What is diabetes?
Diabetes is a currently incurable condition in which too much glucose (sugar) is present in the blood.
Diabetes arises because the body can't use glucose properly, either because of a lack of the hormone insulin or because the insulin available doesn't work effectively. Not only is excess sugar found in the blood but it may appear in the urine too.
The full name 'diabetes mellitus' derives from the Greek word 'diabetes' meaning siphon - to pass through, and 'mellitus,' the Latin for honeyed or sweet. It refers to a major symptom of diabetes - sugar in the urine - and is a far more acceptable name than the one it was known by in the 17th century - when it was called the 'pi*sing evil'.
Diabetes has been a recognised condition for over 3,500 years. About 2,000 years ago, it's said that Arataeus of Cappadocia described diabetes as 'a melting down of the flesh and limbs into urine.' This reflected the weight loss and excess passing of urine that occurs in acute, undiagnosed diabetes.
Diabetes is common, and more than 2 million people in the UK are known to have the condition (statistics supplied by Diabetes UK). However, at least one million people are believed to have diabetes but don't realise it. More than three-quarters of those with diabetes have what is now called 'type 2 diabetes mellitus'. This used to be known as 'non-insulin dependent diabetes mellitus (NIDDM)' or 'maturity-onset diabetes mellitus'. The remainder have 'type 1 diabetes mellitus', which used to be known as 'insulin-dependent diabetes mellitus'.
Types of diabetes
There are two main types of diabetes:
Diabetes is a currently incurable condition in which too much glucose (sugar) is present in the blood.
Diabetes arises because the body can't use glucose properly, either because of a lack of the hormone insulin or because the insulin available doesn't work effectively. Not only is excess sugar found in the blood but it may appear in the urine too.
The full name 'diabetes mellitus' derives from the Greek word 'diabetes' meaning siphon - to pass through, and 'mellitus,' the Latin for honeyed or sweet. It refers to a major symptom of diabetes - sugar in the urine - and is a far more acceptable name than the one it was known by in the 17th century - when it was called the 'pi*sing evil'.
Diabetes has been a recognised condition for over 3,500 years. About 2,000 years ago, it's said that Arataeus of Cappadocia described diabetes as 'a melting down of the flesh and limbs into urine.' This reflected the weight loss and excess passing of urine that occurs in acute, undiagnosed diabetes.
Diabetes is common, and more than 2 million people in the UK are known to have the condition (statistics supplied by Diabetes UK). However, at least one million people are believed to have diabetes but don't realise it. More than three-quarters of those with diabetes have what is now called 'type 2 diabetes mellitus'. This used to be known as 'non-insulin dependent diabetes mellitus (NIDDM)' or 'maturity-onset diabetes mellitus'. The remainder have 'type 1 diabetes mellitus', which used to be known as 'insulin-dependent diabetes mellitus'.
Types of diabetes
There are two main types of diabetes:
- In type 1, the body's unable to produce any insulin. This usually starts in childhood or young adulthood. It's treated with diet control and insulin injections. Type 1 diabetes used to be called 'insulin-dependent diabetes'.
- In type 2 diabetes, not enough insulin is produced or the insulin that is made doesn't work properly. This tends to affect people as they get older, and usually appears after the age of 40. It used to be known as 'maturity-onset diabetes' or 'non-insulin dependent diabetes (NIDDM)'.
Normal blood sugar control
In the body, glucose is converted into energy. This glucose comes ready-made in sweet foods such as sweets and cakes, or from starchy foods such as potatoes, pasta or bread when they're digested. The liver is also able to manufacture glucose.
Under normal circumstances the hormone insulin, which is made by the pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells to absorb enough glucose from the blood for the energy, or fuel, that they need. Insulin also stimulates the liver to absorb and store any glucose that's left over. After a meal the amount of glucose in the blood rises, and this triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too. A second hormone manufactured by the pancreas is called glucagon. It stimulates the liver to release glucose when it's needed, and this raises the level of glucose in the blood.
