The symptoms of diabetes are caused by having too much glucose in the blood. There are two main forms of the disease: type-1 accounts for about 10% of cases and type-2 for about 90%. A third variety, gestational diabetes, which is similar to type-2, affects 2%-10% of pregnant women and usually disappears after they have given birth.The symptoms are the same for all three: frequent urination, excessive thirst and a dry mouth, unexplained weight loss, fatigue, blurred vision, itchiness around the genital area and episodes of thrush. The cause is also the same: a lack of insulin, the hormone produced in the pancreas that controls the level of blood sugar.
Type-1 is a lifelong medical condition. It is an autoimmune disease - the body's immune system destroys the cells in the pancreas that make insulin. Unlike type-2, it is not related to age or to being overweight.
Before insulin was isolated in the laboratory and manufactured, type-1 diabetes was a death sentence. Now it can be successfully managed with regular injections of the hormone.
The development of type-2 is strongly linked to obesity and lack of exercise, though there is likely to be a genetic component in both types. If you have type-2, your pancreas does produce insulin, but there is not enough of it or your body can't use it effectively. Type-2 can sometimes be managed purely through lifestyle changes, such as eating more healthily, exercising more and losing weight, though some people also have to take a drug called Metformin or, in some cases, insulin.
Who is most at risk?
Besides being overweight and not exercising enough, there are several other factors that can lead to an increased risk of developing diabetes.
If you are white, the risk increases once you are over 40. If you are black, Chinese or South Asian, the risk is greater once you are over 25.
You are between two and six times more likely to get type-2 if you have a parent, brother, sister or child who has or had it.
Anyone who has high blood pressure is more likely to get it, and the usual suspects - too much alcohol or smoking - also increase the risk.
Unusually, it is thought that even lack of sleep or mental conditions such as depression could affect the likelihood of developing diabetes
It's complicated
In the long-term, high blood sugar damages the blood vessels. This can lead to serious complications all over the body, including heart attack and stroke.
Some people develop an eye disease called diabetic retinopathy, which can affect their eyesight. If it is picked up - usually by an eye screening test - it can be treated and sight loss prevented.
Foot problems are also common. They can be serious and in some cases lead to amputation if left untreated. Nerve damage caused by the disease affects the feeling in your feet, and raised blood sugar damages the circulation, so any sores or cuts might go unnoticed or by slower to heal. If you have type-2 it's important to tell your doctor if you notice any change in how your feet look or feel. As well as affecting the feet, nerve damage caused by diabetes can also affect how you see, hear and move.
Over a long period diabetes can cause damage to your kidneys, making it harder to clear extra fluid and waste from your body. This is known as diabetic nephropathy.
Too much glucose in your blood can lead to more in your saliva. This promotes the growth of bacteria that produce acids which attack your tooth enamel and damage your gums. The blood vessels in your gums can also be damaged, leading to infections.
Having diabetes means you're more at risk of developing certain cancers. Some cancer treatments also affect your diabetes by making it harder to control your blood sugar.
For both women and men, damage caused by diabetes to blood vessels and nerves can restrict the amount of blood flowing to the sexual organs, resulting in a loss of sensation. Women are more likely to get thrush or urinary tract infections and men become more susceptible to erectile dysfunction.
Testing time
If you have either of the common types of diabetes it is essential that you measure your blood sugar regularly. How often will depend on whether you have type-1 or type-2 and other factors such as what medicines you are taking.
It's important because it can indicate whether you need to take more medication, when you should eat, and also tell you whether you are at risk of any of the complications of the disease. The higher your blood sugar and the longer it is high for, the more at risk you are.
There are two common ways to measure your blood sugar at home. The first is a finger-prick blood test, where you put a drop of blood on a test strip that is inserted in a meter. The other is a flash glucose monitor, which uses a sensor attached to your skin.
At least once a year your doctor will ask you to come in for an HbA1c blood test. This checks your average blood sugar over the past three months so indicates trends over time
Eat healthily
It is a common misconception that a diagnosis of diabetes means you must immediately give up eating foods that contain carbohydrates, which are digested and turned into glucose. In fact, there is no specific diet for either type-1 or type-2, or a list of foods that must be avoided.
Rather, the key is to eat a healthy and balanced diet in sensible portions. This will both help to control your blood sugar and almost certainly help you to get down to the correct weight.
There is credible evidence that some people with type-2 diabetes have gone into remission purely by losing enough weight.
Some carbohydrates are broken down more quickly than others and can cause a spike in blood glucose, while others are broken down more slowly. Increasing the slow-release carbs in your diet can help regulate blood glucose levels.
The charity Diabetes UK has plenty of advice about diet on its website, diabetes.org.uk. Making healthier food choices will help to manage your diabetes but also reduce the risk of complications associated with it.
Stay active
Exercise is good for everyone, whether they have diabetes or not, and is particularly important as we get older. It's most important effects for people with diabetes is that it helps to lower blood pressure - meaning you are less at risk of complications - and can help you lose weight.
It also increases the body's sensitivity to insulin, so if you have type-2 diabetes the insulin you produce gets used more efficiently.
Regular exercise also gives you more energy, helps you to sleep more soundly, improves muscle strength and flexibility, reduces stress and can improve mood.
◆ diabetes.org.uk
This feature first appeared in the August 2024 issue of The Lady magazine.
Picture: Adobe Stock
