Say you’re shoveling coal into a boiler that runs a steam train. The train isn’t going anywhere, so the coal isn’t being used to power the locomotive. The boiler is already full, but you keep on shoveling. The engineer keeps turning up the heat in the boiler to burn all that coal, but eventually the machine can’t keep up and starts to break down.
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This is a very simplified description of what happens to a person with diabetes or pre-diabetes.
Dr. Matthew Davies, an endocrinologist at Swedish Medical Center, puts it this way. We are living a relatively sedentary lifestyle. We have a high calorie/high carbohydrate diet. This means we are “trying to stuff sugar and other carbohydrates into muscles that are already full.” We need more of the hormone insulin to help glucose (digested sugars and carbohydrates) enter the cells and be used for energy. “Eventually, the pancreas can’t make all of the insulin the person needs and begins to wear out,” Davies says.
The pancreas either ceases to produce enough insulin or the body ceases to use the insulin correctly (insulin resistance). Glucose then builds up in the bloodstream where it can be measured with blood tests. A person with high levels of blood sugar is diagnosed with type 2 diabetes. A person with blood sugar levels higher than normal, but not as high as the threshold for full-blown diabetes, has pre-diabetes.
Diabetes is a train wreck for the body. The excess glucose can attach to proteins in the blood vessels and alter their normal structure and function. One effect of this is that the vessels become thicker and less elastic, making it hard for blood to squeeze through. If blood sugar levels are not controlled, a diabetic person is two to four times more likely to suffer heart disease or stroke than a person with normal blood sugar. She is more susceptible to blindness, kidney disease, nerve damage and circulatory problems, which, in the worse case, can lead to infections and amputations.
It is a disease to be avoided at all costs, and yet its incidence has been steadily rising, in tandem with a rise in the number of people who are overweight or obese. Presently, 23.6 million Americans — about 7.8 percent of the population — have diabetes.