Understanding Diabetes- An Overview

Four years ago, I was in the centre of things, working as an intern in a teaching hospital. I was posted on the Endocrine ward, where about 80% of the patients we managed were diabetic. It was eye-opening—and not in a good way. Most of our patients weren’t just dealing with diabetes; they were facing severe complications from it. Some were coming out of surgery after limb amputations, others were there because of diabetic nephropathy (that’s the medical term for kidney disease caused by diabetes).

It was my job to help these patients recover, but every day, I had the tough task of delivering bad news after bad news. In life, people say you win some, you lose some, but here? It felt like we were losing more than we were winning. We had more grieving families than we could count, and each day seemed to bring a fresh dose heartbreak. I was constantly breaking the news about irreversible eye damage, kidney failure, and sometimes, the loss of life.

That experience left a mark. I started to dread the word diabetes. I was terrified, and like anyone who’s afraid, I ran. I avoided anything diabetes-related—meetings, lectures, you name it. But in hindsight, I wish I’d faced that fear head-on. I wish I’d taken the time to understand diabetes, asked my questions, and found answers.

So, what exactly is diabetes? Why does it have such a devastating impact?

Before we dive into that, let’s take a step back in time.

Brief History

Diabetes has a long history. The first known descriptions date as far back as 1500 B.C., with the Egyptians recording symptoms that sound very much like diabetes. In fact, ancient Greeks and Indians even called it "honey urine" because the urine had a sweet smell and taste(yes they tasted urine back then).

The Greeks used the word diabetes, meaning “to pass through” or “siphon,” referring to how fluids seemed to just pass through people with the condition. One moment they were drinking, the next they were peeing out all they had just drunk.

Later, the Greeks added mellitus, which means "honey-sweet," due to that sugary nature of the urine. And that’s how we ended up with the name “Diabetes Mellitus.” The name has stuck till today.

But it wasn’t until the 1920s, in the 19th century, that two Canadian scientists, Frederick Banting and Charles Best, discovered insulin—the game-changing hormone produced by the pancreas. This discovery finally gave people with diabetes a fighting chance against what was, for so long, a feared and deadly condition.

How Does Diabetes Work? A Peek at Insulin

Diabetes is a metabolic disorder, which means it’s linked to the way the body uses energy. And because every cell in our body needs energy to function, diabetes doesn’t just affect one area—it can impact the whole body.

The body uses sugar (glucose) for energy, and it regulates blood sugar levels very carefully. The pancreas is responsible for producing a hormone called insulin, which plays a crucial role in keeping blood sugar in check. Think of insulin as a “key” that unlocks cells, allowing sugar to enter and provide energy.

Here’s where diabetes comes in. If the body doesn’t produce enough insulin, or if the cells become resistant to insulin, blood sugar levels rise. This is the fundamental problem in diabetes.

To make it simple, there are two main ways insulin can fail to do its job:

1. Insulin deficiency: There isn’t enough insulin being produced. Without enough insulin, blood sugar can’t get into the cells, so it builds up in the bloodstream. This scenario is characteristic of Type 1 diabetes.

2. Insulin resistance: The body produces insulin, but the cells don’t respond to it effectively. It’s as if the “key” isn’t working properly, so glucose can’t enter the cells, leading to a build-up in the blood. This is what happens in Type 2 diabetes.

There are other types of diabetes, but they all revolve around the fundamental principle that involves either a lack of insulin or an issue with how the cells respond to it.

Understanding diabetes is no small task. But looking back, I wish I’d faced my fear of it sooner. Diabetes can be a formidable condition, but learning about it brings a new level of respect for the fight people go through. For them, and for everyone who cares about them, knowledge is a powerful tool.

Thanks for reading.

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