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Diabetes

What is Diabetes?

Diabetes is currently the fifth most common reason for death in the world.

Diabetes mellitus (DM) commonly referred to as diabetes causes a person’s blood sugar level to become too high. The amount of sugar in the blood is controlled by insulin, which is produced by the pancreas (a gland behind the stomach).

There are two main types  – type 1 and type 2. Type 1 is an autoimmune disease while type 2  is acquired and results from lifestyle choices especially regarding diet. Type 1 and type 2 have much in common despite having these differences.

Type 1

Type 1 diabetes is less common than type 2.

As an autoimmune disease the precise cause of type 1 diabetes has not been established but it is known that the immune system rather than being directed only at foreign antigens which are attacking the body is directed at the body’s own tissues, in the case of diabetes attacking the cells of the pancreas which produce insulin. As the pancreas stops making insulin, your glucose levels increase, which can seriously damage the body’s organs. The illness and symptoms develop quickly over weeks or even days because the level of insulin in the bloodstream becomes very low.

Type 2

Type 2 diabetes symptoms tend to develop gradually over weeks or months. This is because you still make insulin in type 2 diabetes (unlike type 1 diabetes), however you do not make enough insulin for your body’s needs and/or your body doesn’t use insulin properly (insulin resistance). The cells in your body become resistant to normal levels of insulin and you need more insulin to keep the blood sugar at normal levels.

Many people have type 2 diabetes for years without realising it because symptoms tend to be ignored.

Who it Affects

Type 1 diabetes is also sometimes known as juvenile diabetes or early-onset diabetes because it usually develops before the age of 40, often during the teenage years.

Type 2 diabetes is acquired and results from lifestyle choices especially regarding diet. Diabetes has assumed epidemic proportions in parallel with the obesity crisis. Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it’s more common in older people.

It is estimated that 382 million people are living with diabetes in the world, which is estimated to be 8.5% of the world’s population and an estimated 175 million people have undiagnosed type 2 diabetes.

Diabetes Symptoms

The onset is often gradual and damage may have occurred before a diagnosis has been made and treatment begun. Early signs and symptoms can range from drinking more water than usual (and passing more urine), developing more infections, losing weight unexpectedly, tiredness and blurred vision.

Occasionally the micro-circulation to the nerves of the eye muscles is compromised and can cause double vision. This double vision fortunately often recovers.

Diabetes

Tests

In many cases diabetes is diagnosed during a routine medical. A simple dipstick test may detect sugar (glucose) in a sample of urine. However, a blood test for elevated glucose and HbA1c is needed to make a diagnosis.

Diabetes is known as a “micro-angiopathy” meaning that it affects the very small blood vessels throughout the body. These changes can be detected in the eyes, and this allows opticians to diagnose diabetes during a routine sight test: the blurred vision mentioned above may have been caused by a change in the lens of the eye, and an early cataract is detectable on sight-testing.

Once diagnosed annual examination of the back of the eye should be done (usually by photographic screening) to monitor possible progression of diabetic retinopathy and the need for better control or treatment such as by laser.

Diabetic Retinopathy

Diabetes Treatment

If you’re diagnosed with type 1, you’ll need insulin injections for the rest of your life.

You’ll also need to pay close attention to certain aspects of your lifestyle and health to ensure your blood glucose levels stay balanced.

For example, you’ll need to eat healthily, take regular exercise and carry out regular blood tests.

If you’re diagnosed with type 2, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels.

However, as type 2 is a progressive condition, you may eventually need medication, usually in the form of tablets if you do not take further action.

Diabetes Prevention

While diabetes usually requires treatment, diet plays a very important role and dietary changes will have a significant impact on the course of the disease.

I have been able to advise patients with diabetes how they can improve the control by a simple concept. Find out more.

Further Information

  1. Facts and figures about diabetes: http://www.who.int/diabetes/facts/en/
  2. Diabetes Prevalence: http://www.diabetes.co.uk/diabetes-prevalence.html

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