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What Is Diabetes?
Diabetes mellitus (the full medical name) is a health condition characterised by high levels of glucose (sugar) in the blood, which the body cannot use properly and eventually excretes in the urine, together with a lot of water. It is caused either by the pancreas not producing the hormone insulin - or not enough of it - or by the body cells' inability to react to insulin.
Insulin is produced by the pancreas and acts
as a key that lets glucose into the body's cells.
Glucose is a sugar that is a vital source of
energy for all cells and thus the main fuel for
the body's processes. It comes from digesting
carbohydrates and it's also partially produced
by the liver. Carbohydrates are the main
nutrient in healthy foods such as wholegrain
or rye bread, pasta, oats, brown rice, pulses
(beans, peas and lentils), sweet potatoes, and
in not so healthy foods such as white bread,
cakes, sweets and other sugary foods.
If the body cannot use glucose as a source
of energy, it uses fat instead but this inevitably
disturbs the biochemical balance of the body
and leads to further health complications.
Typical examples of this are unhealthy diets
such as the Atkins, where carbohydrates are
avoided in favour of fatty foods. Symptoms of
diabetes include tiredness, irritability, nausea,
hunger, thirst, weight loss, blurred vision,
tingling sensations in the hands and feet and
dry, itchy skin.
In 1985, an estimated 30 million people
worldwide had diabetes; a decade later this
figure had increased to 135 million and by 2000
an estimated 171 million people had diabetes.
It is predicted that at least 366 million people
will have diabetes by 2030. This rapid increase
is attributed to a range of factors, including
population growth, ageing, unhealthy diets that
are high in saturated fat and cholesterol,
obesity and lack of physical exercise.
In the UK alone, 2.8 million people have
been diagnosed with diabetes but it is
estimated that up to half a million more have
the disease but have not yet been diagnosed.
Just in 2008, 145,000 people were
diagnosed with diabetes in the UK - that's
around 400 people every day! According to the
latest numbers, it is expected that by 2025
over four million people will have it. Because
of a rapid increase in the number of
overweight and obese people, and because
the population is ageing, most of these cases
will be type 2 diabetes.
Diagnosing diabetes
A diagnosis is arrived at after repeated blood tests which measure the amount of glucose (sugar) in the blood, specifically in the part of the blood called plasma. You will be diagnosed with diabetes if your tests show that:
- plasma glucose after fasting for 8-12 hours is more than 7.0mmol/l (126mg/dl)and/or
- plasma glucose two hours after ingesting a special glucose drink is more than 11.1mmol/l (200mg/dl)
Another criterion is called glycosylated
haemoglobin (HbA1c) which reflects the
average level of blood glucose over a period of
weeks. Haemoglobin molecules are one of the
main components of red blood cells and when
glucose binds to haemoglobin in the
bloodstream HbA1c occurs. The more glucose
there is, the more HbA1c will be present. Red
blood cells survive for eight to 12 weeks
before renewal and so by measuring HbA1c,
an average blood glucose reading can be
established.
For non-diabetics, the usual reading is 3.5-
5.5 per cent. For people with diabetes, an
HbA1c level of 6.5 per cent is considered good
control, although the closer to the nondiabetic
figure, the better.
Type 1 diabetes
Type 1 diabetes usually develops early in life
when the immune system attacks the insulinproducing
cells in the pancreas and effectively
destroys them. The body is then unable to
produce any insulin. Because insulin is the
key which allows glucose to enter the body's
cells, when it is absent the glucose goes
unused and builds up in the blood.
Type 1 diabetes accounts for approximately
10 per cent of all people with diabetes but is
increasing rapidly in all age groups, with a
particularly steep rise amongst children
under five years old.
The evidence is growing that a combination of
susceptible genes and early exposure to cows'
milk is responsible for this self-harming reaction
of the body. A virus or other infection may also be
implicated in triggering the condition.
|
HbA1c & Glucose Blood Levels |
|
HbA1c (%) |
Avg. Blood Glucose (mmol/l) |
Stage of diabetes |
13 12 11 10 9 8 7 |
18 17 15 13 12 10 8 |
Levels of HbA1c above 6.5% are considered diabetic |
| 6 |
7 |
HbA1c 6 - 6.5% is
considered pre-diabetes or at risk of diabetes |
| 5 |
5 |
HbA1c 3.5 - 5.5% is considered normal |
Type 2 diabetes
In type 2 diabetes, the body can still make
some insulin but not enough, or it doesn't
react to insulin properly (insulin resistance)
so, again, glucose builds up in the blood.
Approximately 90 per cent of all people with
diabetes in the UK have type 2.
It usually develops in people over the age of
40, but South Asian and African-Caribbean
people are at greater risk as they often become
diabetic relatively early in life - around the age
of 25. The disease is rapidly becoming more common in children, adolescents and young
people of all ethnicities as it is closely linked to
the rapid increase in childhood obesity.
Metabolic syndrome
Metabolic syndrome, or Syndrome X, is
characterised by central obesity (weight
accumulated mostly around the waist), raised
blood pressure, raised triglycerides (fats in the
blood), low HDL (the 'good' cholesterol that is
being cleared from the bloodstream) and
impaired glucose metabolism. Impaired
glucose metabolism means that the body is
not using glucose properly and the level in the
blood is raised but has not yet reached
diabetic levels.
All these symptoms significantly increase
the risk of diabetes and cardiovascular
(heart) disease.
Pre-diabetes
Those with impaired glucose metabolism are
diagnosed with pre-diabetes - a condition
associated with insulin resistance. The main
cause is obesity and related risk factors
include high blood pressure, low HDL
cholesterol, and high triglycerides.
Pre-diabetes almost always precedes type 2
diabetes but many people don't know they
have it until diabetes develops. However, both
pre-diabetes and metabolic syndrome are
reversible with the right approach.
It's not all sweet
Diabetes is not usually diagnosed immediately
after it starts and so by the time the diagnosis
is made, many people will have already
developed other health complications
resulting from diabetes. Even those who are
aware of their diabetic condition and have
adjusted their lifestyle, are still at
considerable risk of heart disease, stroke,
eye problems, kidney disease, nerve damage
and amputations.
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