What is Diabetes?

Diabetes mellitus, commonly referred to as diabetes, is a medical condition associated with abnormally high levels of glucose (or sugar) in the blood (hyperglycaemia).

Glucose is a type of sugar found in certain foods such as honey and some, but not all, fruits. It is also the form of sugar that all sugary and starchy foods are converted to in the body after digestion. Glucose is used by the body to make energy.

Normally, blood glucose levels are tightly controlled by insulin, a chemical signalling substance (hormone) that is produced by a gland near your stomach called the pancreas.

Insulin lowers the blood glucose level because it stimulates the body to make use of glucose.

When the amount of glucose in the blood increases, for example, after eating food, insulin is released from the pancreas to normalise the glucose level. However, in patients with diabetes mellitus, the elevated glucose levels cannot be normalised. This causes abnormally high levels of blood glucose, which ultimately leads to the presence of glucose in the urine (glucosuria).

How do you get Diabetes?

There are two main types of diabetes mellitus. These are known as type 1 and type 2.

Type 1 diabetes mellitus used to be called insulin-dependent diabetes mellitus, or juvenile-onset diabetes mellitus, because it usually begins in childhood or adolescence.

In type 1 diabetes mellitus, the pancreas releases no insulin at all because the body has destroyed the cells that produce it (islet cells). The patient therefore relies on treatment with insulin.

Type 2 diabetes mellitus is the most common form of diabetes. It used to be called non-insulin dependent diabetes mellitus, or adult onset diabetes because it usually begins in adulthood.

In type 2 diabetes, patients can still produce insulin, but they do not produce enough and/or their bodies cannot use it properly.

Another form of diabetes, known as gestational diabetes, occurs in some women during pregnancy. It is a temporary condition caused by pregnancy and usually occurs in the later stages, once the baby has formed but is still growing.

How serious is Diabetes?

The early symptoms of untreated diabetes mellitus are related to the elevated blood glucose levels. Excess glucose in the blood ultimately results in high levels of glucose being present in the urine (glucosuria). This increases the urine output, which leads to dehydration and increased thirst. Other symptoms include extreme tiredness, weight loss, blurred vision, itchy skin and repeated minor infections such as thrush and boils.

People with type 1 diabetes must be treated with insulin in order to stay alive.

If uncontrolled for many years, diabetes mellitus can lead to more serious health problems:

Blood vessel damage within the eye (retinopathy). This can lead to blindness.

Kidney disease (nephropathy) or kidney failure.

Nerve damage (neuropathy) especially of the hands and feet, causing tingling, numbness and weakness.

Narrowing of the blood vessels due to fatty deposits (atherosclerosis). This increases the risk of heart attack, stroke and poor blood flow in the legs.

Uncontrolled gestational diabetes can result in a large baby and a difficult birth. It can also increase the risk of developing type 2 diabetes later in life.

How long does Diabetes last?

Diabetes Mellitus is a life-long, chronic condition.

Type 1 diabetes usually begins in childhood or adolescence. The symptoms tend to occur suddenly after the onset of the disease and are usually more obvious than those of type 2.

Type 2 diabetes usually begins in adulthood (mainly after 40 years of age). It develops gradually in most cases and may be present for several years before it is detected.

Gestational diabetes is a temporary condition that may occur during pregnancy and usually goes away after the baby is born.

How is Diabetes treated?

Treatment is aimed at controlling the elevated blood glucose without causing an abnormally low glucose level (hypoglycaemia). An important aspect of your treatment plan will involve eating a healthy diet (low fat, salt and sugar and high fibre). You should also monitor your blood glucose levels.

Type 1 diabetes mellitus is treated with insulin, exercise, and a healthy diet.

Type 2 diabetes mellitus is first treated with weight reduction, a healthy diet and regular exercise.

In type 2 diabetes, if the above measures fail to control the elevated blood glucose, oral (by mouth) medicines are used to try to boost insulin production, improve the body’s use of it, or reduce the speed at which glucose enters the blood. Treatment with insulin will be considered if these other medicines are insufficient.

Gestational diabetes is usually controlled by a healthy diet and regular exercise. Some women may require treatment with insulin.

Treating high blood pressure and controlling the levels of fats (lipids) in the blood are also very important in patients with diabetes as they are at greater risk than the normal population of developing serious cardiovascular diseases.

A group of medicines known as ACE (angiotensin converting enzyme) inhibitors are sometimes used to reduce the risk of developing cardiovascular complications in diabetes and can also reduce the risk or progression of kidney and eye diseases.

Although there is currently no cure for diabetes mellitus, it can be controlled successfully with an active treatment plan. The potential benefit of pancreas transplants and islet cell transplants in type 1 patients is being investigated.