Diabetes and metabolism explained

Medically reviewed on February 15, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

If you feel like your metabolism has become more sluggish lately, you’re not alone. Many people suffer from a slowing metabolism as they age [1]. Often, this is because of the loss of muscle mass and movement that takes place when you get older. One factor that doesn’t influence metabolic rate is whether you have diabetes.

Diabetes doesn’t directly influence metabolism. However, it does impact how the body uses insulin, which can affect health and weight. In this guide, you’ll learn more about diabetes and metabolism, what diabetes may mean for weight, and what hormone regulates your metabolism (also consider learning more about the at-home Metabolism Test).

What is Diabetes?

Diabetes is a chronic condition that affects the body’s response to, or production of, insulin [2]. There are two types of diabetes, type 1 and type 2. How insulin is impacted depends on the type of diabetes an individual has.

Type 1 Diabetes

Type 1 diabetes is caused by an autoimmune reaction in the body [3]. Researchers believe something triggers the body to start attacking the cells in the pancreas, which is responsible for producing insulin and is necessary for normal hormone production. Type 1 diabetes has several characteristics that differentiate it from type 2, including:

Age of onset – Type 1 diabetes is typically diagnosed in children or teenagers, although it can also occur in older people.

Rate of occurrence – Type 2 diabetes is far more common, accounting for approximately 90–95% of all diabetes diagnoses. Type 1 is only responsible for 5–10% of diabetic conditions. Also, it isn’t known why those who suffer from type 1 diabetes develop the disease.

Impact on insulin – Type 1 diabetics cannot produce enough insulin (the hormone responsible for transporting the sugar from the foods you eat to the cells) for proper blood sugar regulation. When insulin doesn’t get to the cells, the sugar collects in the bloodstream, which may lead to a host of complications and/or potentially fatal issues.

Symptoms – The most common symptoms that differentiate type 1 from type 2 diabetes include stomach pain, nausea, and vomiting.

Type 1 diabetes is diagnosed with a simple blood test. Once the disease is diagnosed, a team of specialists can determine the best options for managing diabetes. These may include one or more of the following:

• Healthy lifestyle actions (diet, exercise, stress relief)
• Regular blood sugar level checks
• Insulin shots
• An insulin pump

Now let’s examine how type 2 diabetes differs from type 1.

Type 2 diabetes

Type 2 diabetes is often caused by poor lifestyle and health choices that damage the body’s ability to use insulin properly. Unlike type 1, type 2 diabetics produce enough insulin. However, in type 2, the body doesn’t use it efficiently [4]. In a type 2 diabetic, the insulin production process is:

• Over time, cells become resistant to the effect of insulin
• To counteract this insulin resistance, the pancreas produces more insulin
• The pancreas becomes overworked and can’t keep up with the demand for insulin
• Blood sugar spikes
• High blood sugar can damage the kidneys, heart, and eyes

Unfortunately, type 2 diabetes can develop over many years. Often, the symptoms are ignored or go unnoticed until full-blown diabetes has taken hold [5]. The symptoms of type 2 diabetes are also associated with type 1 and can include:

• Frequent urination
• Sudden weight loss
• Increased thirst
• Blurred vision
• Exhaustion
• Tingling in the hands or feet
• Extremely dry skin
• Slow-healing sores
• More frequent infections

While many of the endocrine disorder’s symptoms are similar, the cause and age of onset of type 1 vs. type 2 diabetes differ. Type 2 is usually diagnosed in people aged 45 and older. However, the increase in obesity and poor health habits has led to an increase of far younger people developing type 2 diabetes.

The only way to determine if you have either type of diabetes is with a blood test.

How Does Your Metabolism Work?

Now that you know the basics of diabetes, let’s break down how metabolism works. This will help you to understand the relationship that exists between the two. Metabolism refers to how the body uses energy to perform functions [6]. The energy from food is necessary for all of the body’s essential functions, such as:

• Digestion
• Breathing
• Blood circulation
• Temperature regulation
• Cell growth and repair
• Hormone management

The metabolic process is incredibly complex, but three terms can help you understand the basics [7]. These include:

Resting energy expenditure – This is the measure of how much energy is used when at rest. For most people, this accounts for approximately 60% of the body’s total energy usage.

Activity energy expenditure – As the name implies, this is the amount of energy used to perform activities. Exercise and metabolism correlate. If you exercise frequently, the body will use more energy and thus need more calories to provide that energy than someone who is more sedentary.

Basal metabolic rate – The basal metabolic rate is how much energy is needed to stay alive and functioning. It doesn’t consider the energy needed for activities, only what is needed to live while at rest.

