When it comes to diabetes, many people immediately associate it with "eating too much sweet food," but the reality is much more complex. Diabetes is a metabolic disease caused by the combined effects of genetic and environmental factors, with high blood sugar being its main characteristic. The primary pathological and physiological basis of diabetes is the absolute or relative lack of insulin in the body, or accompanied by insulin resistance.

March 5, 2025, volunteers at a trade union station in Shizhong District, Zaozhuang City, Shandong Province, measured the blood sugar of food delivery drivers for free. Xinhua News Agency

Why can someone still get sick even by eating less sugar? Cheng Zezheng, a resident physician in the Geriatric Medicine Department of Beijing Jishuitan Hospital, said: "When consuming food, you can pay attention to the calorie chart on the packaging. Energy and carbohydrate content are clearly visible. As long as you eat food containing calories, blood sugar will rise, just with different speeds and amounts of increase and decrease."

Experts explain that the key to the body regulating blood sugar is insulin, which acts like a 'transporter'. When blood glucose levels rise, insulin immediately 'goes to work' to transport glucose from the blood into body cells, where it is used as energy or stored, maintaining blood sugar within a normal range.

The essence of diabetes is that this 'transport system' malfunctions. "Clinically, type 2 diabetes is the most common, usually seen in people over 40, with the core issue being the 'malfunction' of the body's blood sugar regulation system," said Zhou Lingli, a deputy chief physician in the Endocrinology Department of Peking University People's Hospital. The causes of diabetes are complex and diverse, including genetic factors, disrupted routines, irregular diets, lack of exercise, and high stress, all of which can lead to abnormal blood sugar levels. "Unhealthy lifestyles increase the burden on the 'transport system,' which is also why more and more middle-aged and young people are developing diabetes."

Some may wonder: I already eat very little or have been exercising and working out, why is my blood sugar still not under control? Cheng Zezheng explains that the amount of food consumed should be considered in combination with one's own pancreatic function and daily caloric intake. Relying on hunger therapy to control blood sugar carries risks such as hypoglycemia. Additionally, one of the main goals of exercise is to promote calorie expenditure, but if the intake of calories still exceeds the amount consumed, blood sugar will continue to rise.

On November 23, 2024, in Tangwang Subdistrict, Guangling District, Yangzhou City, Jiangsu Province, doctors provided health consultations to residents. Photo by Ji Chunpeng of Xinhua News Agency.

It should be noted that the onset of diabetes is relatively subtle and can be difficult to detect. Liu Bing, deputy chief physician of the Endocrinology Department at Beijing Friendship Hospital, introduces that the most typical symptoms of diabetes are "three more and one less," which include frequent urination, excessive thirst, increased appetite, and weight loss. For the vast majority of diabetic patients, symptoms are not typical. If symptoms such as fatigue, weakness, dry mouth, increased hunger, blurred vision, excessive sweating, and recurrent gingivitis appear, timely attention should also be given.

How can diabetes be prevented and treated? Liu Bing suggests that first, a balanced diet should be advocated, ensuring food diversity and reasonable combinations, while limiting salt intake, reducing alcohol and simple sugar consumption, and increasing vegetable intake. Second, maintaining moderate exercise to improve physical fitness, control weight, and adopt a healthy lifestyle with psychological balance is important. For high-risk groups, one can control overweight, obesity, and caloric intake based on individual circumstances, enhance physical activity, and conduct early screening. For those already diagnosed, comprehensive treatment should be carried out through medical nutrition therapy, exercise therapy, blood sugar-lowering medication use, and blood sugar monitoring.