Diabetes - or to give it its full name, diabetes mellitus - is a common condition which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly. This is because the body's method of converting glucose into energy is not working as it should.
Normally, a hormone called insulin carefully controls the amount of glucose in our blood. Insulin is made by a gland called the Pancreas, which lies just behind the stomach. It helps the glucose to enter the cells where it is used as fuel by the body.
We obtain glucose from the food that we eat, either from sweet foods or from the digestion of starchy foods such as bread or potatoes. The liver can also make glucose.
After a meal, the blood glucose level rises and insulin is released into the blood. When the blood glucose level falls - for example, during physical activity - the level of insulin falls. Insulin, therefore, plays a vital role in regulating the level of blood glucose and, in particular, in stopping the blood glucose from rising too high.
Type 1 diabetes develops when there is a severe lack of insulin in the body because most or all of the cells in the Pancreas that produce it have been destroyed. This type of diabetes usually appears in people under the age of 40, often in childhood. It is treated by insulin injections and diet.
Type 2 diabetes develops when the body can still produce some insulin, though not enough for its needs, or when the insulin that the body produces does not work properly. This type of diabetes usually appears in people over the age of 40. It is treated by diet alone, or a combination of diet and tablets, or a combination of diet and insulin injections.
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.
In both types of diabetes, the symptoms are quickly relieved once the diabetes is treated. Early treatment will also reduce the chances of developing the serious health problems described later.
Diabetes is a common health condition. About 1.4 million people in the UK are known to have diabetes - that's about 3 in every 100 people. And for every person who knows that they have the condition, there is probably another person with diabetes who does not yet know. Over three quarters of people with diabetes have Type 2 diabetes.
Although the condition can occur at any age, it is rare in infants and becomes more common as people get older.
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 used to be called 'maturity onset' diabetes because it usually appears in middle-aged or elderly people, although it does occasionally appear in younger people. The main causes are that the body no longer responds normally to its own insulin, and/or that the body does not produce enough insulin.
People who are overweight are particularly likely to develop Type 2 diabetes. It tends to run in families and is more common in Asian and African-Caribbean communities.
Some people wrongly describe Type 2 diabetes as 'mild' diabetes. There is no such thing as mild diabetes. All diabetes should be taken seriously and treated properly.
There are some other causes of diabetes, including certain diseases of the Pancreas, but they are all very rare. Sometimes an accident or an illness may reveal diabetes if it is already there, but they do not cause it.
... and some things that do not cause diabetes:
Although diabetes cannot be cured, it can be treated very successfully.
Knowing why people with diabetes develop high blood glucose levels will help you to understand how some of the treatments work.
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 lose weight. The unused glucose passes into the urine, which is why people with untreated diabetes pass large amounts of urine and are extremely thirsty.
Type1 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.
People with Type 1 diabetes need injections of insulin for the rest of their lives and also need to eat a health 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.
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.
Your doctor will decide which kinds of tablet are going to work best for you and may prescribe more than one kind. Your doctor or diabetes nurse will tell you all about the tablets, when to take them and how to monitor your blood or urine glucose levels.
The diet for people with diabetes is not a special diet. It is a normal, healthy diet recommended for everybody - low in fat, sugar and salt with plenty of starchy foods, fruit and vegetables.
What you eat directly affects your blood glucose levels. It can also influence the amount of fat (such as cholesterol) in your blood. So it is important to eat the right kind of foods to stay healthy.
When you are first diagnosed with diabetes, your doctor should arrange for you to see a state registered dietitian who will give you individual advice on the best types of food to eat and how to adapt your usual meals to make them healthier.
Remember that healthy eating can be easy to prepare, varied and delicious - and there is no food that you will have to cut out completely.
Here are some helpful healthy eating tips to help you to control your diabetes:
1. Try to get to the weight that is right for you and stay there. If you need to lose weight, aim for a gradual weight loss that can be maintained rather than rapid weight loss.
2. Eat regular meals. Try to eat similar amounts of starchy foods (such as bread, potatoes and cereals) each day as this will help to control your blood glucose levels.
3. Try to cut down on fried and fatty foods such as butter, margarine, cheese and fatty meat. Instead, choose reduced fat spreads and cheeses and lean meat. Try skimmed or semi-skimmed milk.
4. Eat more fruit, vegetables and pulses such as beans, peas and lentils.
5. Cut down on sugar. Use reduced sugar foods and drinks instead of sweet foods such as chocolate, iced cakes and sugary drinks.
6. Be careful not to use too much salt.
7. Drink alcohol in moderation only and never drink on an empty stomach.
8. Don't be tempted by special diabetic food and drink products. They are expensive and unnecessary.
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 general healthy lifestyle, you should be able to continue your normal, day-to-day life and take part in the activities you have always enjoyed.
You may need to change your heating habits.
Smoking is particularly dangerous for people with diabetes as it greatly increases the chance of developing a serious health problem. If you smokes, it is very important that you quit now.
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.
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 millimoles per litre of blood. This is shortened to 'mmol/l'. You should aim for a level of 4 - 7 mmol/l before meals, rising to no higher than 10 mmol/l 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.
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.
In the last 10-20 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.
Mail:
10 Queen Anne Street
London
W1M 0BD
Telephone: 020 7323 1531
Fax: 020 7537 3644
Email: mailto:info@diabetes.org.uk
Website: http://www.diabetes.org.uk
Diabetes UK, Northern & Yorkshire Regional Office:
Birch House
80 Eastmount
Road
Darlington
DL1 1LE.
Telephone: 01325 488606
Email: mailto:north&yorks@diabetes.org.uk
For guidance on the use of rosiglitazone for
Type 2 diabetes go to:
http://www.nice.org.uk/nice-web/Docref.asp?d=8077&ss=rosiglitazone
This information is courtesy of Diabetes UK (the charity for people with diabetes) who kindly agreed to its publication on this website.