Brief overview of diabetes
Brief overview of diabetes.
By the term 'diabetes', we mean 'diabetes mellitus', where the urine is sweet due to presence of sugar. There is another condition called 'diabetes insipidus' as they have tasteless urine.
1.What is diabetes? - Persistently high blood sugar due to lack of insulin.
2. What is insulin? - A hormone secreted by beta cells of pancreas gland in the abdomen.
3. Types of primary diabetes: two types
Type 1 - young patient, cannot make insulin as the beta cells are destroyed. So they need to take insulin injection daily- IDDM = Insulin-Dependent -Diabetes-Mellitus. Meaning if they don't take insulin, they will be seriously ill and may even die.
Type 2 - Older patients, they make insulin but not enough or the insulin does not work properly. Sometimes they are given insulin to improve sugar control but they are not dependent on insulin -->NIDDM=Non-Insulin-Dependent-Diabetes-Mellitus.
Pointers that someone may have diabetes - Excessive thirst, passing a lot of urine, eating a lot but losing weight inspite of eating more(in type1 daibetes), recurrent infections, family history of diabetes etc.
Effects of persistently high blood sugar :
High blood sugar damages inner lining of blood vessels (arteries mainly) leading to furring and hardening (atherosclerosis). We all get atherosclerosis as we become old. This process is hastened in diabetes. Along with this if he smokes, has high cholesterol, untreated high blood pressure and drinks a lot of alcohol, then the damage will happen very quickly.
Blood vessels carry nutrients and oxygen to all parts of the body and brings back waste products and carbon dioxide to be removed. So, all the organs are affected in diabetes.
Atherosclerosis causes narrowing and blockage of arteries.
Smaller arteries are blocked first, leading to -->
Damage to the back of the eye (retinopathy) leading to blindness.
Damage to small arteries of kidneys which filters blood and excretes waste products in the urine (nephropathy) leading to kidney failure requiring dialysis and kidney transplant.
Damage to small arteries of nerves leads to pins and needles, numbness, pain in hands and feet (neuropathy). It starts in the feet first as their nerves are the longest.
As the disease progresses, larger arteries are affected leading to ->
Damage to the heart causing chest pain (angina and heart attack)
Damage to brain causing paralysis (stroke)
Damage to leg arteries causing pain on walking(claudication) and may end up in amputation of toes, feet or leg.
Treatment of diabetes:
1. Diet
2. exercise
3. Tablets and/or insulin
4. Treatment of associated conditions like high cholesterol, high blood presssure
5. Lifestyle changes - adopting healthy lifestyle more rigorously than others.
Diabetes cannot be cured. It has to be kept under control to prevent or delay the onset of complications as mentioned under effects of high blood sugar.
Your diabetes team will advise about diabetic diet. Principles are:
Avoid sugar because, it is absorbed very rapidly and blood sugar goes up too high, which insulin cannot bring down as quickly. So, low sugar, high fibre, low salt diet with reduced portion of rice bread pasta as well. Use fruit or fruit sugar to sweeten. You can use Canderel or Splenda as well as a sweetener - they virtually have no calories.
Medications :
Type 1 diabetics are treated with insulin given as injections.
Type 2 diabetics in early stage may need diet control only. Tablets and/or insulin are added later.
Oral medications used for type 2 diabetes (Type 1 is always treated with insulins):
1. Small tablets like Gliclazide taken before food - stimulates pancreas to secrete insulin which will reduce blood sugar. There is risk of 'hypo' meaning sugar can go too low. Diabetes team will advise.
2. Big tablets like Metformin, taken after food. Reduces blood sugar but no risk of 'hypo'. Helps losing weight and may make less hungry so that it is useful in overweight diabetic. It may cause tummy upset. Speak to your doctor. He may try 'slow release' form.
3. There are other tablets as well to help lower blood sugar, like Acarbose, Pioglitazone etc.
4. Insulin injection may be added to improve diabetic control.
5. Aspirin to keep the blood a bit on the thin side to prevent clot formation (stroke or heart attack).
6. Statins like Simvastatin to reduce cholesterol.
7. Tablets like Ramipril to protect kidneys and blood vessels. It helps in blood pressure control as well.
8. Blood pressure tablets to control blood pressure if high.
9. Taking a tablet of Multivitamin with iron 14mcg daily is a good idea because of restricted diet. Can be bought over the counter, available at Tesco etc.
10. Elderly patients and post-menopausal women should take Calcium with Vitamin D tablet as doctor will advise.
What is good control of diabetes - No very high or very low blood sugars and able to lead a near-normal lifestyle. (Normal or low HbA1c-a measure of average blood sugar over about 2 month period- may indicate very good diabetic control or frequent hypos) Your weight should be in the healthy range.
Look after your feet as you look after your face. Because of loss of sensation, you may hurt your foot which may get infected and may turn serious. Infections need to be treated early.
Diabetes team will look after you. Keep in touch with them.
Don't miss your follow up appointments.
Diabetes is a big subject. Hope these discussions help you understand a bit about daibetes and the importance of controlling it. With good control, diabetics can have near-normal life-expectancy.
