What is diabetes?
Diabetes Mellitus as it is known in full, is a common health condition where there is too much glucose in the blood. Glucose is a type of sugar that comes from carbohydrates in the food we eat and is also produced by the liver and is our body’s main source of energy. Most of the food we eat is broken down into glucose. The level of glucose in the blood is regulated by a hormone called insulin. Insulin stimulates cells to absorb enough glucose from the blood for the energy they need. Insulin also stimulates the liver to absorb and store any glucose that’s left over. People who have diabetes either do not produce insulin, produce insufficient insulin or the insulin they do produce does not work properly, so the glucose builds up in your blood instead of moving into the cells. Insulin is made by a gland called the pancreas, which lies just behind the stomach. Insulin allows glucose to move from the blood into the body’s millions of cells and be converted into energy needed for daily life.
There are 2 main types of diabetes:
Type 1, also known as insulin dependent diabetes, develops when the insulin producing cells in the pancreas have been destroyed and the person stops producing their own insulin. This may be due to a combination of hereditary and environmental factors, but it could also be as a result of damage to the pancreas from a virus. It generally affects children and young adults of both sexes and will usually become apparent before the age of 40.
Type 2, also known as non insulin dependent diabetes, is the most common type of diabetes. Type 2 usually appears in older people (over 40) though as levels of obesity in the UK are rising, more and more younger people are being diagnosed. Type 2 happens when the pancreas fails to produce enough insulin to completely control the levels of glucose in your blood, or when the body cannot use the insulin that it does produce properly.
How likely am I to have diabetes?
It is estimated that there are more than 2 million people in the U.K. with diabetes and up to 800,000 people are believed to have diabetes without knowing it. The vast majority of people (approximately 75%) have type 2 diabetes which is generally treated with diet and /or tablets. People who have type 1 diabetes are dependent on insulin and life long injections are essential.
What causes diabetes?
The cause of diabetes is a mystery, although the following risk factors appear to play a role.
- A family history of diabetes can increase the risk of the disease developing. This is more common in type 2 diabetes.
- You are of African-Caribbean or South Asian origin.
- Pancreatic disorders – the pancreas produces insulin, and so any disease that affects the pancreas may reduce the production of insulin.
- People who are overweight or who have a large waist size are particularly likely to develop type 2 diabetes.
- Women who developed gestational diabetes are more likely to develop type 2 diabetes in later life.
There are a few myths associated with diabetes such as, eating too many sweets causes diabetes, this is not true! However, eating a high sugar diet can lead to you being overweight which is a risk factor of type 2 diabetes. Diabetes is not contagious, you cannot catch diabetes from somebody with the condition.
What are the symptoms of diabetes?
Symptoms are similar for both types of diabetes. However, type 1 diabetes may develop in a matter of weeks where as type 2 diabetes can develop gradually, and symptoms may be put down to increasing age. Symptoms you may experience include:
- Constant thirst and dry mouth.
- The need to urinate more than usual (especially at night).
- Weight loss.
- Genital itching.
- Extreme tiredness, fatigue and weakness.
- Tendency to get minor infections e.g. boils or thrush.
- Blurred vision.
- Cuts and bruises that are slow to heal.
- Tingling or numbness of the hands or feet.
What might happen if diabetes is left untreated?
The onset of diabetes can be rapid or very gradual. If undiscovered, patients can develop serious complications such as blindness, kidney disease, impotence and nerve damage that could lead to amputation. Studies show that people with undiagnosed diabetes also have a higher risk of coronary heart disease and strokes. Therefore early diagnosis is key and has obvious benefits so if you have any of the symptoms mentioned above or suspect you might have diabetes you must visit your doctor.
How is diabetes diagnosed?
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Diabetes is often diagnosed by a doctor during routine urine or blood tests, when the test shows the presence of glucose. If you suspect you might have diabetes your doctor may start by giving you a simple urine test to look for the presence of glucose in your urine. Normally, there should be no sugar in urine but when the levels of glucose in the blood rise above normal, glucose is spilled into the urine by the kidneys. This is why diabetes symptoms, such as excessive urinating and genital itching, occur. If sugar is present in urine it is a good indicator of diabetes.
