Harriet Kaufman Adwoa,

 Registered Nurse, RN
 Masters in Science Nursing, MSN


Diabetes has been called “sugar” by some and it is not far from the truth because the illness occurs when the body is unable to use sugar in the way it was made to and sugar builds up in the blood.

We know of four different types of diabetes.

Gestational diabetes occurs in pregnant women whose bodies can no longer tolerate sugar or don’t make the insulin to take sugar from the blood stream into the body’s cells. This usually goes away once the baby has been born but often times leads to type 1 diabetes.

Secondary diabetes (not to be confused with type 2 diabetes) is diabetes that develops because of another illness such as cancer of the pancreas or liver, or from taking certain medications that make the body resistant to its own insulin. Many times this will resolve itself if the illness is treated or the medication is stopped but can also become type 1 or 2 diabetes.

Type 1 diabetes occurs when the body cannot produce enough insulin to carry sugar from the blood stream into the cells that need it. This used to be known as juvenile onset diabetes because it usually presented in people under the age of 30 but that is no longer the case. Signs and symptoms usually develop quickly.

Type 2 diabetes occurs when the pancreas does produce insulin but it may not be enough or for some reason the body’s cells are resistant to the insulin and the sugar stays in the blood stream. This type of diabetes is the most common in this country. It develops much more slowly over a longer period of time and many times may only be caught because a person is having their blood tested routinely. Fortunately most people with this type of diabetes do not have to take insulin but may need other types of medications and serious diet control.

For the purposes of this booklet we are only going to focus on Types 1 and 2 diabetes. The management of the other two is similar but have other considerations which are not within the scope of this booklet.

The human body is a most fascinating and complex mechanism that functions perfectly – most of the time. To understand the importance of diabetes, let me tell you a bit about the digestive system first.

Our bodies are made to digest three main food sources: carbohydrates, fats and proteins. Proteins are the building blocks of our physical structure (skin, hair, finger nails, bones etc) and through digestion they break down into amino acids. While important, they are mostly needed in pregnant women, growing children, the ill and the elderly. Fats are used most importantly as the lining around our brain and nerves helping us to reason and react quicker, and they keep us warm. After digestion they break down into fatty acids. When fatty acids are burned excessively they produce a waste product called ketones. Carbohydrates are most important as they are our source of energy or fuel. They are needed constantly just like a car needs petrol to run. None of our body’s functions would be able to happen if we didn’t have energy. Carbohydrates which are any starch (yam, cassava, rice, and wheat), fruits, vegetables and milks are digested into simple sugars, namely sucrose, fructose and lactose which are then further broken down into glucose, the most simple sugar. After digestion, glucose moves to our blood from the intestines and then is assisted into our cells by insulin which is made in the pancreas. Once in the cells glucose is used by our mitochondria to form ATP which is where our energy comes from. This energy is used to do every bodily function we can think of. Excess glucose is stored in the liver as glycogen where it is saved for times of need. So you understand the importance of sugar…..the brain cannot live over 8 minutes without glucose.

In the absence of insulin or with too little insulin we don’t get the sugar into the cells, the blood becomes thick just like when you add sugar to thicken up syrup or jam and we lack the necessary energy to function. What happens is that we seem to be tired ALL THE TIME! We are hungry despite eating regularly because our cells are lacking in their food source – glucose. We have to urinate often and feel thirsty because of the thickening of our blood. In a sense we are trying to ‘thin out’ our blood. Water is being drawn out from the cells into the blood stream to balance things out, so the cells are dehydrated (and we are thirsty), and all that sugar in the blood passes through the kidneys drawing with it a lot of water (so we urinate a lot). In the absence of pancreatic or liver disease, it is not fully understood why this happens to our bodies. It has been thought that diabetes is a genetic illness (in that it passes from generation to generation) and it’s been thought that it may be caused by stress. In a stress reaction the body prepares to ‘fight or flight’. A series of hormones are produced that increase the amount of sugar in our blood so that we have energy to do what we need to do. The extreme example is that we’re walking down the road and we see a cobra. Our bodies automatically do what is necessary to survive. While this is a positive reaction for our safety, constant stress affects us over a long period of time. The body doesn’t return to a relaxed state as easily and perhaps more sugar is left in the bloodstream rendering the cells unreceptive or wearing out the pancreas. Too much of a good thing…… whether this is accurate or not, we do know that stress affects the diabetic much more then it affects the healthy individual. Maybe the person who gets diabetes while having a lot of stress in their life was already predisposed to getting it in the first place. We don’t really know.

Whether you are under a lot of stress or not, it’s a good idea to monitor yourself for these signs of diabetes:

Increased urination
Sores that won’t heal
Constant vaginal yeast infections
Continual fungal infections

If at all possible, have your blood sugar checked at least once a year especially, if you experience any of the above.

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