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Unlocking Diabetes: What You Didn’t Know About How Insulin and Glucose Work

By November 13, 2017October 23rd, 2023Expert Advice Nutrition Well-being
Young female doctor performing diabetes blood test on senior woman

According to the American Diabetes Association (ADA), 1.5 million Americans are diagnosed with diabetes every year. In fact, diabetes is the seventh leading cause of death in the United States.1

Nearly everyone has had at least some exposure to diabetes, whether it’s a childhood friend who grew up with type 1 diabetes, a family member who developed type 2 diabetes, or a warning about prediabetes during a routine check-up.

What we know about diabetes isn’t the problem. After all, detailed information is as close as the Internet. The real challenge is in what we understand about diabetes.

The Basics of Diabetes

Diabetes is a chronic disease that affects the level of sugar (glucose) in our blood stream. In the simplest language, diabetes is when the level of glucose in the body is too high.

In people who don’t have diabetes, the body maintains a glucose level of between 60 – 200 mg/dl at all times. If you haven’t eaten in a while, your blood sugar may be close to 60; after a large meal, it may be between 150 and 200. But, it’s never out of the normal range. Seems pretty straightforward, right? So, why is it such a difficult disease to manage?

How the Body Turns Food to Fuel

When I was in practice, I often found that despite all the information people had, they still didn’t have a basic understanding of what blood glucose does in our bodies. How glucose is metabolized — how it gets from a meal we eat to a glucose molecule that helps our organs function — is the key to understanding diabetes and how it affects the body. Here’s how I used to explain it to my patients:

Glucose: The gas that fuels the body

Think of glucose as the main source of fuel for the body, gasoline for your car, if you will. All organs need glucose, and a lot of what we eat is eventually broken down into the glucose that enables our organs to function. Imagine you are eating a meal…after you chew and swallow your food, it’s eventually broken down and absorbed through your intestine into your blood stream. But, it still can’t go directly to the organs that need fuel.

Insulin: The glucose delivery service

When your glucose level rises after a meal, your body sends a signal to an organ called the pancreas, which secretes a hormone called insulin into the bloodstream. Without insulin, glucose can’t leave the bloodstream and enter the organs.

If you think of your blood vessels as your body’s major highway system, insulin would be the truckers that deliver glucose to the organs. As soon as the glucose level goes up in the bloodstream, the pancreas secretes insulin to join the glucose. Together, they swim along to an organ, “knock on the door,” and, if everything is working properly, enter the organ, bringing the fuel it needs.

Type 1 and type 2 diabetes

It makes sense that if the pancreas suddenly stops producing insulin, blood glucose will quickly skyrocket to extremely dangerous levels. This is what happens in people who have type 1 diabetes. These patients need insulin immediately and will need it the rest of their lives.

In type 2 diabetes, the most common form of the disease, it isn’t necessarily that the body is deficient in insulin. Instead, the insulin doesn’t work as it should. Getting back to our highways and delivery drivers, when the insulin knocks on the door of the organ to deliver glucose, the organ won’t allow the glucose in. Another name for this is insulin resistance.

Why is Diabetes So Serious?

So, why is it so serious when blood glucose levels are too high? Perhaps the most important thing to remember is that diabetes is a whole-body disease. When glucose builds up in the blood stream instead of entering our organs, our organs don’t have enough fuel to operate. Additionally, the blood vessels and organs struggle under the added strain of trying to move and process so much glucose.2 This affects the whole body, and, uncontrolled, can lead to complications and long-term damage:

Organ damage

In medical terms, we call the long-term effects of uncontrolled diabetes end-organ damage. This refers to damage suffered by the kidneys, the eyes, the heart, and the small blood vessels that supply glucose to our nerves.

Kidney damage

Diabetes is the most common cause of kidney failure in the United States.3 Therefore, it’s recommended that diabetics get a urine test yearly, see a kidney specialist, or be prescribed medications that helps protect the kidneys.

How diabetes affects the eyes

High blood glucose also affects the eyes. Diabetics have an increased risk for cataracts and glaucoma and specific diseases that high blood glucose cause, called diabetic retinopathy.4 It is recommended that people with diabetes see an eye care specialist every other year for a dilated exam if your previous exams have been normal (every year if your eye doctor has any concerns).

Increased risk of heart disease and stroke

People with diabetes have a much higher risk for heart disease and stroke, so doctors work with them to address risks that can increase the probability of developing a problem, such as hypertension, obesity, or a smoking habit.4

Nerve damage

Poorly controlled diabetes puts people at risk for a condition called neuropathy. This is a symptom of pins and needles or even no feeling at all in the soles of your feet and less often your fingers.4

Options and Support for Managing Diabetes

Diabetes is a chronic condition that requires patients to be mindful of their medications, diet, and exercise. This can be overwhelming when life is complicated enough! Fortunately, education and a strong support system make it a lot easier. In addition to your doctor, who will be your biggest advocate, diabetes educators, engaged and involved family members, and support groups are a great place to turn.

IBX members have another important resource for support. Achieve Better Health is a well-being program for people with complex conditions. Our registered nurse Health Coaches, available 24/7, can help you get the information and support you need to make the health decisions that are right for you.

Please note that the information in this blog is not intended as medical advice. If you have concerns about your health, you should see your primary care doctor.

1American Diabetes Association. Statistics About Diabetes: Overall Numbers, Diabetes and Prediabetes. Accessed October 2017.
2American Diabetes Association. Kidney Disease (Nephropathy). Accessed October 2017.
3Centers for Disease Control and Prevention. National Chronic Kidney Disease Fact Sheet, 2017. Accessed October 2017.
4Centers for Disease Control and Prevention. Putting the Brakes on Diabetes Complications. Accessed October 2017.


Dr. Heidi J. Syropoulos

I joined Independence Blue Cross in 2015 after practicing Geriatrics for nearly 30 years. In my current role I function as the medical liaison to our Government Markets team, serving as a subject matter expert on clinical medicine and healthcare delivery. What I love about my position is the opportunity to help an entire population of people through the benefits of their health plan.