Diabetes

What is Diabetes?

Diabetes is a disease characterised by an increase in blood glucose levels. Diabetes is a lifelong chronic metabolic disorder characterised by high blood sugar (or glucose) levels in the blood. This is called hyperglycaemia.

Glucose is usually regulated by the hormone insulin, produced in the pancreas within the abdomen.

It is vitally important for a person suspected of having diabetes to attend the practice urgently.

Anatomy of Diabetes

The pancreas is a leaf-shaped organ located just below the stomach and responsible for the regulation of glucose levels in blood. This is done by the secretion of insulin hormone by islets of Langerhans present in the pancreas.

After a meal, the blood glucose level rises, causing the beta cells to release insulin into the blood, which instigates body cells to absorb glucose to be used as fuel.

In diabetes, little or no insulin is produced by the pancreas or the body cells are resistant to the action of insulin, causing increased blood glucose levels (hyperglycaemia).

Symptoms of Diabetes

The main symptoms of diabetes are

• Increased thirst and drinking
• Hunger
• Weight loss
• Frequent urination
• Tiredness
• Fungal infections
• Blurry vision
• Dark pigmentation in certain parts of the body

As the loss of insulin production progresses, a patient may develop

• Stomach pain
• Vomiting
• Become very ill

Sustained, uncontrolled high blood sugar (hyperglycaemia) can damage the heart, blood vessels, eyes, kidneys and nerves.

What is the Impact of Diabetes?

Diabetes is a chronic condition that requires lifelong medication and lifestyle modifications. Regular monitoring of blood glucose levels will be required.

What are the Types of Diabetes?

Types of diabetes are:

• Type 1 diabetes: patients diagnosed as hyperglycaemic are said to have Type 1 Diabetes. Their bodies’ pancreas is producing little or no insulin to convert sugar into energy. It is also called insulin-dependent diabetes.
• Type 2 diabetes: the body becomes resistant to insulin. It is also called non-insulin dependent diabetes and is seen more commonly in adults. Type 2 diabetes is considered ‘lifestyle-related’.
• Monogenic diabetes: (MODY - Maturity Onset Diabetes of the Young) is a genetic form of diabetes affecting about 5% of people with diabetes. Caused by a single gene abnormality that cause diabetes. In some forms, can be managed with tablets.
• Secondary diabetes: this results from other conditions affecting the pancreas such as cystic fibrosis, hormonal disorders, adverse effects of drugs, insulin receptor abnormalities, and some of the genetic disorders.
• Gestational diabetes: type 2 diabetes that develops during pregnancy. This occurs in some women, resolving soon after childbirth, but increases the risk of them developing the condition later in life.

What Causes Diabetes

Type 1 Diabetes is caused by an autoimmune response of the body’s own immune system, where it wrongly considers insulin producing beta cells of the pancreas as harmful and attacks them, destroying many of the cells.

This leads to lowered production of insulin. However, as the immune system does not target the body’s ability to accept insulin, insulin injections can be administered to make up for the low levels.

Type 2 Diabetes typically affects older people Type 2 diabetes is being increasingly diagnosed in more Australians presenting with weight issues

• Lifestyle factors such as
• An unhealthy diet
• Sedentary lifestyle
• Obesity

Can contribute to the development of type 2 diabetes. Conversely it can be managed through diet, exercise and regular blood glucose monitoring.

Diagnosis of Diabetes

The only thing required to diagnose diabetes is

• Random blood glucose
• Blood ketones
• Blood Glucose Level GL 7-10: your doctor may want to contact QPE urgently to discuss the next steps in diagnosis.

Your doctor may order the following tests to diagnose diabetes:

• Urine test: This is done to check for the presence of glucose or ketones in urine. Presence of glucose in urine is highly suggestive of diabetes.
• HbA1c test: This is a blood test that measures the amount of glucose accumulated over 3 months.
• Oral glucose tolerance test: This is done to confirm type 2 diabetes. It measures how quickly glucose can be cleared from the blood. Following an overnight fast, your blood is tested for glucose. This is compared with periodic blood tests taken for the next two hours after drinking a sugar solution. Levels more than 1 mmol/L indicates diabetes, and levels 7.7700 to 11.0445 mmol/L indicates pre-diabetes.
• Fasting blood sugar test: Blood sugar level is tested after an overnight fast. Levels of 5.55 to 6.9375 mmol/L is inferred as pre-diabetes, while levels more than 6.9375 mmol/L, on two or more separate tests, on different days, indicates diabetes.
• Random blood sugar test: Blood is tested at a random time of the day for sugar levels. Blood glucose levels of 11.1 mmol/L or higher indicates diabetes.

Is Diabetes Curable?

Currently diabetes does not have a cure. Treatment will have to be continued throughout life to control the symptoms of the disease.

Timely treatment and lifestyle changes can help control the condition and its symptoms, and prevent serious complications associated with it.

What is the Treatment for Diabetes?

The treatment options for diabetes depends on the type:

• Type 1 diabetes: Insulin injections have to be taken as the body produces little or no insulin. You will have to maintain a strict diet and exercise plan to maintain a steady level of glucose in the blood.
• Type 2 diabetes: Healthy eating and increased physical activity promoting a healthy weight is important. You may be also prescribed medication to regulate the levels of insulin in your body. These may be taken orally or as injections.

If you suspect or know you have diabetes, please contact the practice for testing or management advice.