What is Diabetes?
Diabetes mellitus is a metabolic disease that causes high blood sugar, either because your body doesn’t produce enough insulin or it does not effectively use the insulin it produces. Blood glucose is the body’s main source of energy and comes from the food we eat.
Insulin is a hormone that is needed to carry glucose from the bloodstream to the cells where it is used for energy. If there is too little insulin, or insulin resistance, the blood glucose levels continue to rise because the glucose is not moved from the bloodstream into the cells. Blood glucose levels are sometimes referred to as blood sugar levels.
Different types of Diabetes
The two most common types of diabetes are:
Type 1 diabetes
Type 1 diabetes is an auto-immune disease where the immune system attacks and destroys cells in the pancreas where insulin is made. The condition is usually diagnosed in children and young people so it used to be called juvenile diabetes.
Type 2 diabetes
Type 2 diabetes occurs when your body becomes resistant to insulin. In later stages of the disease your body may not be able to produce enough insulin. Type 2 diabetes is a combination of genetic and lifestyle factors. Being overweight increases your risk of developing Type 2 diabetes as carrying extra weight makes your cells more resistant to the effects of insulin on your blood sugar.
What are the symptoms of diabetes?
The symptoms of diabetes are caused by rising blood glucose levels and include:
- Increased hunger or thirst
- Weight loss
- Frequent urination
- Extreme fatigue
- Sores that are slow to heal or don’t heal
- Blurred vision
What are the risk factors for diabetes?
You are more likely to develop Type II diabetes if you have one or more of these risk factors:
- If you are overweight or obese
- If you do very little physical activity
- If you have a family history of diabetes
- If as a woman you have diabetes when you were pregnant (gestational diabetes)
What do the numbers mean?
A finger prick can be done at your local clinic or pharmacy to give you an idea of how high your blood sugar level is but diagnosis of diabetes requires a blood test.
A Random blood glucose test can be conducted at any time of day and you do not need to fast for this test. A blood glucose level over 11.1mmol/L can be used to diagnose diabetes.
A fasting blood glucose test should be done in the morning and you should have nothing to eat or drink but water from the previous evening.
Fasting blood glucose levels:
| Less than 5.6 mmol/L | Normal and rules out diabetes |
| 6 – 6.9 mmol/L | Impaired fasting glucose – person is at risk for developing diabetes |
| Greater than or equal to 7 mmol/L | confirmed by two tests on two separate days within a two-week period – can diagnose diabetes |
HbA1C – A blood test for HbA1C can also be used to diagnose diabetes. Levels of 6.5% or higher are indicative of diabetes.
What are the complications of uncontrolled Diabetes?
Type 2 diabetes affects many of your body’s major organs, including your heart, blood vessels, nerves, eyes and kidneys. Potential complications of diabetes include:
-
Heart and blood vessel disease – increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis). Damage to the nerves of the heart can cause irregular heart rhythms.
- Nerve damage (neuropathy) in limbs. High blood sugar over time can damage or destroy nerves, resulting in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
- Kidney disease. Diabetes may lead to chronic kidney disease or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
- Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
- Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. In addition cuts and blisters can lead to serious infections. Severe damage may require the amputation of toe, foot or leg.
- Slow healing. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
- Hearing impairment. Hearing problems are more common in people with diabetes.
- Dementia. Type 2 diabetes seems to increase the risk of Alzheimer’s disease and other disorders that cause dementia. Poor control of blood sugar levels is linked to more-rapid decline in memory and other thinking skills.
- Diabetic KetoAcidosis. Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. This is as a result of your body not being able to absorb glucose to make energy and as a result your body uses other stores of energy that can create ketones. This condition often requires admission and treatment in an ICU setting.
If you have diabetes or you’re at risk of diabetes, learn the warning signs of diabetic ketoacidosis and when to seek emergency care.
What can I do to manage or prevent Diabetes?
Type 1 Diabetes cannot be prevented because it is an auto-immune disease
Many of the risk factors for Type 2 diabetes can be managed
Exercise
- Get at least 2 and half hours of exercise per week – make sure you increase your heart rate
Diet
- Eat more whole grains, fruit and vegetables
- Cut refined carbohydrates, and saturated and trans fats from your diet
- Eat smaller portions
Medications
- There are a number of different medications available to help treat diabetes. Your doctor will decide which medication, or combination of medications is suitable for you. Make sure you manage your diet and take your medication regularly in order to control your blood glucose levels.
When should I see a doctor?
You should have your blood glucose levels checked regularly. If you have any of the symptoms listed then make an appointment to see your doctor. It has been estimated that about 1 in 10 South Africans have diabetes and that almost half of these individuals are undiagnosed.
