Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy. Failure to produce insulin, or of insulin to act properly, or both, leads to raised glucose (sugar) levels in the blood (hyperglycemia). This is associated with long-term damage to the body and failure of various organs and tissues.
TYPES OF DIABETES
There are three main types of diabetes:
Type 1 diabetes is sometimes called insulin-dependent, immune-mediated or juvenile-onset diabetes. It is caused by an auto-immune reaction where the body’s defence system attacks the insulin-producing cells. The reason why this occurs is not fully understood. People with type 1 diabetes produce very little or no insulin. The disease can affect people of any age, but usually occurs in children or young adults. People with this form of diabetes need injections of insulin every day in order to control the levels of glucose in their blood. If people with type 1 diabetes do not have access to insulin, they will die.
Type 2 diabetes accounts for at least 90% of all cases of diabetes.
Type 2 diabetes is sometimes called non-insulin dependent diabetes or adult-onset diabetes, and accounts for at least 90% of all cases of diabetes. It is characterised by insulin resistance and relative insulin deficiency, either of which may be present at the time that diabetes becomes clinically manifest. The diagnosis of type 2 diabetes usually occurs after the age of 40 but can occur earlier, especially in populations with high diabetes prevalence. Type 2 diabetes can remain undetected for many yearsand the diagnosis is often made from associated complications or incidentally through an abnormal blood or urine glucose test. It is often, but not always, associated with obesity, which itself can cause insulin resistance and lead to elevated blood glucose levels.
Gestational diabetes (GDM) is a form of diabetes consisting of high blood glucose levels during pregnancy. It develops in one in 25 pregnancies worldwide and is associated with complications in the period immediately before and after birth. GDM usually disappears after pregnancy but women with GDM and their offspring are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.
Other specific types of diabetes also exist.
COMPLICATIONS OF DIABETES
Type 1 and type 2 diabetes are chronic, life-long conditions that require careful monitoring and control. Without proper management they can lead to very high blood sugar levels which can result in long term damage to various organs and tissues.
Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary heart disease (leading to heart attack) and stroke. Cardiovascular disease is the major cause of death in people with diabetes, accounting in most populations for 50% or more of all diabetes fatalities, and much disability.
Kidney disease (diabetic nephropathy): can result in total kidney failure and the need for dialysis or kidney transplant. Diabetes is an increasingly important cause of renal failure, and indeed has now become the single most common cause of end stage renal disease, i.e. that which requires either dialysis or kidney transplantation, in the USA2, and in other countries.
Nerve disease (diabetic neuropathy): can ultimately lead to ulceration and amputation of the toes, feet and lower limbs. Loss of feeling is a particular risk because it can allow foot injuries to escape notice and treatment, leading to major infections and amputation.
Eye disease (diabetic retinopathy): characterised by damage to the retina of the eye which can lead to vision loss.
Women with gestational diabetes may have children who are large for their gestational age.
RISK FACTORS
The risk factors for type 1 diabetes are still being researched. However, having a family member with type 1 diabetes increases the risks for developing the condition, as do the presence of some genetic factors. Environmental factors, increased height and weight development, increased maternal age at delivery, and exposure to some viral infections have also been linked to the risk of developing type 1 diabetes.
Several risk factors have been associated with type 2 diabetes and include:
Obesity, Diet and physical inactivity, Increasing age, Insulin resistance, Family history of diabetes, Ethnicity.
Several risk factors have been associated with type 2 diabetes and include:
Obesity, Diet and physical inactivity, Increasing age, Insulin resistance, Family history of diabetes, Ethnicity.
Changes in diet and physical activity related to rapid development and urbanisation have led to sharp increases in the numbers of people developing diabetes.
Pregnant women who are overweight, have been diagnosed with Impaired Glucose Tolerance (IGT), or have a family history of diabetes are all at increased risk of developing Gestational diabetes (GDM). In addition, having been previously diagnosed with gestational diabetes or being of certain ethnicities puts women at increased risk of developing the condition.
Pregnant women who are overweight, have been diagnosed with Impaired Glucose Tolerance (IGT), or have a family history of diabetes are all at increased risk of developing Gestational diabetes (GDM). In addition, having been previously diagnosed with gestational diabetes or being of certain ethnicities puts women at increased risk of developing the condition.
WARNING SIGNS OF DIABETES
Individuals can experience different warning signs, and sometimes there may be no obvious warning, but some of the signs of diabetes are commonly experienced:
Frequent urination, Excessive thirst, Increased hunger, Weight loss, Tiredness, Lack of interest and concentration, Vomiting and stomach pain (often mistaken as the flu), A tingling sensation or numbness in the hands or feet, Blurred vision, Frequent infections, Slow-healing wounds.
Frequent urination, Excessive thirst, Increased hunger, Weight loss, Tiredness, Lack of interest and concentration, Vomiting and stomach pain (often mistaken as the flu), A tingling sensation or numbness in the hands or feet, Blurred vision, Frequent infections, Slow-healing wounds.
The onset of type 1 diabetes is usually sudden and dramatic while the symptoms can often be mild or absent in people with type 2 diabetes, making this type of diabetes gradual in onset and hard to detect.
MANAGEMENT OF DIABETES
Today, there is no cure for diabetes, but effective treatment exists. If you have access to the appropriate medication, quality of care and good medical advice, you should be able to lead an active and healthy life and reduce the risk of developing complications.
Good diabetes control means keeping your blood sugar levels as close to normal as possible. This can be achieved by a combination of the following:
Physical Activity: a goal of at least 30 minutes of moderate physical activity per day (e.g. brisk walking, swimming, cycling, dancing) on most days of the week.
Body weight: weight loss improves insulin resistance, blood glucose and high lipid levels in the short term, and reduces blood pressure. It is important to reach and maintain a healthy weight.
Healthy Eating: avoiding foods high in sugars and saturated fats, and limiting alcohol consumption.
Avoid tobacco: tobacco use is associated with more complications in people with diabetes.
Monitoring for complications: monitoring and early detection of complications is an essential part of good diabetes care. This includes regular foot and eye checks, controlling blood pressure and blood glucose, and assessing risks for cardiovascular and kidney disease.
