Diabetes: Care and Cure

The good news about diabetes is that treatments are very effective and the more you know about your condition, the more you can do to help yourself stay healthy; lead the sort of life you want to live, and to avoid the health problems associated with diabetes in later life.

Understanding diabetes

Diabetes mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot use it properly. Glucose comes from the digestion of starchy foods such as bread, rice, potatoes, chapatis, yams and plantain, from sugar and other sweet foods, and from the liver which makes glucose.

Insulin is vital for life. It is a hormone produced by the pancreas, that helps the glucose to enter the cells where it is used as fuel by the body. The main symptoms of untreated diabetes are increased thirst, going to the loo all the time – especially at night, extreme tiredness, weight loss, genital itching or regular episodes of thrush, and blurred vision.

There are two main types of diabetes. These are:

Type 1 diabetes, also known as insulin dependent diabetes.
Type 2 diabetes, also known as non insulin dependent diabetes.

Type 1 diabetes develops if the body is unable to produce any insulin. This type of diabetes usually appears before the age of 40. It is treated by insulin injections and diet and regular exercise is recommended.

Type 2 diabetes 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). This type of diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people often appears after the age of 25. It is treated by diet and exercise alone or by diet, exercise and tablets or by diet, exercise and insulin injections.
The main aim of treatment of both types of diabetes is to achieve blood glucose and blood pressure levels as near to normal as possible. This, together with a healthy lifestyle, will help to improve wellbeing and protect against long-term damage to the eyes, kidneys, nerves, heart and major arteries.


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 detected 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 it? What causes it?

Diabetes is a common health condition. About 4.8 million people in the world are known to have diabetes — that’s about 8 in every 100 people. And there are an estimated 2.5 million people in the world who have diabetes but don’t know it. 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.

The people most at risk are:
* people with a family history of diabetes;
* people aged between 40 to 75;
* people of Asian or Caribbean origin;
* people who are very over weight; and
* women who have given birth to a large baby (note: Author was born a large baby; he assumes this caused his mother diabetes)

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.

Somethings that don’t cause diabetes are:
* eating sweets or wrong kind of food does not cause diabetes;
* stress does not cause diabetes although it may make the symptoms worse in people who already have the condition.; and
* it is not contagious.

Other causes of diabetes
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.

Treatments

Although diabetes cannot be cured, it can be treated very successfully. Knowing why people with diabetes develop high blood glucose levels will help to 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 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.
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 medicine 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, as required.
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 medicine 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 kind of medicine is 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.

Reduce the risks
People with diabetes have a higher chance of developing certain serious health problems, including heart disease, stroke, high blood pressure, blood 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 helps your doctor to detect 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.

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.

You may need to change your eating habits.

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.

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 millimols 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.