Diabetes Mellitus:

Diabetes Mellitus, known as 'Diabetes', is a common life long health condition and is defined as a metabolic disorder of multiple Aetiology; it is now a major and increasing health problem in all age groups and is a severe and currently incurable life threatening condition, where the body is no longer able to turn glucose from food into usable energy; this is dangerous because the brain, muscle cells and other body tissues need set levels of glucose and carbohydrates to maintain their natural functions; brain cells and red blood cells rely solely on glucose for fuel.

The digestive system breaks down the carbohydrates into glucose after eating; the glucose is then absorbed from your intestines, which is then transported to the cells via the bloodstream.

Normally, the body keeps a constant glucose concentration in the blood cells and Glycogen is created to store any excess glucose in the liver and muscles and when glucose is in short supply, the body mobilises glucose from the stored glycogen and stimulates hunger.

The pancreas produces Insulin and Glucagon hormones to maintain blood glucose levels; when insulin is secreted it regulates the amount of glucose that is absorbed into the bloodstream and the method by which glucose enters the body's cells; in the cell the glucose is burned along with oxygen to produce energy.

The Islets of Langerhans in the pancreas contain alpha cells which create glucagon to increase blood glucose levels and beta cells that create Insulin, which is required by most of the body’s cells; it lowers blood glucose levels and helps to create glycogen, form fats from fatty acids and Glycerol and proteins from Amino Acids.

Myth: Eating lots of sugar does not cause Diabetes, although, eating too much too often is liable to make you overweight, which in turn can increase your risk of developing Type 2 Diabetes.

All diabetics will exhibit one or more of the following symptoms, Polydipsia, Polyphagia, unexplained weight loss, Glycosuria, Polyuria, sickness, headaches, blurred vision, dry mouth, fatigue, dry and itchy skin, genital itching, recurrent episodes of thrush, slow healing wounds or sores, numbness or tingling in the extremities, impotence and recurrent infections, as well as passing out, but not all diabetics will have the same symptoms.

Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly; this is because your pancreas does not produce any insulin, or not enough, to help the glucose to enter your body’s cells, or the insulin that is produced does not work properly, known as insulin resistance.

Glucose comes from digesting carbohydrate and is also produced by the liver; carbohydrate comes from many different kinds of foods and drink, including starchy foods such as bread, potatoes, chapatis, fruit, some dairy products, sugar and other sweet foods.

For those without Diabetes the correct amount of insulin is present allowing the cells to have the proper glucose uptake and metabolism; for those with Type 1 Diabetes there is no or little insulin present to allow the cells to have the proper glucose uptake and metabolism; for those with Type 2 Diabetes insulin is present, but the signal to allow cells to have the proper glucose uptake and metabolism is lost; therefore, some glucose intake may occur.

How Glucose Gets Into The Cells:

After a meal, blood glucose levels are controlled by the action of insulin on fat and muscle cells; the binding of insulin to its receptor causes numerous glucose transporter proteins to move from storage sites within each cell to the cell surface, where they act as pores that allow glucose to enter.

This process requires the interaction of a complicated array of proteins known as SNARE complexes; the defective assembly and regulation of these complexes is thought to underlie the Insulin Resistance that causes Type 2 Diabetes; however, the exact mechanisms by which this occurs are, as yet, poorly understood.

Diabetes Mellitus is now escalating in the UK; over 2.9 million people are already diagnosed as diabetics and around a million more are thought to have Diabetes without knowing it; it is one of the most common of the Endocrine diseases in all populations and age groups and is the commonest cause of blindness in the UK population.

Diabetes is split into four main types:
Type 1 – Also known as insulin dependent Diabetes Mellitus or Juvenile Diabetes.
Type 2 – Also known as non insulin dependent Diabetes Mellitus.
Type 3 – Maturity Onset Diabetes of the Young, known as MODY.
Type 4 – Gestational Diabetes, which develops or is discovered during pregnancy.

Out of the above four types of Diabetes, more people are at risk of developing Type 2 than any other type of Diabetes and Type 2 Diabetes is the main type of Diabetes that can be brought on by lifestyle choices.

Who Is At Risk Of Developing Type 2:

Those with a family history of Diabetes.
Those who are overweight.
Those who are not physically active.
Those who are of Asian, African, or Afican Caribbean origin.

Diabetes Medication:

Along with meal planning and physical activity, many diabetics have to take Diabetes Medication as well; diabetes pills help people with Type 2 Diabetes or gestational diabetes to keep their blood glucose levels on target; several kinds of pills are available and each works in a different way; many people take two or three kinds of pills and some people take combination pills, which contain two kinds of diabetes medicine in one tablet and some people take both pills and Insulin.