------------------------------------------------------
Articles like healthy lifestyle, losing weight are on my website http://www.ideaas.eu
By the term 'diabetes', we mean 'diabetes mellitus', where the urine is sweet due to presence of sugar. There is another condition called 'diabetes insipidus' as they have tasteless urine.
1.What is diabetes? - Persistently high blood sugar due to lack of insulin.
2. What is insulin? - A hormone secreted by beta cells of pancreas gland in the abdomen.
3. Types of primary diabetes: two types
Type 1 - young patient, cannot make insulin as the beta cells are destroyed. So they need to take insulin injection daily- IDDM = Insulin-Dependent -Diabetes-Mellitus. Meaning if they don't take insulin, they will be seriously ill and may even die.
Type 2 - Older patients, they make insulin but not enough or the insulin does not work properly. Sometimes they are given insulin to improve sugar control but they are not dependent on insulin -->NIDDM=Non-Insulin-Dependent-Diabetes-Mellitus.
Pointers that someone may have diabetes - Excessive thirst, passing a lot of urine, eating a lot but losing weight inspite of eating more(in type1 daibetes), recurrent infections, family history of diabetes etc.
Effects of persistently high blood sugar :
High blood sugar damages inner lining of blood vessels (arteries mainly) leading to furring and hardening (atherosclerosis). We all get atherosclerosis as we become old. This process is hastened in diabetes. Along with this if he smokes, has high cholesterol, untreated high blood pressure and drinks a lot of alcohol, then the damage will happen very quickly.
Blood vessels carry nutrients and oxygen to all parts of the body and brings back waste products and carbon dioxide to be removed. So, all the organs are affected in diabetes.
Atherosclerosis causes narrowing and blockage of arteries.
Smaller arteries are blocked first, leading to -->
Damage to the back of the eye (retinopathy) leading to blindness.
Damage to small arteries of kidneys which filters blood and excretes waste products in the urine (nephropathy) leading to kidney failure requiring dialysis and kidney transplant.
Damage to small arteries of nerves leads to pins and needles, numbness, pain in hands and feet (neuropathy). It starts in the feet first as their nerves are the longest.
As the disease progresses, larger arteries are affected leading to ->
Damage to the heart causing chest pain (angina and heart attack)
Damage to brain causing paralysis (stroke)
Damage to leg arteries causing pain on walking(claudication) and may end up in amputation of toes, feet or leg.
Treatment of diabetes:
1. Diet
2. exercise
3. Tablets and/or insulin
4. Treatment of associated conditions like high cholesterol, high blood presssure
5. Lifestyle changes - adopting healthy lifestyle more rigorously than others.
Diabetes cannot be cured. It has to be kept under control to prevent or delay the onset of complications as mentioned under effects of high blood sugar.
Your diabetes team will advise about diabetic diet. Principles are:
Avoid sugar because, it is absorbed very rapidly and blood sugar goes up too high, which insulin cannot bring down as quickly. So, low sugar, high fibre, low salt diet with reduced portion of rice bread pasta as well. Use fruit or fruit sugar to sweeten. You can use Canderel or Splenda as well as a sweetener - they virtually have no calories.
Medications :
Type 1 diabetics are treated with insulin given as injections.
Type 2 diabetics in early stage may need diet control only. Tablets and/or insulin are added later.
Oral medications used for type 2 diabetes (Type 1 is always treated with insulins):
1. Small tablets like Gliclazide taken before food - stimulates pancreas to secrete insulin which will reduce blood sugar. There is risk of 'hypo' meaning sugar can go too low. Diabetes team will advise.
2. Big tablets like Metformin, taken after food. Reduces blood sugar but no risk of 'hypo'. Helps losing weight and may make less hungry so that it is useful in overweight diabetic. It may cause tummy upset. Speak to your doctor. He may try 'slow release' form.
3. There are other tablets as well to help lower blood sugar, like Acarbose, Pioglitazone etc.
4. Insulin injection may be added to improve diabetic control.
5. Aspirin to keep the blood a bit on the thin side to prevent clot formation (stroke or heart attack).
6. Statins like Simvastatin to reduce cholesterol.
7. Tablets like Ramipril to protect kidneys and blood vessels. It helps in blood pressure control as well.
8. Blood pressure tablets to control blood pressure if high.
9. Taking a tablet of Multivitamin with iron 14mcg daily is a good idea because of restricted diet. Can be bought over the counter, available at Tesco etc.
10. Elderly patients and post-menopausal women should take Calcium with Vitamin D tablet as doctor will advise.
What is good control of diabetes - No very high or very low blood sugars and able to lead a near-normal lifestyle. (Normal or low HbA1c-a measure of average blood sugar over about 2 month period- may indicate very good diabetic control or frequent hypos) Your weight should be in the healthy range.
Look after your feet as you look after your face. Because of loss of sensation, you may hurt your foot which may get infected and may turn serious. Infections need to be treated early.
Diabetes team will look after you. Keep in touch with them.
Don't miss your follow up appointments.
Diabetes is a big subject. Hope these discussions help you understand a bit about daibetes and the importance of controlling it. With good control, diabetics can have near-normal life-expectancy.
------------------------------------------------------
Articles like healthy lifestyle, losing weight are on my website http://www.ideaas.eu
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