Insulin is manufactured and stored in the pancreas, which is a thin gland about 15cm (6in) long that lies crosswise behind the stomach. It's often described as being two glands in one, since in addition to making insulin it also produces enzymes that are vital for digestion of food. These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.
The symptoms of diabetes
In type 1 diabetes the symptoms tend to develop more quickly, over a couple of weeks, and are more severe. In type 2 diabetes the symptoms develop slowly and are usually not so severe.
The common symptoms of both types of diabetes are:
In the body, glucose is converted into energy. This glucose comes ready-made in sweet foods such as sweets and cakes, or from starchy foods such as potatoes, pasta or bread when they're digested. The liver is also able to manufacture glucose.
Under normal circumstances the hormone insulin, which is made by the pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells to absorb enough glucose from the blood for the energy, or fuel, that they need. Insulin also stimulates the liver to absorb and store any glucose that's left over. After a meal the amount of glucose in the blood rises, and this triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too. A second hormone manufactured by the pancreas is called glucagon. It stimulates the liver to release glucose when it's needed, and this raises the level of glucose in the blood.
Insulin is manufactured and stored in the pancreas, which is a thin gland about 15cm (6in) long that lies crosswise behind the stomach. It's often described as being two glands in one, since in addition to making insulin it also produces enzymes that are vital for digestion of food. These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.
The symptoms of diabetes
In type 1 diabetes the symptoms tend to develop more quickly, over a couple of weeks, and are more severe. In type 2 diabetes the symptoms develop slowly and are usually not so severe.
The common symptoms of both types of diabetes are:
- increased thirst
- passing water frequently, especially at night
- tiredness and fatigue
- loss of weight
- genital itching or recurrent thrush.
In type 1 diabetes less common symptoms are:
- cramps
- constipation
- blurred vision
- recurrent skin infections.
In type 2 diabetes symptoms may go unnoticed for years, and only when complications of diabetes - such as foot ulceration or blurred vision occur - is the diabetes diagnosed. Remember that all the symptoms may not be present. Whenever any of these symptoms arise it's important that diabetes is tested for.
Diagnosing diabetes
Diabetes may be detected in a routine urine test where excess glucose is noted to be present. In the case of type 1 diabetes people often develop symptoms over a short period of time, usually weeks. They may feel thirsty all the time and need to pass water a lot, and they may find themselves feeling tired and losing weight.
When symptoms have drawn attention to the problem, a blood test that measures the level of glucose in the blood will confirm whether or not the underlying cause is indeed diabetes.
Treatment
Both type 1 and type 2 can cause serious health problems such as heart disease, stroke, blindness, kidney damage and nerve damage if they aren't treated well. Tight control of the blood sugar level helps to reduce the chance of these problems arising.
There are two main aims of diabetes treatment: to eliminate any symptoms of diabetes and to prevent the possible complications it can cause.
The type of treatment needed depends on the type of diabetes.
In both types of diabetes, dietary measures play a crucial role. Specially-trained dieticians can offer invaluable advice about which foods are good and which aren't so good.
Treating type 1 diabetes
Type 1 is treated with insulin and by eating a healthy diet. Insulin can't be taken by mouth because the digestive juices in the stomach destroy it. This means that it has to be given by injections. Most people find giving the injections simple and relatively painless, since the needle is so fine.
How often someone needs to inject depends on what their diabetes specialist has recommended, and which type of insulin they're using. Insulin is given at regular intervals throughout the day, usually between two to four occasions. Each injection may contain one type, or a combination of different types of insulin. They act for a short (short-acting) , intermediate (intermediate- acting), or longer (long-acting) period of time.
The injection can be given using either the traditional needle and plastic syringe, or the newer injection pen devices that many people find more convenient.
What is insulin?
Insulin was first used to treat diabetes in 1921. Under normal circumstances, it's made by beta cells that are part of a cluster of hormone-producing cells in the pancreas. The hormone regulates the level of glucose in the blood, preventing the level from going too high. Insulin enables cells to take up the amount of glucose they need to provide themselves with enough energy to function properly. It also allows any glucose left over to be stored in the liver.
