Le diabetes is an incurable disease that occurs when the body fails to properly use the sucre (glucose), which is an essential “fuel” for its functioning. Glucose, poorly absorbed by cells, then accumulates in the blood and is then released into the urine. This abnormally high concentration of glucose in the blood is called hyperglycemia. Over time, it can cause complications in the eyes, kidneys, heart and blood vessels.

Diabetes can result from an inability, partial or total, of the pancreas to make the insulin, which is a hormone essential for the absorption of glucose by cells. It can also arise from an inability of the cells themselves to use insulin to take up glucose. In both cases, the cells being deprived of their main energy source, it inevitably follows important physiological consequences, such as extreme fatigue or healing problems for example.

Le glucose comes from 2 sources: foodstuffs rich in carbohydrates that are ingested and liver (which stores glucose after a meal and releases it into the bloodstream as needed). Once extracted from food by the digestive system, glucose passes into the blood. So that the cells of the body can use this essential source of energy, they need the intervention of the insulin.

The main types of diabetes

For a detailed description of the types of diabetes (symptoms, prevention, medical treatments, etc.), consult each of the sheets devoted to them.

• Type 1 diabetes. Also called “diabetes insulinodépendant “(DID) or” diabetes juvenile Type 1 diabetes occurs when the pancreas no longer produces or does not produce enough insulin. This can be caused by a viral or toxic attack, or by an autoimmune reaction that destroys the beta cells in the pancreas, which are responsible for the synthesis of insulin. This type of diabetes mostly affects children and young adults, although the incidence in adults appears to be increasing. It affects about 10% of diabetics.
• Type 2 diabetes. Often referred to as “non-insulin-dependent diabetes” or “diabetes. of the adult Type 2 diabetes is characterized by the fact that the body becomes resistant to insulin. This problem usually occurs in people over 45 years of age, but the incidence is growing sharply in younger people. This type of diabetes, by far the most common, affects nearly 90% of diabetics.
• Gestational Diabetes. Defines as any diabetes or glucose intolerance that manifests during the pregnancy, most often during the 2^e or 3^e trimester. Often, gestational diabetes is only temporary and goes away soon after childbirth.

There is another form of diabetes called diabetes insipidus. It is a fairly rare disease caused by insufficient production of the antidiuretic hormone by the pituitary gland called “vasopressin”. Diabetes insipidus is accompanied by an increase in urine output, while blood sugar levels remain completely normal. So, it has nothing to do with the diabetic sugar. It is called “diabetes” insipidus because, as in diabetes mellitus, urine flow is abundant. However, urine is tasteless rather than sweet. (The term comes from ancient diagnostic methods: urine tasting!)

Diabetics, more and more numerous

Although heredity plays a role in its onset, the increasing prevalence of diabetes tofood and way of life which are common in the West: abundance of refined sugars, saturated fat and meat, lack of dietary fiber, excess weight, lack of physical activity. The more these characteristics increase in a given population, the greater the incidence of diabetes.

According to thePublic Health Agency of Canada, in a report published in 2008-09, 2,4 million Canadians were diagnosed with diabetes (6,8%), including 1,2 million between the ages of 25 and 64.

The pattern seems to hold true when studying the incidence of the disease in developing countries: as large segments of the population adopt a food and one way of life similar to ours, the incidence of diabetes, both type 1 and type 2, is increasing¹.

Possible complications of diabetes

In the long term, people with diabetes who have inadequate control of their disease are at risk of various complications, mainly because of hyperglycemia prolonged causes tissue damage in the blood capillaries and nerves, as well as narrowing of the arteries. These complications do not affect all diabetics, and when they do, it is to varying degrees. For more information, see our Complications of Diabetes sheet.

In addition to these chronic complications, poorly controlled diabetes (for example due to forgetfulness, incorrect calculation of insulin doses, sudden changes in insulin requirements due to illness or stress, etc.) can lead to water complications following:

Diabetic ketoacidosis

This is a condition that can be fatal. In people with diabetes type 1 untreated or receiving inadequate treatment (eg lack of insulin), glucose remains in the blood and is no longer available for use as a source of energy. (This can also happen in people with type 2 diabetes treated with insulin.) The body must therefore replace glucose with another fuel: fatty acids. However, the use of fatty acids produces ketone bodies which, in turn, increase the acidity of the body.

Symptoms : fruity breath, dehydration, nausea, vomiting and abdominal pain. If no one intervenes, difficult breathing, confusion, coma, and death can occur.

How to detect it: high blood sugar, most often around 20 mmol / l (360 mg / dl) and sometimes more.

What to do : if ketoacidosis is detected, go to emergency service hospital and contact your doctor afterwards to adjust the medication.

Hyperosmolar state

When the Type 2 diabetes left untreated, hyperglycaemic hyperosmolar syndrome may occur. This is a real medical emergency who is fatal in more than 50% of cases. This condition is caused by the accumulation of glucose in the blood, exceeding 33 mmol / l (600 mg / dl).

Symptoms : increased urination, intense thirst and other symptoms of dehydration (weight loss, loss of skin elasticity, dry mucous membranes, increased heart rate and low blood pressure).

How to detect it: a blood glucose level exceeding 33 mmol / l (600 mg / dl).

What to do : if a hyperosmolar state is detected, go to emergency service hospital and contact your doctor afterwards to adjust the medication.