Diabetes is a chronic life-long disease in which the body cannot properly convert food into energy. Most food that a person eats is eventually broken down into blood glucose (also called blood sugar), which cells need for energy and groW*H. Insulin (produced by the pancreas), is a hormone that helps glucose to enter cells. Normally, the body controls blood glucose levels with a hormone called insulin but in diabetics, either: - the insulin doesn't work as well as it should, or
- not enough insulin is produced, or
- the body stops making insulin altogether.
This causes glucose to build up in the blood instead of moving into the cells. Hyperglycaemia and other related disturbances in the body's metabolism can lead to serious damage to major health problems like:
- blindness
- kidney failure
- heart disease
- stroke
- and nerve damage (which can, in turn, lead to impotence)
The key to avoiding these complications is early diagnosis, effective treatment and good self-management.
There are two basic forms of diabetes:
Type 1:
People with this type of diabetes produce very little or no insulin. People with type 1 diabetes require daily injections of insulin to survive.
It develops when the body still produces some insulin, but not enough, or when the insulin no longer works properly. This is the type that affects the vast majority of diabetics (over 75%).
Type 2:
People with this type of diabetes cannot use insulin effectively. People with type 2 diabetes can sometimes manage their condition with lifestyle measures alone, but oral drugs are often required, and less frequently insulin, in order to achieve good metabolic control.
Most people with diabetes have type 2. Many of them have no symptoms and are only diagnosed after many years of onset. As a consequence, almost half of all people with type 2 diabetes are not aware that they have this life-threatening condition.
If you've developed diabetes and it isn't being treated, you are likely to have some of the following symptoms, to a greater or lesser degree: - General tiredness and lethargy
- Increased thirst
- The need to urinate all the time, especially at night
- Unexplained Weight loss, especially in Type 1
- Itchiness, especially around the genitals
- Blurred vision
- Extreme hunger
- Numbness in hands or feet,
- Dry mouth
- Dry skin
- Some other symptoms such as nausea, vomiting and stomach pains may also be present.
- Being male :
Men are one-and-a-half times more likely to get diabetes than women. - Family history :
The closer a relative with diabetes, the greater the risk of developing it yourself. At least 30% of Type 2 diabetics have a family history, although that's true of only 10% of Type 1 diabetics. - Age :
Up to about 75 years of age, the older you are, the greater the risk. The average age of diagnosis for Type 2 is 52 in people with no family history, or 51 in those with a family history. - Ethnic background :
People from Afro-Caribbean or Asian cultures living in the UK are four to five times more likely to develop diabetes than Caucasian members of the population. - Weight and shape :
Over 80% of Type 2 diabetics are overweight. The more overweight you are — and the less physical activity you do — the greater your risk of developing diabetes.
Diabetes cannot be cured, but it can be treated very successfully. The main aim of all treatments is to keep blood glucose levels within a normal range. Diabetes is a progressive condition, which means that it is likely to get worse over time (though this progression can be slowed down with treatment). Studies have also shown that people who begin taking medication as soon as they need it are less likely to suffer diabetic complications.
Primary prevention, healthy diet and regular physical activity, protects susceptible individuals. It has an impact by reducing or delaying both the need for diabetes care and the need to treat diabetes complications. It should be emphasized particularly in the poorest regions of the world where resources are severely limited.
Secondary prevention includes early detection and good treatment. The treatment of high blood pressure and raised blood lipids, as well as the control of blood glucose levels, can substantially reduce the risk of developing complications and slow their progression. Large, population-based studies in China, Canada, USA and several European countries suggest that even moderate reduction in weight and half an hour of walking each day reduced the incidence of diabetes by more than one half in overweight subjects with mild Impaired Glucose Tolerance (IGT).
Treating Type 1 diabetes
Type 1 diabetics have to rely on daily insulin injections for the rest of their lives. Because insulin is destroyed by the digestive juices in the stomach it cannot be taken by mouth and must be injected. Typically, Type 1 diabetics inject insulin two or four times a day.
As well as controlling blood glucose levels, there is growing emphasis on keeping blood pressure levels within normal limits, using tablets if necessary. In addition to insulin injections and, where needed, blood pressure tablets, Type 1 diabetics must eat a healthy diet and should stay physically active.
Treating Type 2 diabetes
Type 2 diabetics can manage their diabetes in a number of ways:
- Healthy diet and physical activity alone.
- Healthy diet, physical activity and tablets.
- Healthy diet, physical activity and insulin injections.
Diabetes is not a condition you can ignore. To avoid diabetic complications you've got to look after yourself — good diabetes care is all about self-management. Although you'll probably have to make some changes to your lifestyle, you should be able to continue enjoying a normal, day-to-day life. Here's what you need to do:
- Follow a healthy diet.
- Quit smoking. You may think that smoking is one of your last pleasures, but smoking is probably the worst thing you can continue with since it further increases an already heightened risk of developing heart disease.
- Get physical. The fitter you are, the easier it is to control your diabetes.
- Follow your treatment plan. Don't be tempted to miss out on your treatment, whether that's diet, medication or physical activity. You should be aiming to keep your blood glucose and blood pressure levels as near to normal as possible.
- Have regular medical check-ups. Everyone with diabetes should have a thorough medical check-up at least once a year. Diabetic complications such as eye disease can be caught early on before any symptoms are obvious, and can be treated very successfully. Your annual check-up should test:
- Blood glucose
- Blood pressure
- Kidney function (including a urine test for protein which may be an early indicator of diabetic kidney disease)
- Cholesterol levels
- Weight
- Legs and feet for skin and circulation problems
- Eyes
- Insulin injection sites
- The blood for glycated haemoglobin (HbA1c).
Because of its chronic nature, the severity of its complications and the means required to control them, diabetes is a costly disease, not only for affected individuals and their families, but also for the health systems. Studies in India estimate that, for a low-income Indian family with an adult with diabetes, as much as 25% of family income may be devoted to diabetes care.
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