when your body does not have enough insulin. To make more, your body tries to break down fats into glucose. However, this produces waste products called ketones. Your body cannot tolerate large amounts of ketones and tries to remove them through the urine. Unfortunately your body cannot remove all of the ketones this way and they can build up in your blood. This excess of ketones in your blood can lead to ketoacidosis. This is a life-threatening condition that needs to be treated immediately.

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Next: What health problems occur as a result of diabetes?

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