Diabetes - FAQ

What is diabetes?

Diabetes mellitus is a chronic disorder in which the body’s ability to use sugars is reduced. This can cause raised levels of glucose in the blood and its excretion in the urine. These changes are the result of a deficiency of the pancreatic hormone, insulin. There are two main types of diabetes: type 1 or insulin-dependent diabetes mellitus (IDDM), and type 2 formly know as non-insulin-dependent diabetes mellitus (NIDDM). Diabetes can also be diagnosed during a pregnancy and when due to the extra demands of the pregnancy is called gestational diabetes.

What are the differences between type 1 and type 2 diabetes?

This division is important because it affects the subsequent treatment. The mechanisms of the two differ, though they both result in an inability to regulate glucose properly.

Type 1: This form has a sudden onset (at most a few weeks), usually before the age of 40, but can occur at any age. The beta cells in the pancreas which produce insulin are killed off by the person’s own body. Insulin treatment is essential for life and will always have to be taken. Without insulin, blood glucose levels become too high and fat is broken down as an alternative source of energy. This results in the production of ketone bodies which, if they accumulate, can lead to ketoacidosis. This in turn can cause nausea, vomiting and drowsiness, and can lead to diabetic coma. Insulin is currently given by injection or pump.

Type 2: This is the form that most people with diabetes have. It affects mostly people over the age of 40 and has a slow onset (years) that may go undiagnosed. People with type 2 diabetes still secrete insulin, though there is almost always some reduction in the quantity produced.

Although type 1 and type 2 are clinically distinct from each other, many people with type 2 may develop a need for insulin injections in order to manage their diabetes effectively.

What are the symptoms of diabetes?

The ‘classical’ symptoms of both types of diabetes are thirst, tiredness, itching or rash in the genital areas caused by yeast-like infections of glucose-rich urine, over-production of urine (especially at night) and weight loss. In type 1, less frequent symptoms are cramps, constipation, blurred vision, and skin infections. In type 2 diabetes, the onset of symptoms may be so gradual that they go unnoticed. People with type 2 diabetes who have remained undiagnosed for some years may eventually be diagnosed because they go to the doctor complaining of deteriorating eyesight or with foot ulcers or pain in the limbs, which are some of the signs of complications of diabetes.

What is the connection between obesity and Type 2 diabetes?

Obesity is one of the fastest-growing medical epidemics affecting people. It appears that in obese individuals (especially those with much fat in the abdomen), the cells in the body begin to develop a resistance to insulin. They then fail to use blood glucose properly and glucose intolerance develops. Some obese individuals initially produce more insulin in compensation, but this also soon fails and diabetes results. Hence it is very important to try and maintain a reasonable weight. Obesity can be defined in terms of a number called the BODY MASS INDEX or BMI. To calculate your own BMI, measure your weight (in kilogrammes) and your height (in metres). Then divide your weight by the square of your height. The result can be compared to the following chart:

  • less than 20 –underweight
  • 20 to 25 – ideal
  • 25-30 – overweight
  • above 30 – clinically obese
  • above 40 – extremely obese

Do the genes we inherit play any part in diabetes?

Type 1 is not inherited through the transfer of a single gene, but some people have genes that increase their likelihood of getting it. Several studies have shown that in identical twins (who have identical genes), only 25-60 per cent of both individuals get diabetes, thus strongly indicating that there are other non-inherited factors involved. Overall, a child with a mother with type 1 has a small increased risk of developing diabetes, amounting to 3 per cent, a child with a father with type 1 has an increased risk amounting to 9 per cent. If both parents are affected, then the risk is significantly higher.

Type 2 tends to run in families more strongly than type 1. Detailed studies have shown that the chance of both identical twins developing type 2 diabetes can approach 100 per cent when followed over their lifetime. There are also a few well-studied families who pass on the disorder to some of their children through a dominant gene. This type of diabetes is called MODY, or Mature Onset Diabetes of the Young. In these cases, the disorder often emerges in childhood and has been linked to specific gene.

How is diabetes diagnosed?

Glucose levels are measured in blood samples (usually sent to a hospital laboratory). This is done using the following tests: random glucose test:glucose levels are taken at a random time on two occasions. Any figure above 11.1mmol/l is a diagnosis of diabetes. Fasting glucose test:the glucose level is measured after an overnight fast and on two different days. Above 7.0mmol/l is a diagnosis of diabetes.

You may only need to give one blood sample if you have other symptoms of diabetes.

Can I prevent myself getting Type 2 diabetes ?

Some people are more at risk of developing diabetes than others, the known risk factors include - a family history of diabetes, being overweight (80% of people with diabetes are overweight), age (the likelihood of developing diabetes increases with age), lack of exercise or having diabetes during pregnancy. However, regardless of your current risk, you can reduce the likelihood of developing diabetes by being careful with your refined sugar intake, lose weight if you are overweight and stay as active as possible. The Diabetes Prevention Programme and numerous other scientific studies have proven that diabetes can be prevented or at least it’s onset delayed by 58% by attention to lifestyle factors (diet and exercise).

APP/KOL/AC 22/02/07