Diabetes

Many people think that diabetes is caused by eating too much sugar, but of course it’s not as simple as that. Diabetes refers to a group of metabolic diseases where a person has high blood sugar – or glucose. This happens when the pancreas doesn’t produce enough insulin, or when the cells of the body no longer respond as they should to the insulin produced.

Insulin is a hormone produced by the body and responsible for regulating blood sugar levels. In diabetes the body is not able to regulate these levels and so glucose builds up in the bloodstream.

As insulin is a protein it would be broken down during digestion if taken in pill form, therefore diabetic patients take it as a subcutaneous injection.

There are three main types of diabetes: 

• Type 1
• Type 2 
• Gestational

Although Type 1 diabetes can affect both adults and children, it is most common in Children which is why it is often referred to as “juvenile diabetes”. This form of diabetes can start suddenly if the pancreas is no longer able to produce insulin, either for genetic reasons or because of infection.

In Type 2 diabetes your body no longer produces enough insulin or doesn’t use it properly, or a combination of both. This form of the disease is more common and usually affects adults over the age of 40. It is caused by lifestyle factors such as obesity, lack of physical activity, poor diet and stress.

The third main type is gestational diabetes and affects 2-5% of pregnant women. It can be treated but requires careful medical supervision during the pregnancy to safeguard the health of both mother and baby. After giving birth the diabetes may improve or disappear completely.

As you can see insulin plays a key role in diabetes. It is needed to convert sugar, starch and other food into the energy our cells need to work. When this no longer happens the cells don’t get the energy they need and sugar accumulates in the blood, which is damaging to our health. Although this damage is not immediate, there is the risk of long-term complications that tend to develop after around 10-20 years.

The long term damage caused by having high blood sugar for long periods of time can affect the eyes (causing visual impairment and blindness), the nerves (numbness in feet, legs and arms), the heart (atherosclerosis and related diseases), and the kidneys.

In the kidneys, high blood sugar levels can cause tissue scarring and the kidneys may eventually stop working. Diabetes is actually the most common cause of kidney failure and around one in five people on dialysis have diabetic kidney disease, (also called diabetic nephropathy).

The symptoms of Type 2 diabetes are not always clear and as they appear gradually at first, a patient may not even be aware he has the disease. Other patients however do experience symptoms which may indicate they have diabetes. The most common signs are passing large amounts of urine, feeling thirsty, increased hunger, weight loss and tiredness. Other signs can be irritability, tingling hands or feet, blurred vision, frequent infections, slow-healing wounds, vomiting or stomach pain.

In Type 1 diabetes the symptoms develop rapidly over a period of weeks or months, whereas in Type 2 diabetes symptoms develop more slowly, or may not appear at all.

Diabetes is a chronic disease and there is no known cure to date, however it can be treated. Treatment consists in managing blood sugar levels to keep them as close to normal as possible without letting them get too low, causing hypoglycaemia. This can be done by means of medication, appropriate diet and exercise.

If you have diabetes your doctor will most probably advise you:

• to stop smoking
• to keep your cholesterol levels and blood pressure under control
• to lose weight if you are overweight or obese
• to do some regular physical exercise

If you have Type 1 diabetes your doctor may prescribe you insulin, whereas for Type 2 diabetes you may need oral medications and possibly also insulin.