Diabetes ABCs, Health

Diabetes ABCs: B

Beta Cells

Beta cells are the cells in the pancreas that make insulin, a hormone that helps move glucose out of the blood and into cells for energy. Type 1 Diabetes is an autoimmune disease where the body’s immune system attacks and destroys these cells.  As a result, a person with Type 1 is no longer able to produce insulin on their own and must supply it through daily insulin injections or an insulin pump.

(Content reviewed by MGH Diabetes Center)


By Eileen B. Wyner, NP
Bulfinch Medical Group

Basal is a word with many definitions but in the medical world it refers to a minimal level that is necessary for health, such as the minimum insulin dose. People without diabetes are constantly producing insulin to keep the blood sugar level constant. This is called basal insulin. People with diabetes are not producing natural insulin as efficiently, so there are blood sugar fluctuations. Basal insulin therapy is indicated so blood sugar fluctuations can be well controlled. It may be injected once or twice a day and taken in conjunction with other medications to control diabetes.


By Eileen B. Wyner, NP
Bulfinch Medical Group

A bolus refers to the administration of a medication, given to raise its concentration in the blood to an effective level. People with diabetes often use a bolus dose of rapid-acting insulin with a meal to keep the after meal time blood sugar well regulated. The key is that rapid acting insulin acts quickly, so it’s important to take this insulin within 15 minutes of the meal in question. There are instances where a bolus of insulin may be used to control high blood sugars in the event of an illness or infection – this would be closely monitored by your health care provider. There are many cases where a combination of basal and bolus insulin are used together for better blood sugar control.



 caduceusWhen we talk about Diabetes, we generally specify between Type 1 and Type 2.  Type 1 Diabetes is an autoimmune disease, meaning at some point the body’s immune system began attacking and destroying the cells in the pancreas that produce insulin.  A person with Type 1 can no longer produce their own insulin and must supply themselves with insulin daily, either through injections or an insulin pump.  Because Type 1 is usually diagnosed at a young age (the peak age for developing Type 1 is 13-15) it was once commonly referred to as Juvenile Diabetes.  

In Type 2 Diabetes, the pancreas still produces some insulin but not enough.  Because Type 2 is often diagnosed in adults, it was once referred to as Adult Onset Diabetes.  As the names imply, it was generally believed that only children developed Juvenile Diabetes and if you were an adult, you had Adult Onset.  We know now, though, that the age division between types of Diabetes isn’t as cut and dry as once thought.  

Diabetes, whether Type 1 or Type 2, can develop at any age.  Although Type 1 is commonly diagnosed in childhood and adolescence young people can also develop Type 2.  Likewise, people in their 30s (or later) can be diagnosed with Type 1.  LADA, or Latent Autoimmune Diabetes in Adults, is essentially Type 1 Diabetes diagnosed in people who are older.  

There is some controversy, however, over whether LADA is just a slowly progressing form of Type 1, or a unique type of Diabetes.  Diagnosing Type 1 is somewhat imprecise.  Relying on the presence of antibodies produced by the immune system attacking the pancreas to diagnose Type 1 is not always 100% certain.  And, as insulin levels vary from person to person over the years, neither is measuring the amount of insulin produced by the pancreas.    

Remember, everyone is different and management plans for Diabetes are developed around an individual’s specific needs.  Talk to your health care provider or Certified Diabetes Educator if you have any questions about your care plan.

(Information reviewed by MGH Diabetes Center)