Overview
The Daily Problem: Glucose Does Not Match the Body's Needs
Diabetes causes chronic hyperglycemia because the body has too little insulin, does not use insulin effectively, or both.
Diabetes causes chronic hyperglycemia because the body has too little insulin, does not use insulin effectively, or both. Insulin normally moves glucose from the bloodstream into cells for energy. When that process fails, glucose remains in the blood while cells cannot access it efficiently. Type 1 diabetes reflects little or no endogenous insulin production. These patients need basal insulin plus mealtime or correction insulin; insulin is not optional, even during illness. Type 2 diabetes is driven primarily by insulin resistance, often with progressive loss of insulin secretion over time. Some patients manage type 2 diabetes with nutrition changes and oral medications, while others need injectable medications or insulin. Sustained high glucose injures small blood vessels and nerves, leading to retinopathy, kidney disease, and neuropathy. It also accelerates atherosclerotic cardiovascular disease. Daily self-care is therefore not simply about a number on a meter. It is how the patient prevents both immediate glucose emergencies and gradual organ injury.
