-----------------------------------------------------------------------------------------
What is diabetes?
There are three main types of diabetes. These are:
|
--------------------------------------------------------------------------------- 
What are the symptoms of diabetes?
The main symptoms of diabetes are:
increased thirst
going to the all the time – especially at night
extreme tiredness
weight loss
genital itching or regular episodes of thrush
blurred vision.
Type 2 diabetes develops slowly and the symptoms are usually less severe. Some people may not notice any symptoms at all and their diabetes is only picked up in a routine medical check up. Some people may put the symptoms down to 'getting older' or 'overwork'.
Type 1 diabetes develops much more quickly, usually over a few weeks, and symptoms are normally very obvious.
In both types of diabetes, the symptoms are quickly relieved once the diabetes is treated. Early treatment will also reduce the chances of developing serious health problems.
---------------------------------------------------------------------------------
Who gets diabetes & what causes it?
Type 1 diabetes
Type 1 diabetes develops when the insulin – producing cells in the pancreas have been destroyed. Nobody knows for sure why these cells have been damaged but the most likely cause is an abnormal reaction of the body to the cells. This may be triggered by a viral or other infection. This type of diabetes generally affects younger people. Both sexes are affected equally.
Type 2 diabetes
Type 2 develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). In most cases this is linked with being overweight. This type of diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people it often appears after the age of 25.
However, recently, more children are being diagnosed with the condition, some as young as seven.
Reducing the risk of serious health problems (Diabetic Complications)
Following your treatment plan
It is very important that you follow the treatment that your doctor or diabetes nurse has advised. You will feel much better if you keep your blood glucose levels as near normal as possible. Blood glucose levels are measured in milligrams per deciliter of blood. This is shortened to mg/dl. You should aim for a level of 70 - 120 gm/dl before meals, rising to no higher than 160 mg/dl two hours after meals. Your doctor or diabetes nurse will advise you on what is best for you. They can also advise you on the many gadgets available that can help you to monitor your blood glucose levels.
---------------------------------------------------------------------------------
How diabetes is treated?
Although diabetes cannot be cured, it can be treated very successfully. Knowing why people with diabetes develop high blood glucose levels will help you understand how some of the treatments work.
Blood glucose levels
When sugar and starchy foods have been digested, they turn into glucose. If somebody has diabetes, the glucose in their body is not turned into energy, either because there is not enough insulin in their body, or because the insulin that the body produces is not working properly. This causes the liver to make more glucose than usual but the body still cannot turn the glucose into energy. The body then breaks down its stores of fat and protein to try to release more glucose but still this glucose cannot be turned into energy. This is why people with untreated diabetes often feel tired and loses weight. The unused glucose passes into the urine, which is why people with untreated diabetes pass large amounts of urine and are extremely thirsty.
Type 1 diabetes is treated by injections of insulin and a healthy diet. Type 2 diabetes is treated by a healthy diet or by a combination of a healthy diet and tablets. Sometimes people with Type 2 diabetes also have insulin injections, although they are not totally 'dependent' on the insulin.
Treatments for Type 1 diabetes
People with Type 1 diabetes need injections of insulin for the rest of their lives and also need to eat a healthy diet that contains the right balance of foods. Insulin cannot be taken by mouth because it is destroyed by the digestive juices in the stomach. People with this type of diabetes commonly take either two or four injections of insulin each day.
If you or someone close to you needs insulin injections, your doctor or diabetes nurse will talk to you, show you how to do them and give you support and help. They will also show you how you can do a simple blood or urine test at home to measure your glucose levels. This will enable you to adjust your insulin and diet according to your daily routine. Your doctor or diabetes nurse will advise you what to do if your glucose level is too low.
If you have Type 1 diabetes, your insulin injections are vital to keep you alive and you must have them every day.
Treatments for Type 2 diabetes
People with Type 2 diabetes need to eat a healthy diet that contains the right balance of foods. If your doctor or diabetes nurse finds that this alone is not enough to keep your blood glucose levels normal, you may also need to take tablets.
There are several kinds of tablets for people with Type 2 diabetes. Some kinds help your pancreas to produce more insulin. Other kinds help your body to make better use of the insulin that your pancreas does produce. Another type of tablet slows down the speed at which the body absorbs glucose from the intestine.
