Diabetes is a chronic health condition where the body cannot properly regulate blood sugar levels. There are two main types of diabetes – type 1 and type 2. In both types, high blood sugar can damage organs over time if not properly managed. So what organ is most affected by diabetes? The pancreas is the central organ involved in diabetes.
The Pancreas and Its Role in Diabetes
The pancreas is an organ located behind the stomach that plays an important role in regulating blood sugar. It contains special cells called beta cells that produce the hormone insulin. Insulin allows cells throughout the body to take up glucose from the bloodstream and use it for energy.
In type 1 diabetes, the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This leaves the body unable to produce enough insulin to regulate blood sugar. In type 2 diabetes, the body becomes resistant to the effects of insulin over time and cannot properly use it to lower blood sugar levels. Eventually, the stressed beta cells may burn out and stop producing enough insulin altogether.
So in both major forms of diabetes, the pancreas and its insulin-producing cells are damaged. This organ is essentially ground zero for the disease. Without a properly functioning pancreas, diabetes occurs.
Pancreatic Damage Starts Early in Diabetes
Research shows that pancreatic damage occurs early on in the progression of diabetes. One study found that beta cell mass was already reduced by around 50% at diabetes diagnosis. Another study showed that people with prediabetes – higher than normal but not yet diabetic blood sugar levels – had already lost up to 40% of their beta cell mass.
So by the time elevated blood sugar is detected, significant damage to the insulin-producing cells in the pancreas has already occurred. This underscores the importance of early screening and intervention to detect prediabetes and treat it before pancreatic function is irreversibly compromised.
Extensive Pancreas Deterioration Over Time
As diabetes progresses over months and years, the pancreas continues to deteriorate. Several large studies have quantified the extent of pancreatic damage in long-term diabetes:
– After 15 years with type 1 diabetes, beta cell mass was found to be just 8% of normal levels.
– Autopsy studies show that after 25 years of living with type 1 diabetes, nearly all beta cells are destroyed.
– In type 2 diabetes, one study found beta cell mass was 63% lower than in age-matched non-diabetic individuals after several years of living with diabetes.
So while the pancreas sustains early hits, the damage deepens over time. After surviving with diabetes for many years, there is extensive death of insulin-producing cells and severe impairment of pancreatic function.
Consequences of Pancreatic Damage in Diabetes
The loss of pancreatic beta cells and insulin production capacity has significant consequences:
Difficult Blood Sugar Control
Since the pancreas can no longer produce enough insulin, it becomes very difficult to control blood sugar levels. Even with medication and insulin injections, maintaining healthy blood sugars within a normal range is challenging. Blood sugar highs and lows outside the normal range start accumulating over time.
Increased Risk of Complications
Poorly controlled blood sugars greatly increase the risk of both short-term acute complications and long-term complications from diabetes. Acute complications include diabetic ketoacidosis and hyperosmolar hyperglycemic state, which are medical emergencies. Long-term high blood sugars raise the risk of kidney disease, eye disease, nerve damage, heart disease, strokes and infections. Keeping blood sugars controlled is critical to preventing these complications.
Eventual Dependence on Insulin Therapy
As endogenous insulin production dwindles, all people with type 2 diabetes – and anyone left surviving with type 1 diabetes – eventually require insulin administration to stay alive. While oral medications can help improve insulin sensitivity early on in diabetes, they cannot fully replace lost insulin production capacity over time as the pancreas fails.
Increased Risk of Death
Studies show that diabetes-related damage to the pancreas increases the risk of earlier death. One study found that people with type 2 diabetes losing 50% or more of their beta cell function were twice as likely to die earlier compared to those with less than a 50% loss of beta cell mass. The increased risks of heart disease, cancer and stroke may be magnified by progressive pancreatic dysfunction.
Protecting the Pancreas in Diabetes
Since sustained high blood sugars are toxic to the insulin-producing pancreatic cells, keeping sugars controlled is key to preserving pancreas function in diabetes. Here are some tips:
Monitor Blood Sugars
Check blood sugars regularly with a glucose meter to catch highs and lows early. Continuous glucose monitoring systems can track levels 24/7 and spot patterns needing attention. A1C tests check average blood sugars over a 2-3 month period.
Follow Prescribed Treatment Plan
Take all diabetes medications and insulin as directed. Inform the healthcare team of any difficulties managing the treatment regimen. Make diet and exercise changes recommended by your diabetes educator.
Get Regular Screenings
See all providers regularly to monitor diabetes progression and detect any complications early when they are most treatable. This includes eye exams, foot exams, kidney function tests, cardio exams, etc.
Manage Stress
High stress drives up blood sugars. Make time for relaxing activities and develop healthy stress coping strategies. Consider counseling or joining a diabetes support group.
Don’t Smoke
Smoking further damages the pancreas and makes diabetes worse. Get help to successfully quit smoking.
Stay Up to Date on Vaccines
People with diabetes are at higher risk of infections. Follow the CDC vaccine schedule and get your flu shot annually. Talk to your doctor about vaccines for pneumonia, hepatitis and COVID-19.
The Pancreas Over Time in Diabetes
In summary, here is what happens to the pancreas as diabetes progresses:
Prediabetes Stage
– Up to 40% loss of beta cells
– Elevated but not yet diagnostic blood sugars
– Intervention can still preserve pancreas function
Diagnosis Stage
– Around 50% loss of beta cells already
– Diabetes criteria officially met
– Pancreas damage has begun
5 Years After Diagnosis
– Up to 75% loss of beta cells
– Difficulty controlling blood sugars starts
– Risk of complications increases
15+ Years After Diagnosis
– Over 90-95% loss of beta cells
– Dependent on insulin injections
– Extremely prone to complications
25+ Years After Diagnosis
– Essentially complete beta cell destruction
– Entirely insulin dependent
– Complications often severe and disabling
The Bottom Line
Diabetes causes progressive damage to the insulin-producing beta cells in the pancreas over time. This impairs blood sugar regulation and increases risks of medical complications. While no cure exists yet, controlling blood sugars optimally from diagnosis onward can help preserve pancreatic function and delay deterioration. Managing diabetes effectively requires diligence, self-care and ongoing medical treatment and monitoring.