According to Diabetes UK there are around 4.6 million people in the UK living with diabetes, and these figures are set to rise. There are many more people who are at risk of developing diabetes or are pre-diabetic. It is a serious lifelong condition which is caused by too much glucose in the blood and not enough insulin which can lead to complicated health conditions if left untreated. Diabetes puts you at risk of heart attacks and strokes, kidney problems, nerve damage and more.
There are two types of diabetes, type 1 and type 2, and there are different causes of each type and different ways of treating them. For instance, type 1 diabetes can be hereditary and is treated with daily insulin injections, whereas type 2 develops as a result of an unhealthy and inactive lifestyle. Type 2 can be treated with lifestyle improvements and medication to regulate glucose levels.
“Diabetes is a lifelong condition that must be managed with treatment, a healthy lifestyle, and monitored by a GP regularly. Many people may not know they have diabetes until the serious complications occur, this is particularly common in type 2 diabetes. There are a number of ways you can manage your diabetes and control your glucose levels. Diabetes doesn’t have to hinder your life, once under control you can live normally. All treatments must be taken alongside healthy eating and being active.”
What is diabetes?
Diabetes is a serious, long term health condition that affects the blood sugar levels in the body. In diabetics the blood sugar levels become too high due to lack of insulin production and too much glucose. We need some glucose (sugar) in our blood to give us energy which we get from carbohydrates, but too much glucose can cause diabetes. The hormone, insulin, which is located in the pancreas regulates the level of glucose in the body. The pancreas senses when glucose is in the bloodstream and releases insulin to move the glucose from the blood and into the cells for energy production. However this system does not work in people with diabetes. The reason why this happens depends on the type of diabetes and there are two types which include, type 1 and type 2.
Type 2 is the most common type of diabetes, with over 90% of adult diabetics having type 2. There are many differences between type 1 and type 2 in terms of cause, treatment and prognosis. However, the common symptoms of diabetes are similar in both. These include:
- Needing to pee a lot or more than usual
- Feeling really thirsty all of the time
- Feeling extra tired
- Losing weight without trying to
- Recurring thrush or itching of the genitals
- Cuts and wounds that take longer to heal
- Blurred vision
What is type 1 diabetes?
In type 1 diabetics the levels of glucose in the blood become too high because the body isn’t producing enough insulin. This is due to the immune system attacking and destroying the cells which produce this hormone. As there is no insulin being produced, the glucose can’t make its way to the cells to fuel and energise the body and instead builds up in the bloodstream. The body’s way of ridding the excess glucose is through the kidneys, hence why you will pee a lot. Type 1 diabetes makes up for around 10% of all diabetics which is a small statistic in comparison to the 90% of type 2 diabetes sufferers. There is no reason why type 1 diabetes occurs, it can affect anyone but it can be genetic, if one or both of your parents have it your chances of developing type 1 diabetes is higher.
How is type 1 diabetes treated?
The first step in treating type 1 diabetes is getting to know your blood sugar levels which you can do so with a finger prick test, a flash glucose monitor which tracks your glucose levels throughout the day, or with a continuous glucose monitor. Monitoring your glucose levels throughout the day will help you to manage your medication and the foods that you’re eating so that you’re always at a healthy range to avoid complications of diabetes. A normal range for an adult is between 5 to 7 mmol/l.
In order to keep the glucose levels under control in type 1 diabetics, daily insulin injections are required using an insulin pump. The pump is attached to the skin and injects small amounts of insulin into the body throughout the day and night. This helps to keep your glucose levels more stable. The insulin is delivered through a pump which is replaced every 2-3 days.
Type 1 diabetics will need to take insulin for the rest of their lives and constantly monitor their glucose levels. You may need to take insulin continuously throughout the day which is known as background (or basal) insulin, or you may need to take it at meal times as glucose levels can rise with food, this is known as bolus insulin. Fast-acting insulin, short-acting insulin and mixed insulin are types of bolus insulin which are taken around meal times.
As well as insulin you should also manage the amount of carbohydrates you take in, and live a healthy lifestyle. You may also need to take medication to reduce the risk of developing long term health conditions such as heart disease, stroke and kidney disease. You may need to take statins to reduce high cholesterol, anti-hypertensive medicines to control high blood pressure, and aspirin to prevent stroke.