---------------------------------------------------------------------------------
Reducing The Risk of The Serious Health problems
People with diabetes have a higher chance of developing certain serious health problems, including heart disease, stroke, high blood pressure, circulation problems, nerve damage, and damage to the kidneys and eyes. The risk is particularly high for people with diabetes who are also very overweight, who smoke or who are not physically active.
You will greatly reduce your risk of developing any of these complications by controlling your blood glucose and blood pressure levels, and by eating healthily and doing regular physical activity.
Regular medical check-ups
In the last 10 to 20 years, the care for people with diabetes has improved dramatically. One of the most important developments has been improved methods of screening which will help your doctor to pick up any health problems at an early stage so they can be treated more successfully.
This is why having regular medical check-ups, at least annually, is so important.
Diabetes in pregnancy (Gestational diabetes - GDM)
GDM is the diabetes that begins during pregnancy, usually after the 5 th or 6 th months.
Those with a family history of diabetes, a prior pregnancy with diabetes or those who are obese are at risk of GDM.
During pregnancy the placenta which provides nutrients for the growing baby also produces hormones to sustain the pregnancy. These hormones are “diabetogenic” i.e. they increase the tendency for higher blood sugars.
During pregnancy high blood sugar is treated firstly with a healthy diet plan. This often needs the help of a dietitian and nutrients have to be maintained for proper baby growth while avoiding rich and refined food. If blood sugars remain above target, insulin injections are started. This ranges from one bedtime injection to 4 injections a day. Blood sugars are kept much tighter during pregnancy. Fasting blood sugars are kept below 90 mg/dl, pre-meals below 100mg/dl and 2 hours post-meal below 140 mg/dl.
Complications to the mother & baby
High blood sugars in the mother can lead to the formation of a large-for-dates baby (Macrosomia). A large baby is difficult to deliver in the normal way and often this leads to higher incidence of caesarean section. A large baby delivered normally is at risk of becoming stuck and this may lead to nerve damages in the arms. The baby which is exposed to high blood sugars during the pregnancy tends to have higher levels of insulin and when born can become severely low in sugar (hypoglycemia). This if undetected can lead to irreversible brain damages. These babies are also susceptible to infections and breathing difficulties in the first few days. In the long run, these large babies tend to become over weight children and teenagers, and are prone to become diabetics themselves.
The diabetic pregnant lady is more likely to develop high blood pressures and fits during the pregnancy and delivery. They also develop more wound infections and a higher rate of caesarean sections. Persons with GDM also go on to develop Type 2 diabetes in the near future.
Already a Diabetic & Becoming pregnant
In the first 4 – 8 weeks of pregnancy most organs of the baby has started to develop. If blood sugars are not controlled during this first 4 – 8 weeks, the fetus develops severe damage to its organs and often undergoes spontaneous miscarriages.
Therefore it is essential that the blood sugar must be as close to normal as possible during this early stage. This stage is often passed even before the urine pregnancy test becomes positive. Hence a lady who is diabetic and wishes to become pregnant needs to plan the pregnancy adequately and use contraceptive methods until the blood sugars are very well controlled. Only then should she attempt to conceive. Those who are on oral tablets to control blood sugars will need to switch over to insulin prior to conceiving.
---------------------------------------------------------------------------------
Help yourself to stay fit & healthy
If you have diabetes, you will have to make some changes to your way of life. However, by sticking to your treatment, monitoring your condition and following a generally healthy lifestyle, you should be able to continue your normal, day-to-day life and take part in the activities you have always enjoyed.
Healthy eating
You may need to change your eating habits – a dietitian's advice.
If you smoke – quit now
Smoking is particularly dangerous for people with diabetes as it greatly increases the chance of developing a serious health problem. If you smoke, it is very important that you quit now.
Physical activity
It is a good idea to take up some form of regular physical activity, such as walking, swimming, dancing or cycling. Consult your doctor or diabetes nurse before taking up any regular exercise, particularly if you are overweight.
Following your treatment plan
It is very important that you follow the treatment that your doctor or diabetes nurse has advised. You will feel much better if you keep your blood glucose levels as near normal as possible. Blood glucose levels are measured in milligrams per decilitre of blood. This is shortened to mg/dl. You should aim for a level of 70 - 120 mg/dl before meals, rising to no higher than 160 mg/dl two hours after meals. Your doctor or diabetes nurse will advise you on what is best for you. They can also advise you on the many gadgets available that can help you to monitor your blood glucose levels.
---------------------------------------------------------------------------------