DIABETES
PROGNOSIS |
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What is
diabetes?
Diabetes is a condition of
absolute or relative lack of insulin, a hormone secreted by the beta
cells in the pancreas gland. Lack of insulin means that the body
cannot effectively utilise glucose as fuel. As a result, the sugar
and fat levels in the blood rise.
There are two types of diabetes. Type 1 is known as insulin-dependent
diabetes. Type 1 is the least common type of diabetes - only 10% of
people with diabetes have type 1. It is most common among children
and young people under the age of 25.
Type 2 diabetes, also known as non-insulin-dependent diabetes, or
adult onset diabetes, accounts for 90% of all diabetes. |
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What causes diabetes?
Type 1 diabetes develops
when the beta cells in the pancreas cease functioning. This type of
diabetes generally appears very quickly, usually over days or weeks.
The cause of type 1 diabetes is not known, but both genes and
viruses play a part (antibodies caused by a prior infection destroy
the beta cell). Type 1 diabetes must be treated with insulin
injections.
Type 2 diabetes is
caused by a defect in the pancreas and a resistance by the body to
the action of insulin. People with type 2 diabetes often have high
blood sugar levels and high insulin levels initially but, in many
cases, the pancreas fails completely with time. The most important
factors leading to type 2 diabetes are:
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A
family history of diabetes (substantially increases risk of type
2 diabetes); |
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Being
overweight; |
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Aged
over 40; |
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A
sedentary lifestyle; |
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Women
who have previously had a large baby or have had diabetes in
pregnancy (gestational diabetes) are at higher risk of
developing diabetes in middle age. |
People with type 2
diabetes are also at risk of developing high blood pressure, high
cholesterol and high triglycerides, which puts them at increased
risk of heart disease. Other possible complications include kidney,
eye and nervous system disorders. Part of the routine care of
diabetes involves regularly checking for symptoms of these
complications. |
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What are the symptoms of diabetes?
Typical symptoms of diabetes include:
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Increased thirst
and a dry mouth; |
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Passing large
amounts of urine (day and night); |
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Tiredness; |
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Weight loss; |
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Hunger; |
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Abdominal pain; |
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Genital itching; |
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Skin infections. |
Type 1 diabetes can
develop very quickly over a matter of weeks. Type 2 diabetes,
however, develops gradually (3-7 years) and is therefore hard to
detect. In some cases diabetes has been calculated to be present for
an average of seven years before diagnosis. In fact, many people are
diagnosed for the first time when they present with other problems
such as heart disease, damage to the back of the eye, or damage to
the nerves and blood vessels in the feet. Early diagnosis and expert
treatment is essential to prevent these complications so if you
suspect that you may have diabetes it is important to make an
appointment to see your GP as soon as possible. |
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How is diabetes treated?
Diabetes cannot be cured. However, with the correct treatment and
management, most people with diabetes can lead normal lives.
Depending on individual circumstances, diabetes may be treated with
insulin injections, diet and exercise, medication and regular blood
glucose monitoring.
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Insulin injections.
Type 1 diabetes must be treated with insulin injections.
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Medication.
Treatment for type 2 diabetes usually starts with weight
reduction and exercise. However, medication may also be
necessary. The two main types of medication are:
1. Tablets that stimulate insulin secretion (the sulphonylurea
type of drugs);
2. Tablets that improve insulin resistance (biguanides and the
thiazolidinediones).
Sometimes drugs that inhibit carbohydrate or fat absorption are
also used. Some people with type 2 diabetes will eventually need
insulin to control their blood sugar.
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Blood glucose
monitoring.
Both type 1 and type 2 diabetes need to be managed by regular
blood glucose monitoring. This can be done by a simple finger
prick blood test, which, following instruction from a GP or
staff in the hospital's Diabetic Day Centre, the person with
diabetes can carry out themselves using a simple spring loaded
device. Results are obtained within a few seconds.
The diabetes care team will advise on when blood sugar should be
tested and what adjustments should be made for optimum
management of diabetes if the blood sugars are too low (hypoglycaemia)
or too high (hyperglycaemia). Good blood sugar control will help
ensure a healthy and complication-free life.
The person with diabetes should remember that he or she is the
most important partner in the diabetes team. It is up to them to
agree targets for blood sugar, blood pressure and cholesterol
and it is their responsibility to meet these targets.
Fasting and pre-meal blood sugar levels should be between 4 and
9mmol/l. Levels below 3mmol/l will result in hypoglycaemia. The
warning signs of hypoglycaemia include sweating, trembling,
confusion and eventually loss of consciousness. Emergency
treatment is sugar and a person with type 1 diabetes should
carry sugar/ a sweet with them at all times.
Persistent high blood sugar - fasting and pre-meal levels that
are consistently higher than 7.0mmol/l - require alteration in
treatment and should be reported to your GP or diabetes care
team. The main symptoms of high sugar levels are tiredness,
thirst, dry mouth, passing lots of urine day and night, genital
itching and rash. However, sometimes none of these symptoms are
felt, which is why it is so important to monitor blood sugar
levels on a regular basis. Left unchecked, persistent high blood
sugar can cause damage to the arteries.
It is also important to have a HbA1c test done every 3 to 6
months to confirm home readings. This test gives the average
blood sugar level during the preceding eight to twelve weeks.
The HbA1c is very important in monitoring diabetic control and,
if high, indicates a need for increased treatment. |
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