When food is digested, it is converted to glucose for energy. The organ most responsible for this process of conversion is the pancreas. The pancreas produces insulin, a hormone that helps to transfer glucose into the cells of the body. People who have diabetes either do not produce enough insulin or cannot use the insulin as efficiently as they should be able to order to assist in the transfer of glucose in the cells. This leads to high sugar counts in the blood.
Diabetes can cause a number of health complications, and it is the seventh leading cause of death in the United States. According to The Textbook of Diabetes, the symptoms of diabetes may include:
- Frequent urination
- Excessive feelings of thirst
- Excessive hunger
- Weight loss or weight gain without dieting
- Blurred vision or other vision changes
- An alteration with normal healing process, such that wounds heal more slowly
- Frequent infections or illnesses
- Numbness or swelling in the extremities
- Chronic feelings of tiredness or fatigue
- Dry skin
- Gastrointestinal issues that can include vomiting, nausea, and even stomach cramps
Individuals who have diabetes may have some of these symptoms, or they may be asymptomatic. This is part of the problem with diabetes. Individuals who are diagnosed with diabetes often do not experience any significant symptoms and therefore do not see the need to engage in treatment. Many of these individuals may continue engaging in lifestyle choices that exacerbate their condition as they do not feel they are “sick.” Moreover, the acute symptoms of diabetes listed above often do not occur until individuals are well into the course of the disease.
Untreated diabetes can lead to a number of debilitating conditions, including chronic heart disease, problems with blood circulation that can result in amputations, chronic renal problems, blindness, and a number of other issues.
Types of Diabetes
There are a number of different types of diabetes. Most people are familiar with names of the two major types of diabetes (type 1 and type 2), but according to sources like the World Health Organization and the Centers for Disease Control and Prevention, there are several different forms of diabetes.
- Type 1: Type 1 diabetes accounts for up to 10 percent of all diagnoses of diabetes. This form of diabetes is usually identified early in children and adolescents. It is a result of the pancreas not producing sufficient amounts of insulin. People with type 1 diabetes need regular doses of insulin. It is believed that a number of different causal factors contribute to type I diabetes, including genetic factors, autoimmune disorders, and some type of interaction with environmental variables.
- Type 2: Type 2 diabetes, or adult onset diabetes, accounts for the majority of all diagnosed cases of diabetes. In these individuals, there is either too little insulin being produced by the pancreas or the insulin that is produced cannot be used efficiently. Risk factors for type 2 diabetes include age with older individuals having a greater prevalence, obesity, a family history of diabetes, a lack of exercise or physical activity, glucose intolerance, and ethnicity, with certain ethnic groups showing significantly increased prevalence of diabetes (e.g., African Americans and Hispanics). About 40 percent of individuals with this form of diabetes require insulin or medication; however, in many instances, diet and exercise as well as other lifestyle changes can help to treat the condition.
- Gestational diabetes: Gestational diabetes occurs in women who did not have a previous diagnosis of diabetes but who have high blood glucose levels during pregnancy. The prevalence of gestational diabetes may be nearly 10 percent, and women with gestational diabetes are at risk to develop type 2 diabetes later on.
- Other causes: Certain genetic conditions can result in the development of diabetes.
Diabetes and Substance Abuse
According to a 2013 study published in the journal Substance Abuse and Rehabilitation, nearly 20 percent of individuals over the age of 18 with diabetes used tobacco, and it is estimated that 50-60 percent of individuals diagnosed with diabetes use alcohol. A number of studies suggest that illicit drug use is lower among diabetics than individuals in the general population; however, there is still significant use of drugs, such as cannabis and prescription medication abuse, among this group. In addition, some studies suggest that as adolescents with diabetes get older, their rates of substance abuse approach the rates of substance abuse in the general population and may, in some cases, even exceed those rates. Any significant use of alcohol or drugs by individuals with diabetes is concerning for a number of reasons.
For example, drinking alcohol hinders the liver from releasing stored glucose, which can lead to low blood sugar levels in normal individuals. The liver must metabolize alcohol first and break down alcohol before it begins to break down other substances in the body. Thus, individuals with diabetes who drink alcohol may develop hypoglycemia (low blood sugar) at quicker rates. Even one drink of alcohol may result in a significant drop in blood sugar that can be potentially dangerous for an individual with diabetes.
In addition, the symptoms of hypoglycemia and alcohol intoxication are quite similar, and the difference may not be readily ascertainable. Individuals who abuse alcohol and have diabetes increase the risk of health problems related to chronic hypoglycemia. Wearing a medical ID bracelet can help to avoid potential delays in treatment in such cases.
Individuals who are diagnosed with diabetes who use illicit drugs suffer the risk of not eating properly or administering insulin, which can lead to dangerously low blood sugar levels.
This can result in fainting spells that can have potentially dangerous ramifications, issues with cognition, and other issues with health. This is especially serious for individuals with type 1 diabetes who may be prone to developing a serious condition known as ketoacidosis.
Ketoacidosis occurs because the individual’s system begins to break down fats and release toxic acids (ketones) into the bloodstream. Symptoms can include vomiting, abdominal pain, dehydration, thirst, flushed skin, issues with cognition, and sweet-smelling or fruity breath. Issues with cognition as a result of ketoacidosis can lead to a number of potentially dangerous outcomes, including harm from accidents or poor judgment.
Use of stimulant drugs, such as Ritalin, cocaine, or methamphetamine, is associated with a number of health risks, including the development of seizures, heart attack, and stroke. These are increased when these drugs are chronically used by individuals with diabetes. In addition, stimulants depress appetite, and this can have devastating effects for individuals who suffer from diabetes.
Use of cannabis products has the opposite effect, increasing appetite, which can lead to dangerous increases in blood sugar levels in diabetics. Individuals who have diabetes and inject drugs like heroin or snort drugs are placing themselves at increased risk for issues with cardiovascular and respiratory problems.
Individuals with diabetes who have developed a substance use disorder should seek professional treatment. These individuals should be treated by a multidisciplinary team that can address both their issues with diabetes and substance abuse. In general, the treatment of substance abuse in individuals with diabetes will follow the format that is typically used in the treatment of a specific substance use disorder in the general population; however, additional medical treatment and supervision may be needed to address issues related to the diabetes.
Conclusions
Diabetes consists of a number of different conditions that are the result of an individual’s inability to manufacture or use insulin. Diabetes is a significant health concern in the United States, and there are a significant number of individuals with undiagnosed diabetes.
Diabetes is associated with a number of serious health risks, and individuals who are diagnosed with any form of diabetes should refrain from using alcohol or drugs unless directed to use prescription medications by a physician. When attempting to use a new medication, an individual with diabetes should discuss potential side effects with their physician. Individuals should always take their medication for diabetes and wear a medical ID bracelet that identifies them as having diabetes in the case of an emergency.
Individuals with diabetes who struggle with addiction should seek prompt professional treatment to address the addiction. If treatment is not sought, serious medical issues related to their diabetes could be triggered or exacerbated by substance abuse.