Most insulin being used today is 'human insulin', although some people still use the older bovine and porcine insulins. This 'human insulin' is a product of genetic engineering, where bacteria bred in a laboratory are given a gene that allows them to produce insulin.
Enzymes in the stomach destroy insulin, so it can't be taken orally. Therefore, it has to be given by injection at specific times throughout the day. However, in the future it may be possible for insulin to be delivered into the body through an inhaler, thus avoiding the need for injections.
Treating type 2 diabetes
Although in the past type 2 may have been considered the 'milder' form of diabetes, this is no longer the case. For many people their type 2 diabetes can be controlled with diet alone. When this doesn't provide adequate control then medication in tablet form is used. The different types of tablets work by one of these methods:
Diagnosing diabetes
Diabetes may be detected in a routine urine test where excess glucose is noted to be present. In the case of type 1 diabetes people often develop symptoms over a short period of time, usually weeks. They may feel thirsty all the time and need to pass water a lot, and they may find themselves feeling tired and losing weight.
When symptoms have drawn attention to the problem, a blood test that measures the level of glucose in the blood will confirm whether or not the underlying cause is indeed diabetes.
Treatment
Both type 1 and type 2 can cause serious health problems such as heart disease, stroke, blindness, kidney damage and nerve damage if they aren't treated well. Tight control of the blood sugar level helps to reduce the chance of these problems arising.
There are two main aims of diabetes treatment: to eliminate any symptoms of diabetes and to prevent the possible complications it can cause.
The type of treatment needed depends on the type of diabetes.
In both types of diabetes, dietary measures play a crucial role. Specially-trained dieticians can offer invaluable advice about which foods are good and which aren't so good.
Treating type 1 diabetes
Type 1 is treated with insulin and by eating a healthy diet. Insulin can't be taken by mouth because the digestive juices in the stomach destroy it. This means that it has to be given by injections. Most people find giving the injections simple and relatively painless, since the needle is so fine.
How often someone needs to inject depends on what their diabetes specialist has recommended, and which type of insulin they're using. Insulin is given at regular intervals throughout the day, usually between two to four occasions. Each injection may contain one type, or a combination of different types of insulin. They act for a short (short-acting) , intermediate (intermediate- acting), or longer (long-acting) period of time.
The injection can be given using either the traditional needle and plastic syringe, or the newer injection pen devices that many people find more convenient.
What is insulin?
Insulin was first used to treat diabetes in 1921. Under normal circumstances, it's made by beta cells that are part of a cluster of hormone-producing cells in the pancreas. The hormone regulates the level of glucose in the blood, preventing the level from going too high. Insulin enables cells to take up the amount of glucose they need to provide themselves with enough energy to function properly. It also allows any glucose left over to be stored in the liver.
Most insulin being used today is 'human insulin', although some people still use the older bovine and porcine insulins. This 'human insulin' is a product of genetic engineering, where bacteria bred in a laboratory are given a gene that allows them to produce insulin.
Enzymes in the stomach destroy insulin, so it can't be taken orally. Therefore, it has to be given by injection at specific times throughout the day. However, in the future it may be possible for insulin to be delivered into the body through an inhaler, thus avoiding the need for injections.
Treating type 2 diabetes
Although in the past type 2 may have been considered the 'milder' form of diabetes, this is no longer the case. For many people their type 2 diabetes can be controlled with diet alone. When this doesn't provide adequate control then medication in tablet form is used. The different types of tablets work by one of these methods:
- helping the pancreas to make more insulin
- increasing the use of glucose and decreasing glucose production
- slowing down the absorption of glucose from the intestine
- stimulating insulin release from the pancreas
- enabling the body to use its natural insulin more effectively.
In time, a careful diet combined with oral medication may not be sufficient to keep the diabetes under control. If this is the case then insulin injections may be recommended.
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