Diabetes

Theresa Lowry-LehnenRGN, BSc (Hon’s) Specialist Nurse Practitioner, PGCC, Dip Counselling,

Dip Adv Psychotherapy, BSc (Hon’s) Clinical Science, PGCE (QTS), H. Dip. Ed, MEd,

MHS Accredited Emotional Intelligence assessor (Psychology), PhD Psychology

Video- Diabetes made simple.

https://www.youtube.com/watch?v=MGL6km1NB

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Video on Diabetes

https://www.youtube.com/watch?v=sTgB

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Diabetes Mellitus Diabetes comes from the Greek word ‘to pass

through’

Diabetes is a long-term condition caused by too

much glucose, a type of sugar, in the blood.

There are two main types of diabetes, which are

explained below:

type 1 diabetes – Insulin Dependent

type 2 diabetes – Non-insulin Dependent

What are the symptoms? feeling very thirsty

going to the toilet a lot (urine), especially at night

extreme tiredness / fatigue

weight loss and muscle wasting (loss of muscle bulk) mainly type 1 Diabetes. Type 2 is associated with obesity.

Blurred vision.

Recurrent skin infections.

Vaginal infections or infections of the foreskin in uncircumcised men.

Slow healing of wounds / sores.

Symptoms of type 1 diabetes can develop quickly, over

weeks or even days

Many people have type 2 diabetes for years without

knowing it because type 2 diabetes may be associated with

no symptoms

How does diabetes occur?

Diabetes is a metabolic condition in which the body does not properly regulate glucose in the blood.

When we eat carbohydrates, the body breaks them down into sugars, including glucose.

Glucose is transported by the bloodstream to the cells, where it is used for energy.

The hormone insulin, secreted by the pancreas, is responsible for moving glucose from the blood into the cells.

People with diabetes either do not make insulin, or their body does not properly respond to insulin,

Type 1 Diabetes Type 1 diabetes develops as a result of an autoimmune

attack on the pancreas that causes it to stop producing

the hormone insulin. Without insulin, blood glucose is not

regulated and type 1 diabetes develops.

The exact cause is unknown, but the illness tends to run

in families. Among people with a genetic predisposition

for type 1 diabetes, an environmental trigger appears to

stimulate the immune system attack on the pancreas.

Certain viral infections in the first year of life are

associated with an increased risk for type 1 diabetes.

Far less common than type 2 diabetes – 5-10% of all

people with diabetes

Need to take insulin injections for life

Type 2 Diabetes

Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases. Type 2 diabetes typically begins with insulin resistance, a condition in which the pancreas produces insulin but the body cells do not respond to it properly.

As the disease progresses, the pancreas may eventually lose its ability to produce insulin.

Type 2 diabetes also involves a strong genetic component combined with other risk factors, including obesity and a sedentary lifestyle.

Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it is more common in older people.

Diabetes in pregnancy

(Gestational Diabetes)

Gestational diabetes is a form of glucose intolerance that

develops during pregnancy. Although the cause is unknown,

it occurs more often in obese women and women with a

family history of diabetes.

It affects approximately12% of pregnant women.

Gestational diabetes can increase the risk of health problems

in an unborn baby, so it is important to keep the levels of

glucose in the blood under control.

Women who develop gestational diabetes are more likely to

develop type 2 diabetes later in life.

Normal and diabetic blood sugar ranges Normal blood glucose level in humans is about 4

mm (4 mmol/L or 72 mg/dL) When operating normally the body restores blood

sugar levels to a range of 4.4 to 6.1 mmol/L (82 to

110 mg/dL) Shortly after a meal the blood glucose level may

rise temporarily up to 7.8 mmol/L (140 mg/dL)

For people with diabetes, blood sugar level targets

are as follows: Before meals: 4 to 7 mmol/L for people with type 1

or type 2 After meals: under 9 mmol/L for people with type 1

and 8.5mmol/L for people with type 2

Hypoglycaemia Hypoglycaemia is the term for a low level of sugar

(glucose) in the blood (less than 4 mmols/l) and if

untreated can lead to coma/ unconsciousness.

The immediate treatment for a hypo is to have

some food or drink that contains sugar such as a

glass of lucozade, fruit juice or 4 to 5 dextrose or

boiled sweets

After having something sugary, there may be a

need to have a longer-acting carbohydrate food,

such as a few biscuits or a sandwich

Monitor blood sugars regularly.

Hyperglycaemia Hyperglycaemia occurs when there is a higher than

normal level of glucose (sugar) in the blood

Steps need to be taken to lower blood glucose levels, such as increasing the dose of insulin

Diet and exercise can also be used to adjust blood glucose levels

Left untreated, hyperglycaemia can develop into diabetic ketoacidosis which is a serious condition that can lead to coma

Diabetic ketoacidosis will need to be treated in hospital.

How is diabetes diagnosed? Diabetes is diagnosed by examining glucose levels

in blood samples using one or more of the following

tests:

Random glucose test — a glucose level above

11.1mmol/L taken at a random time on two

occasions is a diagnosis of diabetes.

Fasting glucose test — a glucose level above

7.8mmol/L measured without anything to eat and

on two different days is a diagnosis of diabetes.

Glucose tolerance test — a blood glucose test is

taken two hours after a glucose drink is given to the

patient. A level above 11.1mmol/L is a diagnosis of

diabetes, while a level below 7.8 is normal.

Type 1 Diabetes: Do’s Blood glucose testing kit used regularly — to

measure the blood glucose levels and control the

insulin dose.

Learn how to give insulin injections — needed for

life.

If a smoker-stop.

Follow the diet advised by the doctor and eat at

regular times.

Exercise regularly and eat more or decrease the

insulin to prevent low blood sugar levels.

Type 1 Diabetes: Do’s Carry some form of sugar (and a protein snack)so

that a low blood sugar can be treated quickly.

Visit the doctor regularly so that blood glucose

levels can be checked and eyes, urinalysis and

feet examined for signs of diabetic symptoms.

Tell the doctor if you feel ill or if you have been

diagnosed with another disease.

Carry identification (such as a card or bracelet)

that says you have diabetes, in case of an

emergency.

Type 2 Diabetes: Do’s If overweight, lose weight — losing as little as a few

pounds can reduce the need to take medication.

Follow the diet advised by the doctor.

If a smoker-quit.

Learn how to use the home glucose testing kit

(either blood or urine) and use it regularly —to

measure glucose levels.

If need for insulin, learn how to give insulin

injections.

Type 2 Diabetes: Do’s

Visit the doctor regularly so that the blood

pressure, blood glucose levels and amount of

lipids (fat) in the blood can be checked, and your

eyes, urinalysis and feet examined.

Tell the doctor if you feel ill or if you have been

diagnosed with another disease.

Carry identification (such as a card or bracelet)

that says you have diabetes, in case of an

emergency.

Blood glucose monitor

Exercise and Diabetes

Weight loss

Lower blood sugar levels

Lower blood pressure

Stronger muscles and joints

Better self image

Self confidence

Better shape

What is the outlook? Type 1 diabetes:

Type 1 diabetes is a lifelong condition, but, if treated

effectively, will reduce the risk of developing late-

stage diabetic complications.

Type 2 diabetes:

Type 2 diabetes is also a lifelong condition, but it can

usually be controlled with a combination of diet and

medication, although as the disease progresses,

insulin injections may be required to minimise the risk

of further complications.