What causes Diabetes?

Type 1 Diabetes

Found throughout the pancreas, a very specialized tissue called the “Islets of Langerhans” is responsible for manufacturing and secreting hormones. Famed German pathologist Paul Langerhans discovered this tissue in 1869 after observing the cells clustered in groups, almost as if they were little islands (hence the name).

One such group is known as “beta cells”. These cells manufacture insulin according to the level of glucose found in the blood stream. Think of these beta cells as a factory: they only know how much insulin to produce when told by the “foreman” (glucose). When a person ingests food, blood sugars rise significantly, resulting in the release of a substantial amount of insulin. This insulin causes the body’s cells to use the sugar, and the level of sugar in the blood stream quickly returns to normal levels. Concurrently, these beta cells gradually reduce production of insulin until they reach an “idling state”. These beta cells constantly adjust their output, ensuring that there is precisely enough insulin to moderate blood sugar.

When a person has Type 1 diabetes, the body reacts to beta cells as if they were foreign invaders. As such, these cells (crucial to normal functioning) are destroyed. Once the beta cells are lost, the body can no longer produce insulin, and symptoms of diabetes begin to appear.  

Type 2 Diabetes

Type 2 diabetes is most commonly caused by an unhealthy diet and infrequent exercise. When taken together, the result is insulin resistance, a condition in which the body’s cells aren’t sensitive enough to react to insulin.

Insulin resistance is thought to be caused by a breakdown in intercellular signaling. Patients with insulin resistance have cells that don’t “hear” insulin, which means that they don’t ingest it for use. The result is elevated levels of insulin and glucose in the bloodstream.

During the developing stages of insulin resistance, the pancreas makes an attempt to compensate by producing increasing levels of insulin. Eventually, so much insulin is created that the cells once again begin to “hear” the insulin, and blood glucose is returned to a normal level. This is known as compensated insulin resistance.

Unfortunately, this increase in production isn’t sustainable. After a while, the pancreas becomes worn out, and glucose levels consequently remain elevated. When this occurs, it’s called uncompensated insulin resistance.

The following is the chain reaction that occurs over time in a Type 2 diabetes patient.

Too many carbohydrates are ingested, leading to a spike in blood sugar. Insulin is produced. Blood sugar drops. Eventually, this roller coaster begins to affect the body's ability to use insulin. Consequently, the body starts to have trouble metabolizing sugar. Over time, the pancreas begins to weaken, and can no longer produce enough insulin to overcome this insulin resistance. The result is a decreased insulin production and/or increased insulin resistance. Both lead to the propagation of the cycle, with symptoms eventually beginning to develop. Scientists don’t yet have an answer for the “chicken or egg” question regarding the link between obesity and insulin resistance. It’s not clear which causes the other to occur, or if there is even a causal relationship. There is some connection, especially in the weight that gathers in the midsection. Furthermore, a lack of physical activity (exercise) encourages insulin resistance, as well as the ingestion of too many carbohydrates.

Diabetes and Oxidative Stress

Most scientists and doctors agree that oxidative stress is extremely important in determining the root cause of diabetes. The theory is quite complicated, with references to biochemistry. Envision a “free radical”, which is an atom or molecule with an unpaired electron in its outer ring. This atom or molecule desperately wants to find another electron to reach a state of equilibrium. As such, this “free radical” will quickly grab an electron from the nearest molecule. Of course, this converts the other molecule into a “free radical”, needing to find another electron. And so on down the line it goes, a never-ending cycle occurring over and over again.

Scientists call this cycle the “chain reaction of free radicals”. The most dangerous aspect of these rogue free radicals is the damage they wreak on DNA and the cell membrane. Think of their activity as cells running amuck, destroying everything in their path.

The body’s natural defense against free radicals is a system of antioxidants. These are molecules that aren’t affected by free radicals, and can thus sever the chain reaction prior to serious damage occurring. The most important antioxidants are the following:

Alpha lipoic acid, Vitamin E, Vitamin C, glutathione, and CoQ10.

These free radicals affect the various types of diabetes in different ways:

1. Type 1 diabetes: Free radicals damage the important beta cells located in the pancreas, affecting their ability to produce insulin.
2. Type 2 diabetes: Free radicals damage cell membranes, which leads to a breakdown in signaling between cells.

Furthermore, free radicals deplete the body of its store of antioxidants, adding to the problem.

All of this explains why lowering oxidative stress is so crucial. This is done by eating a more healthy diet, increasing the exercise regimen, and making sure to take a full line of antioxidant supplements.

There’s still much research to be done into the causes of diabetes. We do know, however, that the body can start to malfunction 5 to 7 years before the diagnosis of diabetes. This explains why somewhere in the range of 40% of people who have diabetes remain undiagnosed.