We sell a diabetes screening test on this site, which looks for the presence of sugar (glucose) in urine (for more information on our test or to buy click here).
If an initial screening test shows glucose is present in urine then a further test which measures the actual amount of glucose in the blood will need to be carried out. We have a blood glucose monitoring system available on this website which gives an accurate picture of your blood glucose level at the time of the test. For more information or to buy this test click here.
If the level of glucose present is borderline, your doctor may want you to undergo another blood test which is carried out after fasting overnight. Another test called a HbA1c test which looks at long term sugar levels may also be carried out.
What treatment is available for diabetes?
The primary aim of treatment is to keep blood glucose levels stable, the quicker levels are brought under control the better the long term prospect of damage.
Type 1 diabetes requires the use of insulin injections. You will need to take these injections for the rest of your life. In addition to this you will have to stick to a healthy diet and limit your consumption of sweet sugary foods. Insulin can only be given by injection because if it was given by tablets your stomach juices would destroy the insulin.
Type 2 diabetes can often be controlled by diet or a combination of diet and tablets. If however, diet and tablets are not enough to control your blood glucose levels, you may need insulin injections. Your doctor will monitor what treatment is most suitable for you.
Make sure you always take your medication at the prescribed times and don’t miss any meals.
Gestational diabetes and diabetes in pregnancy?
Gestational diabetes develops or is discovered during pregnancy and then usually disappears when the pregnancy is over. Gestational diabetes can develop during pregnancy, because your body may need 3 times as much insulin than what it did before you were pregnant. You will be at an increased risk of gestational diabetes if you are overweight, you have previously had a large baby (over 9.9lb), you have a parent or sibling with diabetes or if you have had gestational diabetes before.
All pregnant women should be tested for gestational diabetes between their 24th and 28th week of pregnancy. Gestational diabetes normally affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is growing.
Diabetes risks and pregnancy
If you have diabetes and are planning on having a baby then you should discuss this with your diabetes specialist to ensure your diabetes is in control.
The risks to mother and baby from this type of diabetes includes the following:
- The baby being small or too large.
- An increase risk of pre-eclampsia
- Risk of premature birth
- Risk of baby suffering from respiratory distress when born
Pregnant women with gestational diabetes or type 1 or 2 diabetes should be looked after carefully during pregnancy and regular blood sugar checks are essential.
Living with diabetes
Whatever diabetes you have, it is very important that you come to terms with it and take responsibility for your every day care. The more you understand your condition and how it affects you, the better you will be able to control it.
Much of the daily care involves trying to keep blood sugar levels from going too high (hyperglycaemia) or too low(hypoglycaemia, see below).
On average you should test your blood glucose levels 3-4 times a day, and it is highly recommended to test your levels before meals, then 2 hours afterwards, this will indicate how the meal has affected your levels. If you are ill, under stress or you have changed your diet or exercise levels then you should carry out additional glucose tests. If you don’t feel quite right and your not sure why you should carry out a test as well .
Your doctor will help and advise you find a blood glucose-testing regime, which is best, suited for you. Your doctor will also want you to have regular check-ups and its important to attend. Your doctor will check your glucose levels, including the HbA1c test to show how well diabetes has been controlled over the previous months. Your doctor may also check cholesterol levels, kidney function, blood pressure and weight. You will also require regular feet and eye examinations.
As diabetes can cause poor circulation and/or numbness in the feet, it is important that you maintain good foot care and always wear comfortable shoes. If you develop any ulcers, corns or calluses on your feet you should seek advice from your doctor or chiropodist, never treat them yourself.
Checking urine for albumin is also an important part of diabetes management. Albumin is a protein that is present in the blood. There is normally only small amounts of albumin found in urine but if the kidneys are not working properly large amounts leak into urine. We sell urine analysis tests on our website which detect the presence of protein in urine. However, it will not tell you which protein is present so if you do have protein in your urine you will need to visit your doctor who may carry out more specific tests. To buy our urine analysis tests click here.
What is hypoglycaemia?
