What is diabetes?

Diabetes is a chronic, incurable disease that occurs when the body doesn’t produce any or enough insulin, leading to an excess of sugar in the blood. Insulin, which is produced by the pancreas, is a hormone that helps the cells of the body use the glucose (sugar) in food. Cells need this energy in order to function properly.

If there isn’t enough insulin or its function is impaired, as is the case with diabetes, the glucose (sugar) cannot be used as fuel for the cells. Sugar builds up in the bloodstream and is excreted in the urine. Eventually, the hyperglycemia (high blood sugar) caused by excessive amounts of glucose in the blood leads to a variety of complications, particularly for the eyes, kidneys, nerves, heart and blood vessels.

Even today, the cause of diabetes remains a mystery. However, we do know that certain factors can trigger the onset of the disease: heredity, obesity, pregnancy, some viruses and medications, etc.

How many Quebecers have diabetes?

An estimated 760 000 people in Quebec have diabetes, 200 000 of whom are unaware that they have the disease. The World Health Organization predicts that the number of people with diabetes will double by 2025, making diabetes the new epidemic.

Costs associated with diabetes

The rising numbers of diabetics will have a major impact on society, especially since 30% of diabetics will suffer debilitating, even deadly, complications. Diabetes is one of the primary causes of blindness, non-trauma amputations, kidney failure, and is a significant factor in heart disease and stroke.

The monetary and social burden from diabetes is enormous – an estimated $2 billion a year in direct and indirect costs for Quebec society.

Types of diabetes

There are two main types of diabetes: type 1 and type 2. Sometimes women temporarily develop diabetes during pregnancy; this is called gestational diabetes.

Type 1 diabetes

Type 1 diabetes occurs mostly in children, adolescents and young adults. In type 1 diabetes, the pancreas no longer produces insulin, making type 1 diabetics dependent on daily insulin injections for their survival. At the present time, we do not know how to prevent this type of diabetes. Research is focused on uncovering the mechanisms underlying the destruction of insulin-producing cells.

Type 2 diabetes

Type 2 diabetes occurs much later in life, generally after 40 years of age. About 90% of diabetics have this type of diabetes. In the last few years, we’ve noticed that this type of diabetes is occurring earlier; in some high-risk groups, it can even occur in childhood.

Aboriginals, Latino-Americans, Asians and people of African descent are more likely to develop the disease than other ethnic groups. A genetic predisposition, being overweight and a lack of exercise contribute to the onset of type 2 diabetes. Some studies suggest that a high-fat diet might also be a risk factor.

Type 2 diabetes is the stealthiest type of diabetes. The symptoms can be mild and therefore overlooked for years. Unfortunately, by the time it’s diagnosed, the damage is done.

By making major lifestyle changes, it is possible to delay the onset of the disease and reduce its impact.

Gestational diabetes

Gestational diabetes occurs during pregnancy, generally toward the end of the second or in third trimester. In 90% of cases, it disappears after the baby is born.

Gestational diabetes occurs in 2% to 4% of pregnancies. It affects both the fetus and the mother. The risk to the baby is that it will be born bigger and fatter than normal. For the mother, having diabetes increases the risk of infection, of excessive fatigue and can cause complications during the delivery.

Gestational diabetes can be treated and controlled through proper nutrition, weight control and a healthy lifestyle. If these measures are not sufficient, insulin injections will be necessary, since oral anti-diabetic drugs are contra-indicated during pregnancy.

Diabetes symptoms

The signs and symptoms of diabetes don’t necessarily all present the same way or with the same intensity. For any type of diabetes, whether type 1, type 2 or gestational, it is essential to see a doctor. The symptoms include:

• fatigue, drowsiness
• frequent urination
• extreme thirst
• excessive hunger
• weight loss
• blurred vision
• cuts and bruises slow to heal
• genital infections
• tingling or numbness in hands or feet
• mood swings

It is important to recognize that there may be no symptoms at all. Diabetes is a serious disease. It can have a major impact on the quality of life of people suffering from this disease.

Sources: Diabetes Quebec, Canadian Diabetes Association, Canadian Medical Association, American Diabetes Association. March 2001. Revised in February 2004.