If you or a family member have been recently diagnosed with type 2 diabetes, or, if you are
just trying to learn a little more about what it is, and why you need to care about it. Then,
this is the video for you. Keep watching because we are going to go over what diabetes is, how you
get it and what are the problems that can happen if you don t treat it and take it serious.
Hi, I m Dr. Erik Richardson a board certified Family Practice physician.
I d like to welcome you to FamilyMed, a channel that focuses giving you practical and accurate
medical information to help you and your family. If you think this would be something that is
helpful to you make sure you subscribe, hit that notification button and follow along with us.
This is the second video in our series on diabetes. In our last video we discussed the
best ways to recognize some of the symptoms of diabetes and when to get tested for it.
Today though, we are going to dive deeper into what diabetes is and help you understand some
of the challenges that can come if you don t take this disease seriously, and get it under control.
We re going to focus mostly on what we call type 2 diabetes, as this is still the most
common type of diabetes and one that can affect all of us if we aren t careful.
So first of all, let s talk a little more about what is adult onset or type 2 diabetes.
This is the most common type of diabetes that we see. In fact there are over 34 million people in
the united states and over 460 million people in the world that are estimated to have it.
Type 2 diabetes is also referred to frequently as adult onset diabetes.
This is a condition that usually comes on slowly over time and because of that, a lot of the time
we don t have any noticeable symptoms. In fact it s so gradual in many, that some of the first
presenting symptoms can be the bad complications that we are going to go over today.
The problem that happens in type 2 diabetes is that your body becomes resistant to insulin.
Insulin is the hormone that is produced by your pancreas that helps bring glucose from the blood
into the different cells in the body to use it as fuel. In a normal body you eat a carbohydrate,
your body digests it and turns it into glucose which is absorbed into the blood stream. Your body
then senses that blood sugars elevate and releases insulin to bring that down. That same process is
happening in diabetes however your body has become resistant to the effects of insulin. You are still
producing it, but it just doesn t work as well. The reason behind all of this is pretty complex,
and frankly we haven t gotten to the bottom of all the reasons why this happens. There are several
factors though that can play a role in developing this insulin resistance. We see that genetics,
age and ethnicity play a role but more importantly things such as excess body weight,
too much belly fat, lack of exercise, smoking and even not getting enough sleep can play a role. On
top of all that, we see as well, that the longer and higher your insulin levels are. It starts to
affect your body over time. The more and more your your cells are exposed to high levels of insulin,
the more they get tired of listening to it. The way that I like to explain it that seems to make
sense to most of us, is that I compare it to the old stereotypical grandpa who is hard of hearing
and wears hearing aids. This grandpa loves to sit on his couch watching his favorite sporting event.
He has a sweet wife though who just loves to talk to him,
especially while he is trying to watch his game. So picture the grandpa sitting on the couch
wanting to watch his game with his sweet wife sitting next to him who just wants to talk.
Being the rude guy that he is, the more she talks to him, what is he going to do? Well,
he s going to turn down those hearing aids so he can concentrate on his game. Well,
the more he turns down those hearing aids, the louder she tries to talk. You can see the cycle
that this puts them in. So in this analogy, your body is like the grandpa with the hearing aids and
the grandma is insulin. The more and louder she talks, the more he turns down those hearing aids.
Now, I need to stop right now and give a disclaimer, I in no way condone this behavior,
grandpa really needs to listen to his wife and turning down hearing aids is not right.
Ok, getting back to the analogy. So the more that your body is producing insulin, over time,
your body stops listening to it and becomes more and more resistant to it.
So when you combine all these factors, the high levels of insulin, the inflammatory processes
which happen with excessive belly fat, genetics etc, you create an atmosphere where your body
just can t handle the sugar load that your body is under. The longer your pancreas works as well
to pump out higher level of insulin, the more and more the cells that produce the insulin
start to burn out and don t produce as much. All of this combines to create the disease that we
call diabetes. Now, it certainly is a lot more complex than I am explaining, however
I think this gives us a general idea on what is happening, and understanding this will
really help us in the future as we try and make changes to our life, that will help us control
and beat this disease. A lot of the focus that we will have when we work on controlling this,
will center on avoiding putting things into our body that raise our sugars and increase the amount
of insulin your body needs. Treatments will also center on decreasing that insulin resistance and
helping our body have adequate supply of insulin to keep our sugars where they need to be.
OK, so that s a brief explanation of what diabetes is. It s vital that you understand
that so as we treat it, you will have a better grasp on why we are doing what we do. Now,
the final part of this video centers on why it s so important that you take this disease serious.
What are the problems that can happen when you don t control your diabetes well? The answer lies in
the damage that elevated blood sugars do to blood vessels as well as to the nerves. High levels of
sugar over time cause damage to the lining of the blood vessels, especially the smaller they are.
Over time, inflammation and hardening occur in these areas, causing the vessels to get weak or
blocked. This same effect happens to nerves, where the elevated levels of sugar interfere with the
nerves ability to send signals. You combine this with poor blood flow from damaged blood vessels,
and you have nerves that are starved of the oxygen and nutrients needed to work properly.
The long term impact of this, is the reason we care about controlling diabetes
and is the reason that you need to be worried about staying on top of it.
We ll start from the top of the body down down describing how it impacts the various organs.
Because it damages small blood vessels, we start to see changes in arteries in the brain.
This can lead over time to issues like dementia but can also cause immediate
events by putting you at risk for a stroke. It can impact the small vessels in your eyes
putting you at risk for cataracts, glaucoma and can cause a condition called diabetic retinopathy
where the blood vessels in your eyes can rupture leading to vision loss and possible blindness.
In fact, Diabetes is one of the leading cause of blindness in the united states. Moving down, that
same damage to blood vessels starts to impact your heart. It increases your cholesterol and blood
pressure causing plaque formation, plugging of the arteries putting you at risk for a heart attack.
Moving to your stomach, it can damage the nerves that control your ability to digest
causing something called gastroparesis, which is a type of paralysis to the stomach.
This slows your digestion causing among other things, a lot of nausea and vomiting. It slowly
starts to cause damage to the filters in your kidneys decreasing the ability of them to function
properly. Diabetes is the leading cause of kidney failure requiring people to go on dialysis.
It affects the circulation and nerves in the extremities, especially in your feet leading
to something called diabetic neuropathy. You can get severe burning pain in your feet as well as
decreased sensation. This nerve damage, combined with poor circulation puts you at risk for injury,
severe infections and ultimately developing gangrene in the foot leading to amputations.
Have I scared you yet? Hopefully, I have a little. Diabetes is not something that you want to ignore.
I have patients tell me all the time, Well, doc, you have to die of something . I promise you,
you do not want to die from diabetes. Now the good news from all this bad news, is that
if you take your diabetes serious, if you make a significant commitment to changing your life and
treating this as the serious condition that it is, and you watch it closely with your doctor,
you have a great chance of avoiding all of these issues and living a long healthy life.
So that s what diabetes is and why you want to treat it. We are just getting started with diving
into diabetes. In upcoming videos we are going to be talking about the things that you can do
to help control this without having to always rely on medication. We will go over the types of things
that you should be checking with your doctor to make sure you don t have complications as well
as some of the more common and helpful medications if that becomes necessary. Now, So you don t miss
out on these, make sure you hit that subscribe and notification buttons right now. When I get
them done, I ll put links to these to the side so you can learn more about beating this disease.
Well, that s all we have today so thanks for watching and we ll see you in the next video.