If you take insulin or tablets to control diabetes you may occasionally suffer a ‘hypo’, this is more common with people who have type 1 diabetes. Hypo is short for hypoglycaemia and it occurs when blood sugar levels fall below normal. This can be caused by you taking too much insulin, eating too little or at the wrong time, too much exercise or from drinking alcohol on an empty stomach. If you feel your glucose levels are low test your levels and eat or drink something sugary, for example, half a can of a fizzy drink (not a diet variety), 2 teaspoons of sugar (or sugar lumps), honey or jam, chocolate or 10 jellybeans. Symptoms of a ‘hypo’ can vary from person to person and in time you will recognise your symptoms. Symptoms may include:
- Aggression/Mood swings
- Rapid heart rate
- Blurred vision
- Clammy skin
In severe cases if the condition is not treated promptly a coma can occur. In these cases an injection of glucagon is given, which will temporarily raise the level of blood glucose. People with diabetes and those close to them should get used to early warning signs and it would be a good idea to keep a supply of sweets around you, leave them in purses, drawers, cars or lockers. If sugar levels are raised quickly this will prevent any serious consequences.
Ensure you also carry some type of identification stating that you have diabetes so that people are aware of your condition should it ever be necessary.
What is hyperglycaemia?
Hyperglycaemia occurs when your glucose levels are above 10mmol/L. The occasional high reading is not a problem but if levels become very high regularly your diabetes is not being controlled and this can lead to serious complications. Symptoms of hyperglycaemia are similar to those of the main diabetes symptoms though they can come on very suddenly and may include:
- Blurred vision
- Increased thirst
- The need to urinate more frequently
Hyperglycaemia can occur if you are unwell, eat too much or do not take enough insulin. If left untreated hyperglycaemia can lead to a condition called ketoacidosis, which can be fatal. Ketoacidosis occurs when your body doesn’t have enough insulin and therefore starts to break down fat rather than glucose. When your body breaks down fats waste products called ketones are produced. Your body cannot manage large amounts of ketones and so some of them will be removed through the urine. Unfortunately, the body cannot release all the ketones via urine and so they build up in your blood, which can lead to ketoacidosis. Symptoms of ketoacidosis include:
- Shortness of breath
- Breath that smells fruity
- Nausea and vomiting
- Very dry mouth
Your doctor will show you how to test your urine for ketones. We sell a variety of urine analysis tests, one which specifically looks for the presence of ketones. Click here for more information on all our available urine tests.
Will diabetes affect my way of life?
Diabetes may change your way of life as far as your daily diet is concerned. You will need to begin to watch what you eat and follow a healthy balanced diet. If you have diabetes it is also important that you eat regular meals and include a wide variety of foods. You should limit the amount of salt you have, as too much salt can cause high blood pressure. You should also eat fewer fried and fatty foods (to reduce your risk of high cholesterol) and eat fewer sweet foods. You can lower your sugar intake by using reduced sugar or sugar free foods. The British Diabetic Association suggests that you avoid special diabetic food and drink products, they say they are unnecessary and expensive.
If you smoke you should certainly give up, as smoking is dangerous to a diabetic. You should also take regular moderate exercise. You can drink alcohol, but as with everyone, only in moderation and you should not binge drink. However, you should remember that alcohol lowers blood glucose and if you are a bit drunk you may be less aware of ‘hypo’ symptoms. If drinking you should ensure you have a meal before and snack while drinking. You should also take an additional glucose test before going to bed and have a bedtime snack.
Learn as much as you can about your condition and be sure to visit your doctor for regular check ups. Your doctor will want to check your blood pressure and your weight on a regular basis. If you are overweight diabetes can be more difficult to control.
Exercise is important part in controlling blood glucose. Our muscles use glucose for energy so the more we use the more we improve insulin sensitivity. Exercise is also important in keeping your weight at an ideal level.
Thousands of people in the U.K. have diabetes and the vast majority live a normal, healthy life. Ex-Footballer Gary Mabbutt has type 1 diabetes and it never stopped him from reaching the top level of the game. He enjoyed a long career for Tottenham as their captain and he also represented England on many occasions. Olympic Gold medallist Sir Steven Redgrave has type 2 diabetes.
Can diabetes be cured?
There is currently no cure for diabetes, once present it is there for life. The good news is that it can be controlled by proper treatment and self care, then once you get used to testing your glucose levels/ taking medication it will become part of your every day life, like brushing your teeth.