What is Diabetes?
Diabetes Mellitus is a chronic metabolic condition, caused when a person’s blood glucose levels are consistently high, also known as hyperglycaemia.
Carbohydrates that we eat are broken into glucose when digested, the glucose is absorbed and released into our bloodstream, which is used for energy or stored for later. When the glucose released is not stored away remaining in excess, it increases our blood sugar levels. This occurs when the body does not produce sufficient insulin, a hormone made in the pancreas, which controls blood glucose levels, or when the body’s cells do not react to the insulin produced.
There are two types of Diabetes. Diabetes Type 1, also known as juvenile diabetes, it comes about due to the body’s inability to produce any insulin. People suffering from Diabetes Type 1 are usually diagnosed in their childhood and remain insulin dependent through their lives. Diabetes type 2 is more common, and occurs when the body doesn’t produce enough insulin or when the body’s cells don't react, or both. There are almost four million people living with diabetes in the UK, 90% of whom suffer from Type 2.
Diabetes Type 2
Blood glucose levels are measured in millimoles per litre (mmol/L). A level between 4-6mmol/L when fasting indicates normal blood sugar levels, between 6-7mmol/L indicates a high risk of developing the condition, while 7mmol/L or above indicates diabetes.
Diabetes Type 2 is closely associated with obesity. At first it can be managed with regular exercise, change in lifestyle habits and healthy eating, however as it progresses, medication is prescribed to keep blood glucose levels normal. Diabetes can come about due to a series of risk factors such as age, family history, lifestyle habits, obesity etc. and can have serious long-term effects, most commonly leading to cardiovascular diseases, kidney failure (nephropathy), loss of vision (retinopathy), nerve damage (neuropathy) and even dental problems. It is extremely important to diagnose your condition as early as possible and effectively manage it.
Signs and symptoms for Diabetes Type 2 aren’t always obvious, as they begin mildly and progress gradually over time. You may have it for many years without realising it. However, there are certain symptoms associated with Diabetes, which come about due to the presence of excessive glucose in your blood, and your body’s effort to get rid of it, these include;
Feeling very thirsty:Excessive sugar buildup in your bloodstream causes fluid to be pulled from the tissues, leaving you thirsty.
Hunger:Without glucose being absorbed into your cells, your muscles and organs become depleted of energy.
Excessive urination:Passing more urine than usual, especially at night.
Fatigue: Feeling unusually tired all the time
Unexplained weight loss: Without the ability to metabolise glucose, the body uses other fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine.
Itching in the genital areas
Cuts or wounds: That heal particularly slowly
Blurred vision: Fluid is pulled from your eyes lenses, blurring vision.
Skin conditions: You may develop patches of dark, velvety skin in the folds of the body, signifying insulin resistance.
High blood glucose occurs when the pancreas are unable to produce enough insulin to control the blood glucose level, or when the cells in the body don’t effectively respond to the insulin that is being produced, also knows an insulin resistance. Insulin is responsible for moving glucose from the blood into your cells where it is stored or converted into energy. Due to the lack of insulin or its inability to regulate blood glucose, levels may become extremely high, resulting in Diabetes and increasing the risk of other associated conditions, such as heart diseases.
Numerous factors can raise your risk of developing Diabetes Type 2;
Age: As you get older, people tend to exercise less and gain weight rapidly. Being over 40 significantly increases your chances of developing Diabetes, however it is increasingly also showing in children nowadays.
Genetics: Having a close relative with the condition, is one of the main risk factors for Diabetes; the closer the relation, greater the risk.
Weight: Being overweight or obese with a BMI of 30 or more. Abdominal fat in particular increases your risk, as it releases chemicals adversely affecting the cardiovascular and metabolic systems. Being overweight also increases your risk of developing other associate conditions such as coronary heart disease, stroke and even some types of cancer.
Ethnicity: Diabetes more commonly occurs in people of South Asian, Chinese, African-Caribbean or African origin. They also have an increased risk of developing complications at a younger age.
Pre-diabetes: If you are diagnosed with pre-diabetes, leaving it untreated usually progresses to developing the condition.
Associated conditions: Conditions such as high blood pressure and Polycystic Ovarian Syndrome in women, are often risk factors for diabetes and are closely associated.
Lifestyle habits: Unhealthy lifestyle habits such as maintaining a poor diet that is high in calories, sugars and salts and low in essential nutrients contributes directly to obesity and therefore diabetes. Other contributing factors include stress, smoking and even lack of sleep.
It is important to be diagnosed early, for treatment to begin as soon as possible avoiding serious complications that occur with advanced cases of Diabetes.
At first a urine sample is tested for glucose. Urine doesn’t normally contain glucose, but when suffering from diabetes, glucose can overflow from the kidneys into your urine. If glucose is found present in your urine, specialised blood tests are carried out to determine the nature and severity of your condition.
Glycated haemoglobin (HbA1c)
This test shows your average blood glucose levels over the previous 2-3 months. It measures the percentage of blood sugar attached to haemoglobin, which carries oxygen around the body, with higher blood sugar levels more haemoglobin is found attached. For those already diagnosed with Diabetes, the test shows how well it is being controlled.
Unlike other tests, this test doesn’t require preparation or fasting.
Glucose Tolerance Test (GTT)
This test shows any problems in processing glucose. You are required to fast for 8-12 hours for the test, when your blood glucose is measured. You will then be given a sweet glucose drink, your blood glucose is then measured again after 2 hours.
Fasting Plasma Glucose (FPG)
This test will measure your blood sugar on an empty stomach.
Usually you will be tested on different days over a period of time to confirm your diagnosis.
There is no cure for diabetes, treatment given aims to regulate your blood glucose levels as much as possible and control the symptoms caused, helping avoid more serious health conditions from developing later in life.
Once diagnosed you must look after your health, closely managing your diet and exercise. Type 2 Diabetes is a progressive condition, and will therefore require medication in the long-run. Your doctor will prescribe treatment based on the results of your blood test. We at The Online Surgery offer a combination of treatment options to help you effectively manage your condition.
Metformin is usually the first medicine prescribed to treat Type 2. It works by reducing the amount of glucose released by your liver into the bloodstream. It also makes the body cells more receptive to insulin. For people who are overweight, Metformin is particularly suitable as it doesn't cause additional weight gain, unlike some other treatment options available.
Sulphonylureas increase the amount of insulin produced by the pancreas. This medicine is prescribed if you are unable to take Metformin or if you aren’t overweight. It may also be given in combination if Metformin is unable to control blood glucose levels on its own.
Sulphonylureas medicines include Gliclazide, Glibenclamide, Glimepiride and Glipzide.