Overview
The Feedback Loop Behind Daily Care
Diabetes mellitus occurs when insulin secretion is inadequate, body tissues resist insulin, or both.
Diabetes mellitus occurs when insulin secretion is inadequate, body tissues resist insulin, or both. Without enough effective insulin, glucose remains in the bloodstream rather than moving efficiently into muscle, fat, and other cells. The immediate result is hyperglycaemia; the long-term result is injury to small and large blood vessels. Small-vessel injury contributes to retinopathy, kidney disease, and neuropathy. Large-vessel injury increases cardiovascular risk. Daily diabetes care is therefore not simply about obtaining a “good number.” It is a repeated process of matching food intake, activity, medication, illness, and glucose data so that extremes are prevented before they cause harm. Type 1 and type 2 diabetes create different self-care risks: - Type 1 diabetes involves severe insulin deficiency. Basal insulin is required even when the person is not eating because the liver continues releasing glucose. Omission of insulin can lead rapidly to ketosis and diabetic ketoacidosis (DKA). - Type 2 diabetes is usually driven by insulin resistance with progressive loss of insulin production. Food choices, activity, weight, and medication adherence strongly affect glucose, but illness or medication omission can still cause...
