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What you should know about diabetes

Diabetes is a condition where the blood sugar level is higher than normal. There are two main types of diabetes. Type 1 diabetes or insulin-dependent diabetes. It is usually seen in young people.

Type 2 diabetes – usually non insulin-dependent diabetes. It tends to affect adults over 40 and overweight people.

Pregnancy diabetes. This is known as gestational diabetes. It’s associated with pregnancy and symptoms usually disappear after the birth. If you get gestational diabetes, you have an increased risk of developing one of the main types of diabetes later in life.

Secondary diabetes. This is when diabetes is caused as the result of another condition, eg inflammation of the pancreas, or by the use of certain medication such as diuretics or steroids.

How common is diabetes? It’s estimated that more than half a million people have the condition but are unaware of it.
What causes diabetes? Glucose is sugar. Blood sugar level is the same as blood glucose level.

Insulin is a hormone produced by the pancreas gland in the abdomen. It controls the use of glucose within the body.

The blood sugar level will rise if the pancreas produces little or no insulin (Type 1 diabetes); the pancreas produces insulin, but it’s inadequate for the body’s needs and its effectiveness is reduced (Type 2 diabetes).

t’s thought Type 2 diabetes is related to factors associated with a Western lifestyle, since it’s most common in people who are overweight and who don’t get enough exercise.

Gestational diabetes is brought about by the many hormone changes and demands placed upon the body during pregnancy.

Secondary diabetes is much like Type 2 diabetes. It’s quite variable, depending on the underlying cause. It can be caused by damage to the pancreas (eg by alcohol), and drugs such as steroids and diuretics can impair insulin secretion from the pancreas.

Common symptoms
Glucose is one of the body’s main fuels. If there isn’t enough, blood sugar levels rise and glucose is secreted into urine.

This causes: increased thirst, frequent urination, tiredness, weight loss, although appetite often increases (especially in Type 1 diabetes), itchiness, especially around the genitals, recurrent infections on the skin, eg boils.

People with Type 1 diabetes usually develop these symptoms within days or weeks. In Type 2 diabetes, these symptoms often don’t show for years. Many are diagnosed by chance through routine medical check-ups.

How is a diagnosis made?
People with Type 2 diabetes often have:
a family history of diabetes, obesity, increased blood pressure, premature vascular problems such as heart attacks and stroke, raised level of triglyceride (a type of fat) in the blood, impotence (erectile dysfunction).

Glucose levels are measured in blood samples.
This is done using the random glucose test: glucose levels are taken at a random time on two occasions. Any figure above 11.1mmol/l is a diagnosis of diabetes, or fasting glucose test: the glucose level is measured after an overnight fast and on two different days. Above 7.0mmol/l is a diagnosis of diabetes.

Glucose tolerance test
Glucose drink is given containing a standard amount of glucose (75g). Blood samples are taken before the drink is given and two hours later. The test is done after an overnight fast.

* A two-hour blood glucose level above 11.1mmol/l is a diagnosis of diabetes.
* A level below 7.8mmol/l is normal.
How is diabetes treated?

Treatment depends on the individual.
It starts the first time you give yourself an insulin injection or take a diabetes tablet, and continues through eating a well-balanced diet and starting an exercise programme.

Blood sugar levels
Monitoring blood sugar levels is an important aspect of treatment, especially in Type 1 diabetes where levels can change markedly.


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