It’s not really about the use of sugar.
The body has a very powerful system to keep blood glucose levels properly regulated within a small range.
Diabetes is characterized by elevated blood glucose levels, both after meals and when fasting – it’s a breakdown of the regulation system.
The mechanisms of damage are a bit too complicated for ELI5, but one of the mechanisms at work is that too much blood glucose damages the inside of blood vessels. That is why diabetes raises the risk of heart disease and neuropathy (nerve damage) due to the damage of small blood vessels.
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