STAGES OF DIABETES

Stages in the Progression of Diabetes

In this short step-by-step overview of the development of diabetes, I am guided primarily by my experience and what happened to me, as I come to understand that even though our bodies are different and the conditions for the development of diabetes are not the same for all of us, especially, speed, severity, and symptom manifestation, main stages are always the same.

Some of us will get into prediabetes sooner, and some of us later, maybe even after 12 years or longer.

The Ironclad Facts menu will follow these stages and give insight as it happened to me, and it might help you recognize them.

Each stage will be described in its drop-down menu section for easier reading, and if you have any questions, feel free to ask.

First Stage: Normoglycemia

- Definition:  

Blood sugar levels are within the normal range, indicating a healthy glucose metabolism.

- Fasting Blood Glucose: Less than 100 mg/dL (5.6 mmol/L)

- Postprandial Blood Glucose: Less than 140 mg/dL (7.8 mmol/L) two hours after eating

This is the normal stage or simply the “NO Problem” stage. At this point, everything works perfectly, and occasional normal spikes of BS level are dealt with precision and swiftness.

This is also the stage that is the starting point in diabetes development simply because it is here when we slowly start to overwork our pancreas, firstly sometimes and later much more frequently.

Ideally, we should maintain and remain in this stage for the whole of our lives by eating properly being conscious of our pancreas, and giving it rest periods every single day for at least 12 hours between dinner and breakfast.

This is where breakfast got its name: Break Fast!

Second Stage: Normal Blood Sugar but Elevated Insulin Levels

- Definition:  

Blood sugar levels remain normal, but the body compensates with higher insulin production, indicating insulin resistance.

- Significance:

This is often a precursor to more serious metabolic issues and suggests that the body works harder to maintain normal blood glucose levels.

At this point, we are not aware of its developmental stage simply because there are no symptoms that we can experience.

Nothing is happening alarming us that the system has been breached and something is wrong. The significance of this stage is that it can take ages until it recognizably manifests itself and makes us do something about it.

In my case, it took about 10 or even more years by my calculations before I was aware of something being wrong. 

Third Stage: Early Diabetes Mellitus

What is happening?

Hypoglycemia, Slightly Elevated Fasting Blood Glucose, and Slightly Elevated Blood Glucose After Meals

- Definition: Blood sugar levels start to rise, but not enough to be classified as diabetes. The body may experience episodes of low blood sugar (hypoglycemia) due to inconsistent insulin secretion.

- Fasting Blood Glucose: 100-125 mg/dL (5.6-6.9 mmol/L)

- Postprandial Blood Glucose: 140-199 mg/dL (7.8-11.0 mmol/L) two hours after eating

In my case, I simply ignored this stage, and the reason why is: that at that stage, I still had no symptoms of any kind suggesting something was wrong. Symptoms of hypoglycemia I wrongly associated with just regular hunger.  

Don’t fall into the same trap!!!

From here to overt diabetes, we can go in just a year but also it can take much longer depending on our lifestyle.

Fourth Stage: Overt Diabetes Mellitus and persistent Hyperglycemia

- Definition: Blood sugar levels are consistently high, indicating a clear diagnosis of diabetes.

- Fasting Blood Glucose: 126 mg/dL (7.0 mmol/L) or higher

- Postprandial Blood Glucose: 200 mg/dL (11.1 mmol/L) or higher two hours after eating

What is happening?

Symptoms of diabetes become apparent, and the condition is diagnosed clinically. Symptoms may include frequent urination, excessive thirst, and unexplained weight loss.

At this point, many of us have a sense that something is not right, even if we don't know it for sure. I noticed a change in my body because of one specific symptom, which led me to visit the doctor.

Interestingly, fatigue was not the main reason I sought medical advice. However, my test results were surprising. The doctor told me I have full-blown diabetes.

Do I have to say that I didn’t have 90% of the symptoms usually attached to this stage?

Maybe you don’t as well.

Fifth Stage: Advanced Diabetes - Microvascular Complications

- Definition:

Small blood vessels are damaged due to prolonged high blood sugar levels, leading to complications.

In most cases, they are diabetic retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage).

Larger blood vessels are affected, leading to cardiovascular diseases, heart attack, stroke, and peripheral artery disease.

Five years after I was diagnosed with diabetes, all the symptoms hit me at once. I went back to the doctor, and he told me it was time to switch from pills to insulin injections because my A1C levels were through the roof.  

That wake-up call made me change my lifestyle, become proactive, and discipline myself.

Sixth Stage: End-Stage Diabetes - Severe Insulin Resistance

- Definition:

The body’s cells become extremely insulin-resistant, making blood glucose control very difficult.

This stage often requires high insulin or other medications to manage blood sugar levels.

The pancreas produces little to no insulin, necessitating external insulin administration which occurs due to pancreatic burnout after prolonged overproduction of insulin and here we are talking 10 years and more.

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Following is the worst-case scenario

In the worst-case scenario, unmanaged diabetes can lead to severe and life-threatening complications. Chronic high blood sugar levels can damage various organs and systems in the body. Some of the most serious consequences include:

Cardiovascular Disease:

Increased risk of heart attack, stroke, and atherosclerosis (narrowing of the arteries).

Kidney Damage (Diabetic Nephropathy):

Potentially leading to kidney failure, requiring dialysis or a kidney transplant.

Nerve Damage (Diabetic Neuropathy):

Causing pain, tingling, or loss of sensation, particularly in the extremities, and potentially leading to amputations.

Eye Damage (Diabetic Retinopathy):

Leading to vision loss or blindness.

Foot Damage:

Poor blood flow and nerve damage can lead to severe infections, ulcers, and potential amputation.

Skin Conditions:

Bacterial and fungal infections, as well as other skin problems.

Hearing Impairment:

Increased risk of hearing problems.

Alzheimer's Disease:

Potentially higher risk of cognitive decline and Alzheimer’s disease.

Diabetic Ketoacidosis (DKA):

A serious condition where the body produces high levels of blood acids (ketones), leading to diabetic coma or death if untreated.

Hyperosmolar Hyperglycemic State (HHS):

Extremely high blood sugar levels without ketones, leading to severe dehydration, seizures, coma, or death.

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This scenario is sadly very common, even though it can be avoided, which is why I say unfortunately.

I'm not sure if it's due to a lack of interest, fear, panic, or a mix of all these. What I do know is that if people understood how easy it is to reverse the condition, this outcome would never happen.

Finding out where diabetes leads got me absolutely terrified.

Luckily, I dodged this bullet by inch. I am now convinced and strongly believe that if I had ignored the doctor again, I would have faced end-stage within one year. It was that close.

Understanding these stages helps in recognizing the progression of diabetes and the importance of early intervention and management to prevent severe complications.