What is Diabetes?

Diabetes is a condition where people don't produce enough insulin to meet their body's needs and/or their cells don't respond properly to insulin. Insulin is important because it moves glucose, a simple sugar, into the body's cells from the blood. It is a chronic (long-term) condition characterised by high levels of glucose in the blood (hyperglycaemia).  If not treated it can cause long-term complications such as heart disease, kidney damage, stroke, circulatory problems and damaged vision.

Nearly 24 million, or about 8% of U.S. children and adults have diabetes. Another 57 million have pre-diabetes. Unfortunately, what people living with mental illness don't realize is that Type 2 diabetes, a disease associated with obesity, is appearing with alarming frequency among the mentally ill.

Type of diabetes

Type 1 diabetes

Type 1 diabetes occurs when the pancreas cannot make insulin. Everyone with type 1 diabetes requires insulin injections.This type 1 diabetes is thought to occur as the result of an autoimmune reaction. During an autoimmune reaction the body's immune system attacks the body's own healthy cells and tissues.  In Type 1 diabetes, it is thought that the body attacks and destroys the specialised insulin-producing beta cells in the pancreas, making them incapable of producing insulin.

Type 2 Diabetes

Type 2 diabetes used to be called adult-onset diabetes, but with the epidemic of obese and overweight kids, more teenagers are now developing type 2 diabetes. Type 2 diabetes was also called non-insulin-dependent diabetes. People with type 2 diabetes usually have a family history of this condition and are most often overweight. People with type 2 diabetes may eventually need insulin injections. This condition occurs most commonly in people of First Nations descent, Hispanics, and North Americans of African descent.

Gestational Diabetes

Gestational diabetes is a form of diabetes that occurs during the second half of pregnancy. It is often diagnosed in middle or late pregnancy. Because high blood sugar levels in a mother are circulated through the placenta to the baby, gestational diabetes must be controlled to protect the baby's growth and development. According to the Canadian Diabetes Association (CDA), about 4% of women, and up to 18% of First Nations women, will develop gestational diabetes. The problem usually clears up after delivery, but women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life.

Signs and Symptoms

The main symptoms of diabetes include significantly increased thirst, needing to urinate more often than usual and increased hunger. When hyperglycemia occurs, the body tries to get rid of the excess glucose by excreting it in the urine.  This increases urine output and can lead to dehydration.  At the same time the body's cells are starved of the glucose energy they need The onset of symptoms in Type 1 diabetes is typically quite sudden and symptoms can be severe.  However the symptoms of Type 2 diabetes tend to manifest gradually, so much so that they may go unnoticed.

•  Weight loss
• Increased urination
• Yeast infections
• Skin wounds or infections that are slow to heal
• Increased thirst
• Blurry vision Hunger

Causes

There is no common diabetes cause that fits every type of diabetes.The reason there is no defined diabetes cause is because the causes of diabetes vary depending on the individual and the type.  More on what causes diabetes.  

• Family history of gestational diabetes
• Bad diet
• Chemical toxins within food
• Increasing age
• Overweight or obese
• Trauma or surgery
• Environmental factors
• Viral or bacterial infection
• Some genetic disorders

Diagnosis Diabetes

 If this happens to you, make sure your doctor finds the time to discuss or refer you to someone who will be able to answer the questions you may have.

Fasting blood glucose test

A sample of blood is taken to measure the blood glucose levels in the blood after the person has not eaten for several hours.  This is usually performed in the morning, before breakfast.  It is the most common blood test used to assist with diagnosis.

Random blood glucose test

A sample of blood is taken to measure the glucose levels in the blood - regardless of when the person last ate.A random plasma glucose test, also called a casual plasma glucose test, measures blood glucose without regard to when the person being tested last ate. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes.

 Urine tests

Urine tests may also be done and will demonstrate high levels of glucose.  They are not used in isolation in the diagnosis of diabetes, as the results can be misleading.

 HbA1c test

A blood test called the haemoglobin A1c (HbA1c) assay is often used to indicate a person's average blood glucose levels over a period of time.  As well as being a diagnostic tool, this test is useful in monitoring the progress of the condition and the effectiveness of treatment.

 Treatment

 A variety of different factors have a role to play in treating diabetes. Successful treatment makes all the difference to long-term health, and achieving balanced diabetes treatment can be the key to living with both type 1 and type 2 diabetes. While diabetes cannot be cured, it can be controlled.  The aim of treatment is to maintain healthy blood glucose levels (ie: between 4.0 mmol/L and 8.0 mmol/L) and to prevent diabetic complications.

