• The Challenge of Treatment
    Awake!—2003 | May 8

    • With Type 1 diabetes, insulin is simply not available. With Type 2, the body makes insulin but usually not enough.g Moreover, the cells are reluctant to let insulin in​—a condition called insulin resistance. With both forms of diabetes, the result is the same: hungry cells and dangerous levels of sugar in the blood.

      In Type 1 diabetes, a person’s immune system attacks the insulin-producing beta cells in the pancreas. Hence, Type 1 diabetes is an autoimmune disease and is sometimes called immune-mediated diabetes. Factors that can trigger an immune reaction include viruses, toxic chemicals, and certain drugs. Genetic makeup may also be implicated, for Type 1 diabetes often runs in families, and it is most common among Caucasians.

      With Type 2 diabetes, the genetic factor is even stronger but with a greater occurrence among non-Caucasians. Australian Aborigines and Native Americans are among the most affected, the latter having the highest rate of Type 2 diabetes in the world. Researchers are studying the relationship between genetics and obesity, as well as the way excess fat seems to promote insulin resistance in genetically susceptible people.h Unlike Type 1, Type 2 diabetes occurs mainly in those who are over 40 years of age.

      [Footnotes]

      g About 90 percent of those with diabetes have Type 2. Previously, this was referred to as “non-insulin dependent” or “adult onset” diabetes. However, these terms are imprecise, for up to 40 percent of those with Type 2 diabetes require insulin. Furthermore, an alarming number of young people​—some not even in their teens—​are being diagnosed with Type 2 diabetes.

      h A person is generally considered to be obese when 20 percent or more above his or her ideal body weight.

  • The Challenge of Treatment
    Awake!—2003 | May 8

    • [Diagrams/Pictures on page 8, 9]

      Diabetes Simplified

      PANCREAS

      Healthy Person

      After a meal, the pancreas responds to increases in the glucose content of the blood, releasing the proper amount of insulin

      Insulin molecules become attached to receptors on muscle cells and other cells. This, in turn, activates portals that allow glucose molecules to enter

      Glucose is absorbed and burned by muscle cells. Thus, the glucose level in the bloodstream returns to normal

      Type 1 Diabetes

      The insulin-producing beta cells in the pancreas are attacked by the immune system. As a result, insulin is not produced

      Without the assistance of insulin, the glucose molecules cannot enter into the cells

      Type 2 Diabetes

      In most cases the pancreas produces a limited amount of insulin

      If receptors are less responsive to insulin, portals that are needed to absorb glucose from the blood are not activated

      Glucose builds up in the bloodstream, thwarting vital processes and damaging vessel walls

      [Diagram]

      (For fully formatted text, see publication)

      CELL

      Receptor

      Portal

      Insulin

      Nucleus

      Glucose

      [Diagram]

      (For fully formatted text, see publication)

      BLOOD VESSEL

      Red blood cells

      Glucose

      [Credit Line]

      Man: The Complete Encyclopedia of Illustration/J. G. Heck