Sepsis and Diabetes

Diabetes is a chronic (life-long) disease that has a significant impact on your life. Having diabetes means you must work to control your blood glucose (sugar) levels to be sure that they don’t get too high or too low.

The amount of glucose in your blood is very important. Your body needs glucose for energy, but too much of it destroys body tissues and too little starves your body of the nutrients.

People who have diabetes are at risk of developing wounds and sores that don’t heal well. While the wounds are present, they are at high risk of developing infection. And, again because of the diabetes, the infections can get severe quickly. When infection overwhelms the body, the body can respond by developing sepsis and going into septic shock.

Sometimes called blood poisoning, sepsis is the body's often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.

Worldwide, one-third of people who develop sepsis die. Many who do survive are left with organ dysfunction and/or amputations. (What is the prognosis (outcome) with sepsis?)

What Is Diabetes?

Your pancreas is a small organ (about 6” by 1.5”) that is part of your digestive system. It is connected to your small intestine and it lies just below your stomach towards the back. Your pancreas has a few roles, one is to help digest the food you eat and another is to secrete (send out) insulin, which stimulates your cells to use the glucose in the food and drink you consume.

When a person has diabetes, the pancreas doesn’t function properly and the insulin is either not being secreted at all or isn’t effective, depending on the type of diabetes.

According to the American Diabetes Association 2007 National Diabetes Fact Sheet, 7.8% of the American population has diabetes. That is 23.6 million children and adults. There are 17.9 million people who have been diagnosed and 5.7 who have not. In addition, 57 million people are close to developing diabetes, they fall into the “pre-diabetes” category. There are 1.6 million new cases of diabetes diagnosed every year in people 20 years and older.

Type 1 Diabetes

Type 1 diabetes used to be called juvenile diabetes or insulin-dependent diabetes. It is now called type 1 because many people with type 1 diabetes are not children when they develop it and using insulin isn’t restricted to just people with this type.

With type 1 diabetes, the pancreas cannot not provide the body with the insulin it needs to metabolize the glucose in the blood stream.

Type 2 Diabetes

Type 2 diabetes used to be called adult-onset or non-insulin dependent diabetes. Neither of these names works because now younger people are developing type 2 diabetes and it is not unusual for someone with type 2 diabetes to eventually end up taking insulin.

With type 2 diabetes, the pancreas either doesn’t produce enough insulin or the body cannot effectively use the insulin that is produced.

How Do You Get Diabetes?

Type 1 diabetes has no known cause, although researchers agree that it is an autoimmune disease. There are many theories, a common one being that a virus may trigger the disease in people who may be susceptible to it in the first place.

Although you can’t generally cause type 1 diabetes, it can be brought on by certain diseases that destroy the pancreas’s ability to work properly or by some medications. Usually, if it is caused by a medication, it is reversible.

People at highest risk for type 1 diabetes people:

  • With a family history of type 1 diabetes
  • Who live in countries farther away from the equator (warmer countries tend to have lower rates of type 1 diabetes)
  • Who have a specific gene that seems to be related to developing the disease

Type 2 diabetes is often called a lifestyle disease. While some people develop type 2 diabetes regardless of how healthy they are, most who develop it may have been able to reduce their risk by making some lifestyle changes.

People at highest risk of developing type 2 diabetes include those who:

  • Are over 45 years old
  • Have low HDL (“good”) cholesterol and/or high triglyceride levels
  • Have high blood pressure
  • Have had gestational diabetes (diabetes while pregnant)
  • Have been told they have an impaired glucose tolerance by their doctor
  • Are African American, Hispanic American, or Native Americans, who all have high rates of diabetes