What is Diabetes?

Diabetes is a metabolic disorder. This means that there is a problem with the way the body uses digested food. To explain what diabetes is, we must first consider what happens in normal metabolism.

In normal metabolism, starches and sugars are digested and broken down to a simple sugar, known as glucose. Glucose then passes into the bloodstream and then into cells to be used as energy.   Insulin is a hormone that allows the food to actually enter the cells.   Insulin is made by the Pancreas.  

The pancreas is actually a gland organ that produces both hormones and digestive enzymes and is located in the upper abdomen beneath the stomach.  Insulin is not the only hormone produced by the Pancreas, it also produces glucagon which regulates the amount of glucose stored in the liver.  The two hormones work antagonistically - insulin will lower the amount of glucose in the blood and increase the amount stored in the liver, while glucagon will work to increase the blood sugar levels when they are insufficient.  

When not enough insulin is made or the insulin is not used appropriately by the body the condition is called Diabetes Mellitus.  In diabetes the glucose accumulates in the blood and is eventually passed out in the urine, wasting an important fuel.  The accumulated blood sugar can also damage many of the body’s systems such as heart, nerves, kidneys, eyes and also blood vessels.

Symptoms

  • Polyuria - urination becomes more frequent when there is too much glucose in the blood.
  • Polydipsia -  excessive thirst caused by dehydration from excessive urination unintentional weight loss
  • weakness and fatigue
  • Neuropathy - numbness or tingling in the extremities such as hands.
  • dry and/or itchy skin
  • infections and bruises that taking a long time to heal
  • blurred vision


Types of Diabetes

There are 3 main types of diabetes, Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes:

  • Type 1 diabetes is caused by the body's failure to produce insulin. People with Type 1 Diabetes, therefore, require daily injections of insulin to survive. Symptoms of type 1 diabetes usually develop over a short period. Type 1 diabetes can develop at any age but is most commonly diagnosed in children and young adults.
  • Type 2 Diabetes is caused by the body not producing enough insulin or not using insulin effectively. This is the most common form of diabetes and accounts for around 90% of all diabetes. People with Type 2 Diabetes are usually older than 20 and are often overweight or obese.  People with this type tend to have less symptoms of diabetes at diagnosis and, as a consequence, almost half of all people with Type 2 Diabetes are not aware that they have this life-threatening condition.  
  • Gestational Diabetes refers to diabetes occurring during pregnancy. In this condition blood glucose levels rise because the body does not produce enough insulin to meet the extra demands of pregnancy. It affects less than one in 20 pregnant women and usually disappears after birth, although women with gestational diabetes are more at risk of developing Type 2 Diabetes later in life. Gestational diabetes can be treated by following a healthy diet or through diet and insulin injections.

Complications Associated with Diabetes

  • Cardiovascular disease (CVD).  CVD accounts for between 50% and 80% of deaths in people with diabetes. Risk factors include high blood pressure, high blood cholesterol levels and obesity. Recognition and management of these conditions can help delay or prevent heart disease in people with diabetes.
  • Diabetic neuropathy refers to nerve disorders caused by diabetes and is probably the most common diabetic complication. Studies suggest that up to 50% of people with diabetes are affected to some degree. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men.
  • Diabetic retinopathy refers to damage to the retina of the eye.  Diabetic retinopathy is a leading cause of blindness and visual disability.  Research indicates that at least 90% of these new cases of diabetic retinopathy could be reduced if there was proper and vigilant treatment and monitoring of the eyes.
  • Kidney failure may be caused by diabetes which is among the leading causes of kidney failure.
  • Problems in pregnancy and delivery as babies born to mothers with diabetes are at increased risk of problems during the pregnancy and birth.  This may include problems such as macrosomia which is a large baby for their gestational age; such babies may suffer from their own problems such as very low blood sugar levels.  By controlling glucose levels for the duration of their pregnancy, woman can control these risks.

Prevention and Treatment of Diabetes

  • Primary prevention:  A healthy diet and regular physical activity is vital from the prevention of Type 2 diabetes.
  • Secondary prevention:  includes early detection and good treatment. The treatment of high blood pressure and raised blood lipids, as well as the control of blood glucose levels, can substantially reduce the risk of developing complications and slow their progression.

Type 2 diabetes can sometimes be managed with diet and lifestyle measures alone, but oral medications are often required, and less frequently insulin.  

Diet Recommendations for Diabetes (in 2014)
Recommendations suggest that people with diabetes should follow a diet where 50% of energy they consume comes from carbohydrate (starches and sugars) with only 10% of total being simple sugars (sucrose). 35% of total energy should come from fats, particularly from monounsaturated fats and 15% of total energy should come from protein.