What is type 2 diabetes?
You can be born with type 1 diabetes, whereas you can develop type 2 diabetes at a later stage in life. This is because type 2 diabetes is caused by lifestyle such as being overweight. In type 2 diabetes not enough insulin is being produced, or the body’s cells do not react to insulin. This again causes similar symptoms to type 1 as the level of glucose in the blood becomes too high. This type of diabetes is very common and is linked to being overweight and inactive, and although it is a lifelong condition, type 2 can be reversed with a change of lifestyle and improvement in health.
How is type 2 diabetes treated?
Type 2 diabetes can be managed by losing weight with healthy eating and being active. Medication will be needed when the glucose levels become too high. Type 2 diabetes is commonly treated with medication and insulin will only be needed if the medication is not effective. Medication helps to regulate your blood sugar levels and should be used alongside a healthy diet and exercise. There are lots of types of medication used to treat type 2 diabetes and you may need to try different medications long term.
Metformin is a common medication prescribed for type 2 diabetes usually caused by being overweight. If you’re struggling to lose weight and are therefore at risk of diabetes complications, metformin is usually the first medication that is prescribed. It helps to control high blood sugar levels by controlling the amount of glucose produced by the liver, and helps the body to respond better to insulin. It is a popular treatment for type 2 diabetes as it does not cause weight gain, which can lead to high cholesterol and heart disease.
Other medications are combined with metformin and are prescribed when metformin alone is not effective. These combination medications are known as biguanides which include, Competact (pioglitazone and metformin), Eucreas (vildagliptin and metformin), and Janumet (sitagliptin and metformin). Other biguanide medications include Glucophage and Onglyza (saxagliptin). All diabetes medications aim to lower blood sugar levels.
Complications of diabetes
If diabetes is not monitored for the rest of your life and the condition is not managed you can develop serious life-threatening complications. These complications are categorised as chronic and acute. Chronic complications of diabetes are long term and will often develop gradually, these include:
- Eye problems
- Foot problems
- Heart attack/stroke
- Nerve damage
- Gum disease
- Kidney problems
- Sexual problems
Acute complications are just as serious and may require emergency medical attention as they develop suddenly. Acute complications include:
- Hypos - blood sugar becomes too low
- Hypers - blood sugar becomes too high
- Hyperosmolar Hyperglycaemic State (HHS) - very high glucose levels
- Diabetic ketoacidosis (DKA) - when the body runs dangerously low on insulin there is a build up of the poisonous substance known as ketones.
Having high glucose levels for a long period of time, which usually happens when diabetes isn’t monitored or managed, can cause serious damage to the blood vessels and nerves. With type 2 diabetes you may not know you have this condition as it develops gradually and your blood sugar levels will go unchecked until diagnosis. This means that you may develop complications before you have been diagnosed, and these complications may be the reason you seek medical attention and get diagnosed with diabetes.
This damage to the blood vessels and nerves can cause serious health conditions. One of the symptoms of diabetes is blurred vision, and this is because high glucose levels, as well as high blood pressure and cholesterol can lead to eye conditions such as glaucoma, cataracts, diabetic retinopathy and diabetic macular edema. These conditions will cause problems with your vision and may even lead to blindness. If you’re diabetic you should have a yearly, full, dilated examination of your eyes to monitor your eye health.
Diabetics can also develop problems with their feet, particularly when the nerves are damaged. When the nerves are damaged in the feet you may not be able to feel certain sensations such as extreme temperatures or pain. If you injure yourself you may not be able to feel wounds which could lead to infection if left untreated. This is known as diabetic neuropathy. When there is damage to the nerves the muscles may not be able to work properly and this can affect mobility, particularly if the nerve damage is in the feet.
Diabetes can also inhibit good blood flow and the buildup of sugar in the blood can cause blockages in the arteries which leads to heart attacks and strokes. High blood pressure and high cholesterol can also cause heart attacks and strokes which is why it’s important to keep your diabetes under control. According to Diabetes UK, 530 heart attacks and 680 strokes are caused by diabetes each week in the UK, which highlights the importance of getting diabetes diagnosed and treated sooner rather than later.
At Doctor-4-U you can consult with one of our online doctors to find out the best treatment method to manage your diabetes.