What is diabetes?

Diabetes Mellitus as it is known in full, is a common health condition where there is too much glucose (sugar) in the blood. 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. People who have diabetes either do not produce insulin, produce insufficient insulin or the insulin they do produce does not work properly. 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, usually appears in older people (over 40) though it occasionally appears in the young. 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 1.4 million people in the U.K. today with diabetes and probably as many people again will 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. Those people who have type 1 diabetes are dependent on insulin and life long injections are essential.

What is gestational diabetes?

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. 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. This can lead to a ‘fat baby’, which if left untreated can cause many problems for the baby during or after birth.

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.
• Pancreatic disorders - the pancreas produces insulin, and so any disease that affects the pancreas may reduce the production of insulin.
• People who are overweight are particularly likely to develop type 2 diabetes.
• Cow’s milk - some studies suggest that exposure to cow’s milk during infancy may increase the risk of type 1 diabetes.
• Women who have gestational diabetes are more likely to develop type 2 diabetes in later life.

Eating too many sweets does not cause diabetes, and 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.
• Tiredness 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 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 detection of diabetes has obvious benefits.

How is diabetes diagnosed?

If you have any of the symptoms mentioned above or suspect you might have diabetes you must visit your doctor. Your doctor may start by giving you a simple urine test to look for the presence of glucose in your urine.
We sell a diabetes screening test on this site, which looks for the presence of sugar (glucose) in blood (for more information on our test or to buy click here).

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.

The doctor will then carry out a blood glucose test that measures the amount of glucose in the blood. If the level of glucose present is borderline, you may undergo another blood test after fasting overnight.

What treatment is available for diabetes?

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.

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). If left untreated hyperglycaemia can lead to a condition called ketoacidosis, which can be fatal. Ketoacidosis occurs when you start to produce harmful substances called ketones, which appear in your blood and urine. Symptoms of hyperglycaemia include vomiting, drowsiness, abdominal pain and pains in the legs. Hyperglycaemia can develop if you stop taking your insulin or if you are ill. Your doctor will show you how to test your urine for ketones.

Most diabetics can monitor their own blood sugar levels with one of the many systems available (your doctor will show you how these work). 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 fell 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.

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

What is a ‘hypo’?

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 there are insufficient levels of glucose in the blood. 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 this condition is not treated promptly a coma can occur. 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, honey or jam or 10 jellybeans. It would be a good idea to keep a supply of sweets around you, leave them in purses, drawers, cars or lockers.

Symptoms of a ‘hypo’ can vary from person to person and in time you will recognise your symptoms. Symptoms may include:

• Hunger
• Dizziness
• Confusion
• Aggression
• Rapid heart rate
• Nausea
• Nightmares
• Headache
• Blurred vision
• Clammy skin

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.

Thousands of people in the U.K. have diabetes and the vast majority live a normal, healthy life. Ex-Footballer Gary Mabbutt is a diabetic 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.

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.

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