Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

Links not loading properly?

Some of our pages use Portable Document Format (PDF) files, which require Adobe Acrobat Reader. To download Acrobat Reader for free, visit www.adobe.com.

Sign up for our weekly e-mail newsletter and receive a FREE GIFT! Enter your e-mail below.

Learn more

Learn more about diabetes

Links to help you learn more about diabetes.

Ask a diabetes expert
Other diabetes resources
Browse article topics


What is Diabetes?

by Belinda O’Connell, MS, RD, CDE, and Laura Hieronymus, MSEd, APRN, BC-ADM, C.DE

In the absence of insulin, glucose in the bloodstream cannot be transferred into cells as it normally would, resulting in high glucose levels in the bloodstream and a state of “starvation” within cells. The kidneys filter the excess glucose out of the blood, causing increased urination, thirst, and dehydration. Starving cells, no longer able to use glucose for energy, begin to use fat, resulting in loss of body fat and the production of ketones (chemical by-products of fat metabolism). If not treated (with insulin) in time, the combination of high blood glucose, high levels of ketones, and dehydration can lead to a very serious condition called diabetic ketoacidosis and, potentially, death.

Some people with Type 1 diabetes experience a “honeymoon” period after diagnosis, during which their pancreas regains the ability to produce insulin, and they require little or no injected insulin, but this generally lasts only a short time. Within a few months, most people have very little insulin-producing capacity and require an outside source of insulin.

Type 2 diabetes

Type 2 diabetes is much more common than Type 1 and has a stronger genetic link. (If one identical twin develops Type 2 diabetes, there is a 90% chance that the other one will also.) Symptoms of high blood glucose are less pronounced in Type 2 diabetes compared to Type 1 diabetes; because of this, diagnosis often occurs many years after diabetes initially develops. However, the damage starts even in the absence of acute symptoms: Blood glucose levels above normal are known to increase a person’s chances of eventually developing heart disease and other complications of diabetes.

Unlike Type 1 diabetes, Type 2 diabetes is not caused by an autoimmune attack. Instead, there are usually two underlying problems: insulin resistance and inadequate insulin production. Insulin resistance is when the cells of the body have a decreased response to insulin. Under normal circumstances, when blood glucose levels are high (after eating, for example), the pancreas releases insulin into the bloodstream. Insulin then interacts with muscle cells, fat cells, and other tissues, allowing them to transport glucose into the cells to be burned for energy or stored for use later.

In insulin resistance, these important messages do not get through. Remember playing “telephone” as a child, when one person would whisper a word to the person next to them, and that person would whisper what they heard to the next person, and so on down the line? By the time it got to the end of the line, the word had usually mutated to something completely unrecognizable. A similar breakdown in communication is thought to occur in insulin resistance, where the signal from insulin becomes garbled, and the cell does not respond normally, taking up much less glucose than normal.

When blood glucose levels remain high, the pancreas continues to secrete more insulin to compensate for its decreased effectiveness, and eventually, blood glucose returns to the normal range. Over time, however, the pancreas loses the ability to produce enough extra insulin to compensate for insulin’s decreased effectiveness, and blood glucose levels remain high. At this point, a person might be diagnosed with diabetes or prediabetes, depending on his blood glucose level at the time of testing.

The liver also plays a key role in regulating blood glucose level. It releases glucose to the bloodstream when the blood glucose level is low, and it stores glucose when the level is high. When the blood glucose level is high, insulin has the important role of signaling the liver to turn off glucose production and start storing extra glucose. But if a person is insulin resistant, the liver does not respond normally to insulin, so it continues to release glucose to the bloodstream even if the blood glucose level is already elevated, making it even higher.

Page    1    2    3    Show All    

Also in this article:
for Types of Diabetes



More articles on Diabetes Basics



Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



Chocolate to Fight Diabetes?
For people with diabetes — and many people without it — the holiday season is the... Blog

Why Me? Diabetes and the Story of Job
Once, I wanted to know where my illness came from. What had I done wrong? Was God or the world... Blog

Making Adjustments
I've had Type 1 diabetes for 21 years now. I've spent significantly more time in my life WITH... Blog

I've been experiencing high blood glucose a lot lately. Is there anything I can do? Get tip