Factors that Influence Your Metabolism

Everyone’s metabolism is different. Your body may utilize energy differently than your spouse’s, sibling’s, or friend’s body. The main factors that contribute to metabolic rate include the following [8]:

Body composition – The proportion of muscle to fat in the body impacts how much energy the body uses each day. Muscle requires more energy to build and maintain than fat. Thus, the more muscle you have, the more calories you expend as you go through daily activities.

Age – The reason that age impacts metabolic rate has more to do with muscle mass than the number of candles on your birthday cake. Most of us lose muscle mass as we get older. The less muscle you have, the less energy the body expends.

Weight – The body needs more energy to move and sustain heavier weights. A person who weighs 250 pounds will require more calories each day than a person who weighs 150 pounds to maintain their current weight.

Genetics – Lastly, genetic makeup can also contribute to having a fast or slow metabolism. Some people are genetically predisposed to having higher muscle mass and greater energy needs.

Does diabetes change your metabolism?

Type 2 diabetes and obesity are closely linked. In fact, a 2020 study in the clinical diabetes journal "Diabetologia" found that obese individuals were six times more likely to develop type 2 diabetes than those at a healthy weight [9]. The same study also found that overweight individuals were twice as likely to develop type 2 diabetes.

This doesn’t mean that having diabetes changes metabolism. Instead, type 2 diabetes can severely limit the body’s ability to utilize insulin, which impacts how the body obtains and uses energy.

Insulin and Your Metabolism

If metabolism is functioning optimally, carbohydrates consumed are broken down into glucose, a type of sugar that then enters the bloodstream to fuel the body’s cells [10]. Excess glucose is converted to glycogen and stored in the liver for later use. Any remaining glucose in the blood is turned typically stored as body fat.

Insulin is the hormone that does all the heavy lifting here. It’s responsible for:

• Getting the blood glucose to the cells
• Converting excess glucose to glycogen for storage in the liver
• Turning blood glucose into fat

In type 2 diabetics, the insulin released by the body isn’t used effectively and these systems malfunction. This causes the pancreas to think it needs to produce and release more insulin. Over time, the insulin loses effectiveness, and blood sugar levels will remain continually high.

High blood sugar levels can cause:

• Feeling hungry all the time
• Lack of energy

If this results in excess calorie consumption and less physical activity, weight gain is common, further exacerbating the problem.

Preventing Diabetes and Keeping Your Metabolism Running Smoothly

Diabetes and metabolism may not be directly related. However, keeping metabolism humming along and preventing diabetes requires similar actions. To prevent type 2 diabetes, clinical research from the CDC recommends [11]:

• Eating a healthy diet
• Getting plenty of exercise
• Managing stress
• Keep blood pressure and cholesterol at healthy levels

You’ll notice that these actions parallel the factors that contribute to metabolic efficiency.

Monitor your metabolism with Everlywell

Metabolic rate determines how much energy you need to power your body every day. If you consume more energy than your body needs, you may gain weight. Sometimes individuals feel as though they are gaining weight when they haven’t changed eating or activity levels. This often means something else is wrong, perhaps with the endocrine system.

Since obesity is a leading risk factor for the development of type 2 diabetes, maintaining healthy body weight is advantageous. That’s why at Everlywell, we offer a physician-reviewed, at-home Metabolism Test to help you evaluate some of the key hormones needed to maintain a normal metabolic rate. Take your health into your hands with Everlywell.

References

1. Shimokata H, Kuzuya F. [Aging, basal metabolic rate, and nutrition]. Nihon Ronen Igakkai Zasshi. 1993 Jul;30(7):572-6.

2. Di Iorgi N, Napoli F, Allegri AEM, et al. Diabetes insipidus--diagnosis and management. Hormone Research in Paediatrics. 2012;77(2):69-84.

3. What Is Type 1 Diabetes? Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.

4. Type 2 Diabetes. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.

5. Diabetes symptoms. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.

6. Judge A, Dodd Michael S. Metabolism. Essays in Biochemistry. 2020;64(4):607-647.

7. Westerterp KR. Control of Energy Expenditure in Humans. [Updated 2019 Jul 25]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.

8. MCMURRAY RG, SOARES J, CASPERSEN CJ, MCCURDY T. Examining Variations of Resting Metabolic Rate of Adults. Medicine & Science in Sports & Exercise. 2014;46(7):1352-1358.

9. Schnurr TM, Jakupović H, Carrasquilla GD, et al. Obesity, unfavourable lifestyle and genetic risk of type 2 diabetes: a case-cohort study. Diabetologia. Published online April 15, 2020.

10. Carbohydrates and Blood Sugar. Harvard T.H. Chan School of Public Health. URL. Accessed February 15, 2022.

11. Type 2 Diabetes. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.