5.17 - Diabetes

What diabetes is, and Type 1 versus Type 2

• Diabetes is a condition that affects the body's ability to control its blood glucose level - it's what happens when the normal blood-glucose control mechanism fails.
• Without treatment, the blood glucose level can rise to a dangerously high point.
• There are two types - Type 1 and Type 2 - with different underlying causes.

Type 1 diabetes

• The pancreas produces very little or no insulin.
• Insulin is the hormone that lowers a high blood glucose level, so a person who can't make it has no way of bringing their blood glucose down.
• After a meal containing carbohydrate, the level can rise to a point that is dangerous and can kill them.
• It usually begins early in life, often in childhood, and is not caused by lifestyle.

Type 2 diabetes

• The pancreas may still produce insulin, but the body's cells become resistant to it - they no longer respond properly to the hormone.
• In some cases the pancreas also stops producing enough insulin.
• Either way the insulin can no longer do its job, so the blood glucose level rises to a dangerous level.
• It usually develops in adulthood and is a progressive condition linked to lifestyle.
• Being overweight increases the risk - obesity is a major risk factor.

Signs and complications

• Signs that someone has diabetes:
  • High blood glucose concentration
  • Glucose appearing in the urine
  • Tiredness (lethargy)
  • Thirst
• If left poorly controlled over a long time, it can lead to serious complications:
  • Damage to the eyes (and even blindness)
  • Heart disease and strokes
  • Kidney damage

Treating and controlling diabetes

• Diabetes cannot be cured, but it can be managed.
• The two types are managed in different ways because they have different causes.

Treating Type 1 diabetes

• Treated with insulin therapy - the body makes little or no insulin of its own, so insulin has to be put into the blood from outside by injection.
• Usually means several injections through the day, most often at mealtimes. This removes the extra glucose absorbed from a meal quickly once the food is digested, stopping blood glucose from rising too high.
• A careful diet and regular exercise also help to control it, and the amount of insulin needed depends on the person's diet and how active they are.
• Injecting too much insulin can send the blood glucose dangerously low.

Controlling Type 2 diabetes

• Often controlled without insulin, at least at first, because the body still makes some insulin.
• Managed by:
  • Eating a healthy, carbohydrate-controlled diet
  • Getting regular exercise
  • Losing weight if needed
  • Reducing sugar intake and avoiding obesity
• As the condition progresses, some people also need:
  • Medication - Including drugs that improve how the body's cells respond to insulin
  • Later, insulin injections

The rising cost of diabetes

• The number of people with diabetes is rising rapidly, and the cost of treating it is becoming very high.
• Most of the increase is in Type 2 diabetes, and it is linked to lifestyle - in particular poor diet and a lack of exercise.