Introduction

Today we’re going to discuss how stress impacts diabetes management. Now before we do that, let’s identify the mechanisms involved in diabetes. And let’s also take a look at how diabetes management affects one’s daily life. Take a look at this slide as it diagrams the various changes experienced by the body in diabetes.

Diabetes is a disease of deregulation of glucose control in the blood stream. The cause may be different for each individual including a very complex interplay of insulin production, genetic factors, autoimmune response, hormone imbalance, insulin resistance and lifestyle. For the sake of today’s program we will focus on the most basic diagnostic differentiation in diabetes management, Type 1 diabetes and Type 2 diabetes.

 

Type 1 Diabetes

In Type 1 diabetes the body is unable to provide sufficient insulin production to meet its needs. Exogenous insulin production is reduced due to the autoimmune antibody production, or other destruction of the insulin producing beta cells of the pancreas. Insufficient insulin levels lead to hyperglycemia. Insulin stimulating medications (which stimulate the pancreas to produce more insulin) are not effective in this population as pancreatic function can not be increased.

An autoimmune condition Involves destruction of the insulin-producing beta cells of the pancreas   Lack of insulin produces hypercglycemia, cell starvation, ketoacidosis

 

Type 2 Diabetes

In Type 2 diabetes some level of insulin resistance that still exists causes insulin production needs to increase beyond the body’s ability to self-regulate blood sugar levels. In insulin resistant type 2 diabetes, insulin is produced in large quantities (though this ability may reduce over time as beta cells are damaged) however, the insulin receptors are inhibited or blocked by elevated levels of hormones, triglycerides or other factors in the blood stream. The exact mechanisms of insulin resistance are not fully understood and appear to vary between individuals. Oral medication to increase insulin production may be effective for some patients.

Pancreas makes some insulin Cells can be resistant to insulin Liver makes too much sugar Managed by diet & exercise, and in some cases medication Usually develops after age 40, but may occur at any age May require insulin

 

Type 1.5 Diabetes?

It is important to recognize that though these diagnostic groups are separate, but there is a great deal of cross over. Many people with type 1 diabetes struggle with insulin resistance, while many people with type 2 diabetes simply lack the physiologic capability to produce sufficient insulin to prevent hyperglycemia.

People with Type 1 can suffer from insulin resistance Stigma of resistance being "self-inflicted" People with Type 2 can suffer from under-productive beta cells Stigma of having "failed" other therapies