The system to keep sugar levels within a tight range fails when there is not enough insulin produced to do the job of keeping the sugars down. This can occur because of one or both of:
- More insulin is required to do the job (insulin resistance)
- The beta cells in the pancreas is unable to increase insulin production as requested by the above (reduced beta cell capacity)
Insulin resistance
This is where more insulin is required to keep the sugar levels down. This occurs for many reasons including a significant genetic component but more of reasons relate to lifestyle issues:
- Excess bodily fat
- Inadequate exercises
- Suboptimal diet (especially diets containing excessive processed carbohydrates)
- Loss of muscles
- Excessive alcohol intake
- Some medications including medications for mental health, steroids
- Snoring
This is the usual reason in patients diagnosed with Type 2 diabetes.
Beta cell impairment
These are cells that live in the pancreas. They are responsible for producing the insulin hormones. There are some genetic reasons why in some people, the beta cells are not able to keep up with demand but most of the reasons for the beta cells dying early relate to, once again, lifestyle issues as listed above. The toxic environment from unhealthy lifestyle poisons the beta cells. High blood lipids (especially high triglycerides) and high sugars are particularly potent in killing off the beta cells. When the blood environment is full of sugars and fats, the beta cells just can’t do their job in keeping our sugars down.
In patients with Type 1 diabetes, the beta cells die because of an immunological problem whereby the body’s own immune system kills off the beta cells.
Once gone, we can’t re-grow the beta cells again. Thus, we need to look after those beta cells carefully.
See Types of Diabetes