This will normally involve balancing lifestyle factors (eg: diet and exercise) and medications.

• Health promotion
• Early detection
• Knowledge of the condition
• Effective monitoring
• Control blood glucose levels
• Avoid Smoking

Also considered to be important.  Therefore, as part of the nation-wide management of diabetes all people free diabetes check with their GP or practice nurse once a year. Treatment should be agreed on an individual basis and address medical, psychosocial and lifestyle issues.

 Lifestyle Factors

 Balanced diabetes treatments

Generally it is recommended that foods containing refined sugars be avoided. This includes foods such as,

• Chocolate
• Jam
• Soft drinks
• Sweet biscuits
• Cakes
• Pastries
• Fruit juices
• Natural carbohydrates

This can be converted to energy, are recommended.  This includes foods such as,

• Fruit Vegetables
• Whole meal
• Bread Cereals

The diet should also be low in fat and high in dietary fiber. Alcohol contains a lot of sugar so intake should be minimized. Having a regular eating pattern is also important as this helps to keep blood glucose levels balanced. In some cases, having snacks between meals may be recommended. Again this helps to balance blood glucose levels.

It is recommended that people with diabetes seek dietary advice from a dietitian and that they follow an individualized food plan.

Exercise Regularly

Regular exercise is important in maintaining balanced blood glucose levels.  Exercise also helps to maintain a healthy body weight and control blood pressure and blood cholesterol levels.  Exercise helps

• Control blood pressure
• Control weight
• Control cholesterol levels
• Reduce the risk heart attacks and strokes

It should be remembered however that excessive and/or prolonged exercise can cause the blood glucose levels to drop too low.  It is therefore recommended that any exercise undertaken is regular and moderate.

Other Lifestyle Activities

When the body is stressed, the blood glucose levels are more difficult to control.  It is therefore important that stress is adequately managed. It is recommended that people with diabetes do not smoke.  Smoking plays a part in increasing the risk of developing many diabetic complications. Illness can also make blood glucose levels more difficult to control.  If blood glucose levels become unstable due to illness, it is important to consult a doctor - particularly if vomiting occurs.

 Medications Advises

 Tablets

People with Type 2 diabetes may not be able to adequately control their blood glucose levels through diet, exercise and lifestyle changes alone.  Therefore, in many cases diabetic tablets are required.  There are a variety of tablets available, which work in different ways.  These include: Tablets to increase insulin output from the pancreas eg: [starlist]

• Glipizide
• Glibenclamide

Tablets to reduce insulin resistance eg:

•  Metformin

Tablets that stop the absorption of carbohydrates from the bowel eg:

• Acarbose

Insulin

In people with Type 1 diabetes and in some people with Type 2 diabetes, insulin injections are required.  There are a number of different types of insulin available that vary in the duration of time they are effective. Some are short-acting; meaning they are absorbed quickly by the body and are effective for a short period of time. Others are long-acting; meaning they are absorbed more slowly by the body and are effective for a longer period of time. Often a combination of different types of insulin is required.

Insulin is injected under the skin of the abdomen or thigh and can be administered by using a disposable syringe and needle, or a preloaded insulin “pen”. Insulin can also be administered by a pre-programmed insulin pump. An insulin pump is a small battery powered device into which insulin can be a loaded. The insulin is pumped into the abdomen via a thin plastic tube connected to a very thin plastic needle that is secured under the skin.

It is important that the person is trained in how to correctly administer the insulin.  This training is usually given by a diabetes nurse educator.  The amount of insulin required, and how often it is to be administered will vary according to the needs of the individual and the glucose levels in the blood.

 Blood Glucose Testing

To enable blood glucose levels to be tested, a droplet of blood is obtained from a small finger prick test and is measured on a special testing strip.  The results will help to determine how much medication is required, how much exercise can be undertaken and what foods should be eaten.  This simple home test needs to be performed regularly, in some cases up to several times per day.  It is important to follow the guidelines given by the treating doctor as to how often they should be done.

Diabetes Affect the Body

Knowing how diabetes affects your body can help you look after your body and prevent diabetic complications from developing.

• High cholesterol levels  
• High blood pressure  
• Affected on brain  
• Lower limbs  
• Affected on heart  
• Damage the nerves  
• Affected on Eyes  
• Kidney failure  
• Teeth and gum problems  

Therefore diabetes can affect any part of the body.