What is diabetes? Well, there are two kinds of diabetes: type 1 and type 2 diabetes mostly. And they’re interrelated but not similar, and well, that’s related to insulin.

What is diabetes? Well, there are two kinds of diabetes: type 1 and type 2 diabetes mostly. And they’re interrelated but not similar, and well, that’s related to insulin.So first let’s talk about insulin. What’s insulin, how does it work, everyone knows insulin is related to diabetes. Well, insulin is a hormone, it’s a messenger. It means that it has a message to give to the body.

Insulin is secreted by the pancreas, which is big like my hand, it’s right in the back of the stomach, and when we eat, the food is absorbed, goes next to the pancreas who sees the food, and sends insulin with it in order to inform the whole body that the food is in the blood. So the role of insulin is a little bit like the helper that would go from the milkman’s truck, ring the doorbell of the house and say “You know what? There’s milk on the street ready to be stored in your refrigerator. Do you want some?” And you’ll say “I want two bags”, they’ll give you the two bags and then they go to the next house.

Insulin works the same way: it rings the doorbell of a cell, whether it’s a fat cell, whether it’s a muscle cell, or a liver cell, and says “There’s food in the blood. Do you want to store it?” And the cells say “Yes, I’ll take some food and I’ll store it.” And all this allows that all the food we absorb after a meal is stored in our body within the bowel for two hours. Now there are two diseases where this can go wrong, and the first one, type 1 diabetes, there’s no insulin being produced. So what happens is that the food is absorbed normally with the meal, goes in the blood, but the cells never see it. So they don’t try to store it, they don’t see it.

So the food just circulates, nobody takes it, it comes the next meal, you eat again, more food goes in the blood, and the next meal more food – so the food accumulates in the blood without ever going anywhere.

Up to the point where the kidney sees that and goes “Whoa, the sugar levels are really too high, it’s becoming maple syrup more than blood, it’s becoming difficult to pump, let’s get rid of sugar.” So it takes the sugar and sends it into urine, in order to get rid of it. If we urinated little squares of sugar that would be painful. So the kidneys, when they expel the sugar, make sure they send a lot of water to dilute it.

That’s what causes the classical symptoms of urinating a lot, because all the water comes out with the sugar, losing water causes thirst so people drink a lot, and they urinate a lot. So that’s the classic symptoms of diabetes. At the same time people with type 1 diabetes are diagnosed, they lose a lot of weight, because all the food they eat ends up in urine, not in their cells.

So, these are the classical signs of diabetes at first, and the only treatment that we have is to give insulin, and try to coordinate it with the food to reproduce what’s normal. So people with type 1 diabetes need to take insulin many times a day in order to have the normal physiology restored. Type 2 diabetes is totally different. In type 2 diabetes initially, the pancreas is okay, and it’s related to being obese. So what happens there? Food is absorbed, insulin goes with the food, rings the doorbell, “Do you want to store food?” But there, the cells say “No. I’m full.” The person is obese, all the stores of fat are full.

So the cell resists, the same way as if the milkman comes to your house and says “Do you want milk?” Your fridge is full of milk. You’ll say “No, no, no.  I resist you, I don’t want to have any food, any milk, go and sell that to my neighbour.”

So the cells resist insulin. They say “No, no, no, no no, I don’t want any food, go and store it elsewhere.” Now if the body has difficulty finding a few cells to serve food, well of course the food stays in the blood for a longer period of time, because there’s no place to store it, the next meal arrives, and the next meal, and it starts accumulating and it does a little bit like it does in type 1 diabetes, that is the kidney sees that, sends the glucose into urine, sends water with it, causes thirst, so people pee a lot and drink a lot. Except that here what’s different, is the fact that if we want to treat the best way, is to make the cells more able to respond to insulin, and that’s why making them leaner, so by losing weight, by lifestyle, whether it’s by doing exercise or by dieting, if you lose weight the cells are more empty, and they’ll say yes to more insulin and they’ll store the food, and that’s the way diabetes can disappear with lifestyle.

There are other ways, other medications that can be given that increase the action of insulin, but initially the importance of lifestyle comes from the basic causes of type 1 and type 2 diabetes. Type 1 and Type 2 Diabetes Diabetes Now Patient Communication System. Local Endocrinologist  Presenter: Dr. Jean-François Yale, Endocrinologist, Montreal, QC

Local Practitioners: Endocrinologist