Blood glucose requires a hormone, insulin, produced by cells of the pancreas to transport this food breakdown product into cells. When insulin production stops or the body doesn’t respond to insulin efficiently, diabetes is diagnosed by elevated blood glucose concentrations. Monitoring blood glucose levels often involves pricking a finger and depositing a drop of blood into a machine that measures glucose concentrations.

There are three types: What is the difference?

Type 1 diabetes is considered an autoimmune disorder with a sudden onset when the pancreas simply stops making insulin. Approximately 5-10% of people living with diabetes have Type 1 and, while generally diagnosed in children and young adults, onset can occur at any age. Patients must carefully manage the condition with artificial insulin and strict multi-daily monitoring of blood glucose.

Type 2 diabetes is the most common form, accounting for over 90% of all cases. Rather than not producing insulin, the body doesn’t utilize insulin properly. Typically diagnosed later in life, disease onset is more gradual. Genetics can predispose people to developing Type 2, but lifestyle choices seem to play an equally important role in a diagnosis. If you are predisposed to Type 2 diabetes, there are measures you can take with regards to diet, exercise, and weight control to prevent the disease and at the very least delay onset.

Gestational diabetes occurs in about 7% of pregnancies. Because this condition can lead to pregnancy complications for both mom and baby, prenatal screening is standard practice. While gestational diabetes typically resolves after birth, there is an increased likelihood for women and their babies diagnosed with the condition to develop Type 2 diabetes, and regular screening is advised.

How do diet and lifestyle impact diabetes?

Sedentary lifestyles, obesity, and diet are all implicated in the likelihood of developing Type 2 diabetes, particularly as inactivity, obesity, and diabetes are rising worldwide. However, research has identified many regions of genetic variations that are correlated. Regular exercise, weight control, and eating a healthy plant-forward diet low in refined sugars and alcohol are the most effective ways to reduce the chance of a diagnosis.

Multiple genes are implicated in Type 1 diabetes although the genetic basis is not fully understood. Diet and lifestyle do not seem to play a part in developing the disease—there is a nature vs nurture aspect for most autoimmune disorders, complicating the ability to predict those at risk. However, diet and lifestyle are extremely important in managing Type 1, along with life-long insulin medication. Exercise, while beneficial for many aspects of health, is more complicated and requires a careful balance of insulin, food intake, and monitoring blood glucose levels. This balance is imperative to maintain levels within a relatively narrow range to avoid complications like seizures associated with low blood sugar, or hypoglycemia.

What is the outlook on a cure for diabetes?

There is currently no cure for diabetes. As a chronic condition, it can be managed with medication and healthy lifestyle choices. For most people prone to diabetes (Type 2), the best cure is prevention.

For some patients with Type 1 diabetes that is difficult to control with standard insulin treatments, ongoing clinical research is geared toward improving outcomes for pancreas or islet cell transplants (pancreatic cells from an organ donor are transplanted into the liver). All transplantation treatments come with risks of complications including immunosuppression and rejection and are still only considered for severe cases.

How can foundational research help?

Certain species like cavefish and nectar bats have evolved to consume and store large amounts of sugar. While displaying traits associated with diabetes like high blood glucose, insulin resistance, and increased fat storage, genetic adaptations allow them to remain healthy when these same traits in humans result in disease. Stowers Associate Investigator Nicolas Rohner, Ph.D., investigates the mechanisms underlying how these organisms cope with high blood sugar without corresponding pathologies. Some mechanisms identified so far include genetic adaptations and metabolic reprogramming.

More broadly, a key research focus of the lab of Stowers Investigator Jerry Workman, Ph.D., is how gene activity is impacted by the breakdown products of metabolism. This research may inform our understanding of normal metabolic processes as well as metabolic diseases like diabetes.

Investigating how metabolism works in humans and other species may yield answers for controlling and one day even curing diabetes.