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Understanding the Different Types of Diabetes

When the body metabolizes (i.e., breaks down) molecules of carbohydrates, it converts it into blood sugar. Blood sugar or glucose is the fuel the body needs to carry out its day to day functions. Compared to fats and proteins, carbohydrates are easier to break down.

Glucose is used as rapidly as it is produced. It enables the brain, nervous system, muscles and other organs to function. The body can also store the energy it takes from metabolizing carbohydrates. When it does so, a compound called glycogen is made. Glycogen gets stores in the liver and muscles.

Diabetes is a condition in which the body cannot adequately convert blood sugar into energy. When this happens the blood sugar, called glucose, builds up in the blood stream and does not reach the muscle tissue as it should. This is how diabetes begins to impair major organ functions. There are two major types of diabetes, each of which seeks to control blood sugar in different ways. A third type of diabetes called cystic fibrosis related diabetes is similar to both Juvinile and Type II diabetes with the main difference being that of diet.

Juvenile Diabetes

Children and young adults may develop this form of diabetes following a severe infection such as chicken pox. The body's response to the infection continues even after the main cause of illness has left the body. This results in the body automatically attacking itself, specifically the tissue of the pancreas which is where insulin is produced. Juvenile diabetes is typically controlled by injections of insulin, both short acting and long acting. In addition to controlling blood sugar with these injections, adherence to a diet that counts the number of carbohydrates is recommended. Regular aerobic exercise is another excellent way to keep blood sugars from spiking out of control.

Type II Diabetes

More than 15 million Americans have what is known as non-insulin dependent diabetes mellitus. Predominantly occurring in middle-aged overweight adults, this form of diabetes is controlled by exercise and diet. Individuals are encouraged to not only lose excess weight, but to cut back on bran cereals, excessive sweets and simple sugars like ice cream or candy. Additionally they can work to lower their blood sugar by following a diet that restricts the amount of salt intake as well as saturated fats and sugars.

Cystic Fibrosis Related Diabetes

A third type of lesser-known diabetes is Cystic Fibrosis Related Diabetes or CFRD. Individuals with CFRD are generally in their late teens to early twenties, and are pancreatic insufficient, meaning their pancreas cannot secrete the enzymes necessary to help absorb nutrients and energy from food. Maintaining control over blood sugar levels in people with CFRD involves insulin therapy as well as exercise. Unlike juvenile diabetes or Type II diabetes, people with CFRD are not restricted in their diet.

Understanding Carbohydrates

Commonly referred to as sugars or simple sugars, simple carbohydrates are very easy to digest. They get into the blood stream very quickly. This enables the body to benefit from a burst of energy as the body breaks down the sugar and pulls the nutrients out of it. Foods that contain simple carbohydrates include fruits, some vegetables, honey and other processed sugars.

When it comes to complex carbohydrates, the list is much grander than that of simple carbs. Complex carbohydrates are so named because they are comprised of very complicated structures. These are the carbs that are most often referred to as starch and fiber. They are more difficult for the body to break down rapidly, which ensures a longer, more sustained supply of energy to the body.

How the Body Uses Carbohydrates

When the body metabolizes (i.e., breaks down) the molecules of carbohydrates, it converts it into blood sugar. Blood sugar or glucose is the fuel the body needs to carry out its day to day functions. Compared to fats and proteins, carbohydrates are easier to break down.

Glucose is used as rapidly as it is produced. It enables the brain, nervous system, muscles and other organs to function. The body can also store the energy it takes from metabolizing carbohydrates. When it does so, a compound called glycogen is made. Glycogen gets stores in the liver and muscles. This is why many athletes like to "carbo-load" or eat a diet high in carbs several hours before an even. This helps them maximize the amount of energy available in their muscles.

How Many Carbohydrates Do We Need?

There is no Recommended Daily Allowance (RDA) for carbohydrates, as everyone's body needs a different amount based on their body type and body mass index (BMI.) The government recommends that approximately 55 percent of the diet should include a wide variety of carbohydrates from many different sources. Only 10 percent of the diet should be made up of simple carbohydrates.

Not everyone should have the same amount or type of carbohydrates. People with diabetes for example, should be careful to regulate their blood sugar either by altering their carbohydrate intake, or by using insulin. Hypoglycemic people on the other hand, should keep some simple sugar such as a piece of fruit handy, just in case their blood glucose drops too low. Another special case is people who have cystic fibrosis related diabetes (CFRD.) Because of their requirement for high calorie intake, they should not be limited in how many carbs they have, rather, they should adjust their insulin as needed.

Carbohydrate Pros and Cons

Starchy (complex carbohydrates) are an easy and inexpensive way to ensure good nutrition. A person should be wary of any diet that suggests that they cut out carbohydrates completely.

Simple carbohydrates on the other hand have very low nutritional value. Sodas, ice cream, hard candies and high fructose corn syrups do more to promote tooth decay than benefit the diet.

Uncontrolled diabetes can have a devastating effect on many body systems. Whether a person is an insulin-dependent (juvenile onset) diabetic or non-insulin (adult-onset) dependent diabetic, or even a CF-related diabetic diet plays a very important role in keeping blood glucose levels in the safe and normal range.

The best food choices and diet plans for a diabetic include:

1. Frequent small meals and snacks to keep the blood sugar levels consistent. 5 or 6 small meals throughout the day is better than 2 or 3 larger ones.

2. A good balance of complex carbohydrates (starches) protein, and even a little bit of fat with each meal. Complex carbs like vegetables, cereal and pasta should be the main component of the diet. Lean meats and low fat dairy should account for 10 to 20 percent of the diet.

3. Foods containing natural fiber, like fruits and whole grains. These foods are important because it slows the release of glucose, and helps a person avoid sudden spikes in their blood sugar.

Some examples of meals and snacks that represent a suitable balance of these foods are:

Angel hair pasta with shrimp
Baked potatoes with vegetables and shredded cheese
Chicken salad
Yogurt with cold cereal
Ham and cheese on rye
Soup, salad and bread sticks

With proper exercise and moderation, there are few foods that need to be avoided completely; however it's a good idea to cut down on bran, which makes it harder for the body to absorb certain minerals, like zinc and iron. Simple carbohydrates, especially foods containing high amounts of refined sugars, such as cookies, sodas, syrups and jellies are not good choices for the diabetic.

- Lauren Beyenhof

All Health and medical information found on or at CysticFibrosis.com may not be appropriate for your individual health and medical needs. You should always consult your healthcare specialist or CF Center when determining what course of care is best or safest for you.