By DR MAXWELL ADEYEMI

Diabetes is a chronic metabolic disorder that affects how the body turns the food we eat into energy. It affects the carbohydrate as well as lipid and protein metabolism in the body.

Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose, the principal source of fuel for our bodies. Glucose enters the blood stream but cannot enter our cells without the presence of a hormone called insulin, which is produced by the pancreas. A person with diabetes has a condition in which the quantity of glucose in the blood is too high. This happens when the body does not produce enough insulin, produces no insulin or has cells that do not respond to insulin. This causes glucose to build up in the blood and eventually become toxic to the cells. This condition is referred to as glucotoxicity.

Types of diabetes

• Type 1 diabetes is also known as insulin dependent diabetes and was previously called juvenile diabetes. This occurs mainly in children and accounts for five to ten per cent of diabetes. It is as a result of pancreatic beta cell destruction that prevents the production of insulin. There are two forms of Type 1 diabetes -

Type 1A due to autoimmune or self-destruction of pancreatic cells that causes the body's immune system to destroy the insulin-producing cells of the pancreas, and Type 1B which has no known cause.

• Type 2 diabetes, previously known as adult outset diabetes or non-insulin dependent diabetes, amounts for 85-90 per cent of diabetes cases. It is characterised by insulin resistance and relative insulin deficiency, as some level of insulin is produced.

• Type 3 diabetes describes other specific types of diabetes which may include those caused by:

Genetic defects of beta cell of pancreas

Genetic defect in insulin actions

Diseases of the exocrine pancreas

Disorders of endocrine glands

Drug or chemical-induced diabetes (for example from steroid-based drugs)

Maturity onset diabetes of the young

Latent autoimmune diabetes of the adult

Mitochondria diabetes.

These forms of diabetes require specialised testing to identify and diagnose them, some of which may not yet be locally available.

• Type 4 diabetes or gestational diabetes occurs during pregnancy, and may be caused by hormones produced by the placenta or by too little insulin. Between five to eight per cent of pregnant women develop gestational diabetes. It usually resolves after delivery but about 25-50 per cent of women who had gestational diabetes eventually develop Type 2 diabetes later in life. Also, high blood sugar from the mother can pass to the baby, leading to growth and development problem if left untreated.

Risk factors for Type 1 diabetes

• Genetic and family history. The presence of the disease in first degree relative such as mother, father, sister, brother can put you at ri