However, it is true that people with diabetes may have to limit their sugar intake. That’s because type 2 diabetes is characterized by an inability to properly use insulin, a hormone that helps usher sugar (in the form of glucose) out of the bloodstream and into the cells, where it’s used as energy. Eventually, the body is unable to produce enough insulin to keep your blood sugar levels stable. When doctors and scientists talk about sugar in the blood, they often use the word “glucose.” Glucose is a simple carbohydrate, also known as a “monosaccharide” (meaning, it’s made up of just one molecule). This can also be called blood sugar. Unlike sucrose (table sugar) or fructose (the sweetener found in honey and fruit), you won’t be able to find glucose in the grocery store. Here are some of the most common complications of chronically high blood sugar levels and uncontrolled type 2 diabetes.
How Insulin Is Produced
When food enters the gut, cells in the intestines produce a peptide called GLP-1, which blocks the release of glucagon in the body and increases insulin secretion. (The reason: You don’t need glucagon to draw on your glucose reserves for energy while you’re consuming sugar from a meal.) This also kick-starts the production of insulin by B-cells in the pancreas.
Insulin Resistance: Understanding What Happens in Type 2 Diabetes
In type 2 diabetes, the body has become “insulin resistant,” meaning insulin is no longer able to effectively remove sugar from the blood. As a result, the pancreas ramps up its insulin production to try to keep up with the amount of carbohydrates you’re eating — a state of overproduction that can lead to B-cell fatigue. When B-cells become fatigued (or fail), they can no longer make enough insulin to shuttle glucose out of your bloodstream. The end result: hyperglycemia, or high blood sugar. And when people become resistant to insulin, they can also develop nonalcoholic fatty liver disease. This further complicates type 2 diabetes because the buildup of fat in the liver can exacerbate insulin resistance as well, worsening type 2 diabetes and leading to high blood sugar. From there, the cycle continues. Specifically, the kidneys remove sugar from the blood and use it as their own source of energy, which provides the fuel they need to function. What’s more, in partnership with the liver, the kidneys perform a process called gluconeogenesis, which produces sugar and releases it into the blood for the body to use as fuel. Finally, kidneys’ responsibility to filter waste comes into play. The kidneys’ filters, called glomeruli, remove sugar from urine. Then, sodium-glucose cotransporters — often referred to as SGLTs — reabsorb the filtered sugar, moving it to the bloodstream. (This process is why one of the first signs of undiagnosed diabetes can be the need to urinate frequently!) When these filters are forced to work too hard, they can become permanently damaged, leading to the development of diabetic kidney disease and, eventually, kidney failure. Because the A1C test looks at your blood-sugar levels over a two- to three-month period, the American Diabetes Association likens its reading to a batting average. An A1C reading of 6.5 percent or higher qualifies a diagnosis of diabetes. You and your doctor will work together to adjust your treatment plan — including diet, exercise, and medications — to reach your target A1C.
