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Author: Penny Williams
Source: Working With Older People, March 2004


Explaining About…Diabetes


Penny Williams of Diabetes UK explains how diabetes can develop.


Diabetes – or to give it its full name, diabetes mellitus – is a common condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly. This is because the body’s method of converting glucose into energy is not working as it should.


Normally a hormone called insulin controls the amount of glucose in our blood. An organ called the pancreas, which lies just behind the stomach, makes insulin. Insulin helps the glucose to enter the cells, where it is used as fuel by the body. If the glucose is unable to enter the cells it builds up in the blood. High levels of glucose in the blood can lead to health problems.


We obtain glucose from the food that we eat: either from sweet foods or from the digestion of starchy foods such as bread or potatoes. The liver can also make glucose.


After a meal is digested blood glucose levels rise and insulin is released into the blood. When the blood glucose level falls for example, during physical activity – the level of insulin falls. Insulin, therefore, plays a vital role in regulating the level of blood glucose and, in particular, stopping the blood glucose from rising too high.


Types of Diabetes


There are two main types of diabetes:



  • Type 1 diabetes, sometimes known as insulin dependent diabetes

  • Type 2 diabetes, sometimes known as non-insulin dependent diabetes.

Type 1 diabetes develops when there is no insulin in the body because most or all of the cells in the pancreas, where it is produced, have been destroyed. This type of diabetes usually develops in people under the age of 40, often in childhood, although it can occur at any age. It is treated by insulin injections, diet and regular exercise.


Type 2 diabetes develops when the body can still produce some insulin but not enough for its needs, or when the insulin that the body produces does not work properly (known as insulin resistance). This type of diabetes usually appears in people over the age of 40, although it is being diagnosed more frequently in younger people who are overweight. It is treated by diet and exercise alone or by a combination of diet, exercise and tablets or diet, exercise and insulin injections.


Symptoms


The main symptoms of diabetes are:



  • Increased thirst

  • Needing to go to the loo  all the time especially at night

  • Extreme tiredness

  • Weight loss

  • Genital itching or regular episodes of thrush

  • Blurred vision.

Type 2 diabetes develops slowly over a period of years. Some people may not notice any symptoms at all and their diabetes is only picked up in a routine medical check-up. Some people may put the symptoms down to ‘getting older’ or overwork.


Type 1 diabetes develops much more quickly, usually over a few weeks.


In both types of diabetes, the symptoms are quickly relieved once the diabetes is treated.


Blood Glucose


Although diabetes cannot be cured, it can be treated very successfully. The aim of diabetes treatment is to keep blood glucose levels as near to normal as possible. Knowing why people with diabetes develop high blood glucose levels helps to explain how the different treatments work.


When sugar and starchy foods have been digested, they turn into glucose. If somebody has diabetes, the glucose in their body (which is measured in their blood; thus the significance of blood glucose levels) is not turned into energy, either because there is not enough insulin in their body, or because the insulin that the body produces is not working properly. This causes the liver to make more glucose than usual but the body still cannot turn it into energy. The body then breaks down its stores of fat and protein to try to release more glucose but still this glucose cannot be turned into energy. This is why people with untreated diabetes often feel tired and lose weight. The unused glucose passes into the urine, which is why people with untreated diabetes pass large amounts of urine and are extremely thirsty.