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Diabetes, already a huge health problem, is increasingly rapidly. More than 1.4 million people in the UK are known to have diabetes and even more people in the UK have diabetes but don't even know it!

 

Diabetes Mellitus

By Dr Ian Campbell


Diabetes, already a huge health problem, is increasingly rapidly. More than 1.4 million people in the UK are known to have diabetes and even more people in the UK have diabetes but don't even know it!

In Diabetes the amount of glucose (sugar) in the blood is abnormally high because the body's method of converting glucose into energy is not functioning correctly. A hormone called insulin, made by the pancreas gland, controls the amount of glucose in our blood. Insulin helps glucose enter body cells where it is used as fuel for all the body’s metabolic processes.
After we eat, blood glucose levels rise and insulin is released into the blood, allowing glucose to enter the cells where it is needed. When the blood glucose level falls (e.g. during exercise), the level of insulin falls. Glucose levels in the blood that are too high or too low can cause health complications. Insulin, therefore, plays a vital role in regulating the level of blood glucose and, in particular, stopping blood glucose from rising too high.

There are two main types of diabetes:
Type 1 diabetes (insulin dependant diabetes) develops when there is a lack of insulin in the body because most or all of the cells in the pancreas that produce it have been destroyed. The most likely cause of this is an abnormal reaction of the body to the cells that may be triggered by a viral or other infection. This type of diabetes usually appears in people of both sexes under the age of 40, often in childhood. Type 1 diabetes develops quickly, usually over a few weeks, and the unwitting patient presents acutely unwell, with a short history increased thirst (polydypsia), excessive urine production (polyuria) and sudden weight loss. 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. Usually, between two and four injections of insulin are required each day to stop symptoms, enable a healthy life, and avoid complications.

Type 2 diabetes (non insulin dependant diabetes) develops when the body can still produce some insulin, though not enough for its needs, or when the body no longer responds normally to its own insulin. The most common cause of this is overweight and obesity. Type 2 diabetes usually appears in people over the age of 40, although it is increasingly appearing in younger, obese, people. The best form of treatment of type 2 diabetes is to achieve 5-10% of body weight loss. Many can thereafter be successfully treated by diet alone. But for the others a combination of diet and medication, or a combination of diet and insulin injections may be required. Type 2 diabetes develops slowly and the symptoms are usually less severe than in type 1; in fact the most common symptom is simply “tiredness” and the diagnosis can go unnoticed for months or even years. Some people may not notice any symptoms at all and others put the symptoms down to 'getting older' or 'overwork', their diabetes only being discovered at a routine medical check up.

People who are overweight are particularly likely to develop type 2 diabetes and 90% of new type 2 diabetics are overweight. Just as importantly though, reducing body weight by only 10% can reduce the chance of developing diabetes by up to 44%. It tends to run in families and is more common in Asian and African-Caribbean communities.

In attempting to lose weight, people with type 2 diabetes need to eat a healthy diet that contains the right balance of foods, in the right portions. If this is not enough to keep blood glucose levels normal, medication may also be required of which there are several types. The first drug your doctor may choose should be “metformin” which can reduce blood sugar without the problem of weight gain encountered with other diabetic drugs. However some patients have difficulty with this medication. Alternatives include some which help the pancreas to produce more insulin (eg. sulphonylureas) while others help the body to make better use of the insulin that the pancreas does produce (eg. glitazones). Another type of tablet slows down the speed at which the body absorbs glucose from the intestine (ascarbose).

The main symptoms of diabetes are:

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.



 
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