ulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body, especially liver, muscle, and adipose tissue. Therefore, deficiency of ins ulin or the insensit 3ivity of its receptors plays a central role 0e7a3 io in all forms of diabetes The body obtains glucose from three main places: t 7a3 he intestinal absorption of food, the breakd own of glycogen, the storage form of glucos e7a3 e found in the liver, a e7a3 nd gluconeogenesis, the gene ration of glucose from non e7a3 -carbohydrate substrates in the body.Insulin plays a critical ro le in balancing glucose levels in the body. Insulin can inhib a3it the breakdown of glycogen or th e process of gluconeogenesis, it can stimulate the transport of glucose into 0e7a3 iofat and muscle cel ls, and it can st 7a3 himulate the storage of glucose in the form of glycogen. Insulin is released into the blood by beta cells found in the islets of Langerhans in the pancreas, in response to rising a3levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, fo r conversion to other needed molecules, or for stora e7a3 ge. Lower glu e7a3 hcose levels result in decreased insulin rele 3ase from the 0e7a3 io beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite If the amount of e7a3 insulivcn availa a3ble is insufficient, if cells respond poorly to the effects of insu lin (insulin insensitivity or insulin resistance), or if the insulin itself is defective, then gluco se will not be absorbed properly by the body cells that re a3quire it, and e7a3 it will not be stored approp riately i 7a3 hn the liver and muscles. The net effect is persistently high levels s is a chronic disease, for which there is no known cure except in very specific situations. Ma nagement concentrates on keeping blood sugar levels as close to 7a3 hnormal, without causing low blood su gar. This can usuall a3y be accomplished with a healthy diet, exercise, weight loss, and use of appropri ate medicat 0e7a3 ions (insulin in the case of type 1 diabetes; oral medic 0e7a3 ioations, as well as possibly insul Learning about the disease and actively particip e7a3 ating in the treatment is important, since complicati ons are far less common and less severe in people who have well-managed blood sug e7a3 ar levels.Th e goal of treatment is an HbA1C level of 6.5%, but shoul a3d not be lower than that, and may be set high er. Attention 3is also paid to other health problems that may accelerate the negative effects of d iabetes. These include smoking, elevated cholesterol levels, obesity, high bloo 3d pressure, and lack of regular exercise Specialized footwear is widely used to reduce the risk of ulceration, or re-ulcerati
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