Target millimoles per liter (mmol/l) Blood Glucose Levels:

mmol/l is a unit of measure that shows the concentration of a substance in a specific amount of fluid; in most of the world, except for the United States, blood glucose test results are reported as mmol/l; in the United States, milligrams per deciliter (mg/dL) is used; everyone is different, therefore, the following Diabetes UK Blood Glucose Level recommendations are to be used as a general guide only; you should discuss your target levels with your healthcare team.

Adults With Type 1 Diabetes:

Aim for a target of (4 to 7) mmol/l before meals and no more than 9 mmol/l by 2 hours after meals.

Adults With Type 2 Diabetes:

Aim for a target of (4 to 7) mmol/l before meals and no more than 8.5 mmol/l by 2 hours after meals.

During Pregnancy:

Aim for a target of (3.5 to 5.9) mmol/l before meals and no more than 7.8 mmol/l by 1 hour after meals.

Children (under 16) With Type 1 Diabetes:

Aim for a target of (4 to 8) mmol/l before meals and no more than 10 mmol/l by 2 hours after meals.

Children (under 16) With Type 2 Diabetes:

Individual targets should be discussed with your healthcare team.

What To Do When You Are Ill:

Some forms of illness affect your diabetic control by raising your blood glucose levels; when you are ill, your body reacts by releasing more glucose into the bloodstream and by increasing the Insulin Resistance, stopping it from working properly; this happens even if you are eating less food than normal or vomiting, which means that you end up with higher than normal blood glucose levels.

At these times you need to test your blood glucose levels more often than normal, or at least four times a day and during the night when you wake up; if your blood glucose levels are above 13.5 mmol/l, then you are at risk of developing Keytones and you need to be tested.

Whilst ill you need to eat little and often and to be drinking plenty of water and sugar free drinks; though, if you are throwing up a lot you need alternative drinks such as milk, fruit juice and sugary drinks like flat cola and flat lemonade.

High Blood Pressure Warning:

According to 'Diabetes UK' rates of Stroke and Kidney Failure in people with Diabetes have reached record levels in England; figures from the 2009/2010 National Diabetes Audit (NDA) show a 57% rise in Stroke victims in people with Diabetes since 2006/2007 and if we use these figures as a representative of the rate accross England, it means that more than 16 000 people with Diabetes had a Stroke in 2009/2010; in the case of Kidney Failure, there was a 31% rise in Kidney Failure in people with Diabetes since 2006/2007 and if we use these figures as a representative of the rate accross England, it means that more than 8 800 people with Diabetes had a Kidney Failure in 2009/2010.

A recent 'Diabetes UK' survey revealed that around 22% of people with Diabetes were unaware of having their Kidney Function checked within the previous year and whilst around 91% had had their Blood Pressure checked, NDA figures reveal that only 50.7% of people with Diabetes met their Blood Pressure targets in 2009/2010.

High Blood Pressure - The excessive pressure on your artery walls caused by High Blood Pressure can damage your blood vessels, as well as many organs in your body; the higher the Blood Pressure and the longer it goes uncontrolled, the greater the damage and uncontrolled High Blood Pressure can often lead to Aneurysms, Atherosclerosis, Cognitive Problems, Eye Problems, Heart Attacks, Kidney Failures, Metabolic Syndrome and Strokes.

Aneurysm - An increased Blood Pressure can cause your blood vessels to weaken and bulge, forming an aneurysm; if an aneurysm ruptures, it can be life threatening.

Atherosclerosis - An increased blood pressure can cause the hardening and thickening of the arteries, which can reduce or slow the blood flow.

Cognitive Problems - High blood pressure can cause problems with memory and/or understanding concepts, it may also affect your ability to think, remember and learn.

Eye Problems
- High blood pressure can cause thickened, narrowed or torn blood vessels in the eyes, which can result in vision loss.

Heart Attack - In order to be able to pump blood against the higher pressure in your vessels, your heart muscle thickens; eventually, the thickened muscle may have too hard a time pumping enough blood to meet your body's needs, which can lead to Heart Failure.

Kidney Failure - High blood pressure leads to weakened and narrowed blood vessels in the kidneys, which can prevent the organs from functioning normally.

Metabolic Syndrome - This is a cluster of disorders based around your body's metabolism, including increased Waist Circumference, High Triglycerides, Low or High-Density Lipoprotein (HDL), or 'Good Cholesterol', High Blood Pressure and High Insulin Levels; if you have High Blood Pressure, you're more likely to have other components of metabolic syndrome and the more components you have, the greater your risk of developing Diabetes, Heart Disease or Stroke.

Diabetes Related Information Leaflets

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