Dear Holly: What is the difference between Type 1 and Type 2 diabetes? Am I going to get it? -Sweet Tooth.
Dear Sweet Tooth: Anything that we eat that contains carbohydrates will eventually be broken down in our digestive system to individual sugar molecules. These tiny sugars are the building blocks to starchy breads, potatoes, rice, fruit, milk, and sweets. Any of these foods, not just desserts, can impact blood sugar.
Once sugars are absorbed from our digestive tract into our blood, they are transported to our liver for processing and to each and every cell as fuel. The gatekeeper for entering each cell is insulin, a hormone made by the pancreas. Without insulin, the cells cannot open their gates to allow the glucose inside. Without sufficient insulin, blood sugars can quickly rise and eventually cause damage. Everyone has some circulating glucose – the potential for trouble is if these levels get too high or too low.
Type 1 diabetes is when a person’s pancreas stops making insulin. The remedy? Injecting insulin. These days there are different of types of insulin, ways to inject and how to monitor changes in blood sugar throughout the day. Insulin is an excellent medication and works well if the person managing the blood sugar has the proper education and support.
Type 2 diabetes is more common. Approximately 95% of the people in the US with diabetes have Type 2. Things are more complicated here. The pancreas is still making some insulin, but less than is needed, and the levels decline with time. The muscle cells are also resistant to insulin trying to let the glucose in. My analogy is that the cells are like a bratty teenager – insulin is knocking on the cell door but the cells aren’t responding.
There are a variety of medications used to help support healthy blood sugars. Each carries different risks and benefits. Some medications act at the muscle site to improve the response to the declining levels of insulin, others act at the pancreas to increase production. Some medications decrease carbohydrate absorption from the GI tract and others lower the amount of stored carbohydrate that is released by the liver.
Gestational diabetes can occur during pregnancy. The physiology is similar to that of Type 2 diabetes where the body resists the insulin that is being made. It often resolves after delivery of the baby, but the fact that may get glossed over is that having had gestational diabetes significantly increases your risk for developing Type 2 diabetes down the line.
Will you get diabetes? If I could predict that, I would be accepting a Nobel prize! Risk for developing Type 2 diabetes increases with age, with obesity, a sedentary lifestyle and poor diet. Certain groups are more vulnerable to diabetes because of their genes.
In a diagnosis of any kind of diabetes, a solid foundation of education is imperative to successful management. Doctors and dietitians talk about following a “diabetes diet” but it isn’t really anything so different than my usual goals for clients; moderate portions of carbohydrates at each meal, even spacing of eating throughout the day, skipping concentrated sweets most of the time.
If you have a diagnosis of diabetes, I recommend you make an appointment with a dietitian to optimize your eating and protect your health.
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What’s your question for Holly? Send them to email@example.com. For more information and to make an appointment to work on your goals, visit Grass Roots Nutrition, LLC and BrideBod, owned by me, Holly Larson, a Registered Dietitian. Visit me online at hollylarsonrd.com and follow us on Facebook. Have a delicious, healthy day!