Diabetes is a problem with the body’s fuel system caused by lack of insulin, which is essential for getting energy from food. Key symptoms include extreme tiredness, increased thirst and frequent trips to the toilet. This can lead to a higher than average risk of heart disease, problems with eyes, kidneys, nerves, teeth or skin.
Diabetes is estimated to affect over 2 million people in the UK and there are two main types:
Type I diabetes is caused by the body’s failure to produce insulin (a hormone released by the pancreas which helps control the levels of sugar in the blood).
Type II diabetes is caused when the body doesn’t produce enough insulin or is not using it effectively.
Diabetes can also occur during pregnancy, when it is known as gestational diabetes, and the body is not able to produce enough insulin to meet the extra demands of pregnancy.
Type 1 Diabetes
Normally, the amount of sugar in the blood is controlled by insulin, a hormone which is produced by the pancreas. When food is eaten, the digestive system breaks down food and passes its nutrients into your bloodstream. Insulin moves any glucose (sugar) out of the blood and into cells, where it is broken down to produce energy. However, in those with type 1 diabetes, the body is unable to break down glucose into energy, because there is not enough insulin to move the glucose.
Type 1 diabetes occurs when the body produces no insulin. It is often referred to as insulin-dependent diabetes, and affects only 5-15% of all people with diabetes. Type 1 diabetics will need to take insulin injections for life, as well as ensuring that their blood glucose levels stay balanced by eating a healthy diet and carrying out regular blood tests.
The exact cause of type 1 diabetes is not fully understood, although in most cases it is believed to be an auto-immune condition, where the body's immune system mistakes a natural substance in the body as harmful, and attacks it. It is thought that the immune system attacks cells in the pancreas, destroying or damaging them enough to stop insulin production. It is not known exactly what triggers the immune system to do this, but it may be due to infection with a particular virus.
Type 1 diabetes tends to run in families, so there may also be a genetic cause for the auto-immune reaction. If you have a close relative, such as a parent or sibling with type 1 diabetes, you have roughly a 6% chance of developing the condition yourself. The risk for people who do not have a close relative with type 1 diabetes is approximately 0.4%.
In rare cases, type 1 diabetes may be caused by a condition of the pancreas called Pancreatitis. Pancreatitis causes the pancreas to become inflamed, resulting in severe damage to the cells that produce insulin.
Type 2 Diabetes
Type 2 diabetes occurs when not enough insulin is produced by the body for it to function properly, or when the body’s cells do not react to insulin. This is called insulin resistance. Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body does not produce any insulin at all. Around 95% of all people with diabetes have type 2 diabetes.
Type 2 diabetes may be controlled simply by eating a healthy diet, and monitoring the blood glucose level. However, type 2 diabetes is a progressive condition, and so you may eventually need to take insulin medication, usually in the form of injections.
The exact cause of type 2 diabetes is not fully understood, although there are many factors that make developing the condition more likely:
Being overweight or obese - in most cases, type 2 diabetes is thought to be linked to having excess body fat. If you are overweight or obese, the cells in your body become less responsive to the effects of insulin. It is estimated that 80% of people who develop type 2 diabetes are overweight or obese.
Ethnic origin - it is not known why people of certain ethnicities are more at risk of developing type 2 diabetes than others, but you are at least five times more likely to develop type 2 diabetes if you are African-Caribbean or of South Asian origin and living in the UK, compared with someone who is white.
Age - the risk of developing type 2 diabetes also increases as with age, which may be due to the fact that people usually gain weight and exercise less as they get older.
Genetic factors - there is also a genetic risk factor for type 2 diabetes. You are more likely to develop the condition if you have a close relative such as a parent or sibling who has type 2 diabetes.
Self Help for Diabetics
If you are diabetic, you will need to look after your health very carefully. There are many ways to help control your condition and these include:
- Eat healthily - eat a diet which is high in fibre, fruit and vegetables and low in fat, salt and sugar. However, different foods will affect you in different ways, so it is important to know what to eat so you get the right amount of glucose for the insulin that you are taking.
- Exercise regularly - physical activity lowers your blood glucose level, so it is particularly important to exercise regularly if you have diabetes. You should aim to do at least 30 minutes of moderate exercise, at least five times a week. This can be any activity that gets you slightly out of breath and raises your heart rate. However, you should not start a new activity without consulting your GP or diabetes care team first. As exercise will affect your blood glucose level, you and your care team may have to adjust your insulin treatment, or diet plan, in order to keep your glucose level steady.
- Do not smoke - if you are diabetic, you have an increased risk of developing a cardiovascular disease, such as a heart attack or stroke. If you also smoke, you are increasing this risk even further, as well as increasing your risk of many other serious smoking-related conditions, including lung cancer.
- Drink alcohol in moderation - you should only drink alcohol in moderation, and you should never drink alcohol on an empty stomach. Depending on the amount that you drink, alcohol can cause either high, or low, blood glucose levels (hyperglycaemia or hypoglycaemia). Drinking alcohol may also affect your ability to carry out insulin treatment, or blood glucose monitoring, so always be careful not to drink too much.
- Let others know about your condition - you should wear an identity bracelet in order to let others know that you are diabetic. This will ensure that if you blackout or collapse, emergency healthcare professionals will quickly know that you have diabetes. You should also carry a glucagon kit with you in case of hypoglycaemia (low blood glucose). Your diabetes care team should train you, plus several of your family members, and close friends, in how to use it.
- Look after your feet - Being diabetic means that you are more likely to develop problems with your feet, including foot ulcers and infections from minor cuts and grazes. This is due to the possibility of high blood glucose damaging the nerves in your feet.
- Have regular eye tests - you should have your eyes tested at least once a year to check for retinopathy. Retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness. Regular eye tests should help to ensure that any signs of retinopathy are picked up as soon as they appear.