Diabetes (Diabetes Mellitus)

Diabetes (Diabetes Mellitus)

Diabetes is the name given to a group of conditions that make it difficult to use glucose the way it’s meant to be used. The official name is Diabetes Mellitus (Latin for sweet).

All the conditions result in excessive glucose levels in the blood, although get there in different ways. All of them however are due to some deficiency in insulin, either relative or absolute. Think of insulin as the key that unlocks the gate for insulin to get into most cells.

Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease where the body’s immune system attacks the cells in the pancreas that create insulin. This soon causes an absolute deficiency of insulin, and the body is unable to move most of the glucose it’s absorbing.

It requires replacement of the insulin and cannot be treated with just diet or exercise alone.

Type 2 Diabetes Mellitus (T2DM) is considered a relative deficiency of insulin. As the body begins to take on more energy and store this the body makes more insulin to try and store this away. Eventually the receptors become desensitised, so more insulin is made, and later the ability to make insulin is reduced. So while you still have some in production, your body makes less – and your receptors aren’t as receptive.

T2DM is associated with hereditary factors and lifestyle risk factors including diet, insufficient physical activity and being overweight or obesity.

Lifestyle management of diabetes is very possible. It does take some hard work, needs careful monitoring and learning lots of information about exercise and diet, but it is well worth it; however, diabetes medications or insulin replacement may also be required to control blood sugar levels if the glucose or HbA1C levels are particularly high.

Type 2 diabetes occurs mostly in people aged over 40 years old; however, the disease is also becoming increasingly prevalent in younger age groups.

Gestational Diabetes Mellitus (GDM) occurs during pregnancy. The condition usually disappears once the baby is born; however, a history of gestational diabetes increases a woman’s risk of developing type 2 diabetes later in life.

Three to eight percent of pregnant women are affected, and blood sugar levels are monitored quite carefully during pregnancy to detect, diagnose and manage GDM.

The condition may be managed through adopting healthy dietary and exercise habits, although diabetes medication, including insulin, may also be required to manage blood sugar levels.

Gestational diabetes can cause excessive growth and fat in the baby. If the mother’s blood glucose levels remain raised, the baby may be larger than normal. Following delivery, the baby may experience low blood glucose levels, particularly if the mother’s blood glucose levels were raised before the birth.

Gestational diabetes can be monitored and treated and, if well controlled, these risks are greatly reduced. The baby will not be born with diabetes.

Prediabetes isn’t really a condition, but a name given to people who are at much higher risk of T2DM and have had several high glucose readings, but not high enough to diagnose T2DM formally.

The way to think of having high blood glucose levels is that the body is already beginning to struggle keeping the glucose at the right set point, between 3.4-5.4mmol/L. It’s like standing on an escalator. If you do nothing, you’ll reach the level of T2DM. So here you can get back down to normal sugars, you just have to work against it. It’s very doable with the right guidance.

Complications of diabetes

Why does this glucose level matter? Because if it’s left to run wild, it causes significant damage to the body. These initially affect the smaller blood vessels (microvascular disease) and the organs that are supplied by these, and eventually the larger blood vessels (macrovascular disease) and the organs supplied by those.

Significant complications include

  • Kidney damage (nephropathy) leading to kidney failure
  • Eye damage (retinopathy) leading to blindness
  • Nerve damage (neuropathy) leading to numbness, pain, sores and infections
  • Sexual difficulties (erectile dysfunction
  • Cardiovascular disease (angina, heart attacks, strokes)

Symptoms

Early symptoms of high blood glucose levels include

  • being more thirsty than usual
  • passing more urine
  • feeling tired and lethargic
  • slow-healing wounds
  • itching and skin infections, particularly around the genitals
  • blurred vision
  • nausea and vomiting
  • weight loss
  • mood swings

Testing

Checking for diabetes is prompted if you have a rich family history, have high risk factors for diabetes (check out the Ausdiab T2DM risk assessment tool) and have a chat with your doctor.

Summary

Diabetes is becoming more common. T1DM is diagnosed early, and good control and management is necessary. T2DM is preventable and manageable, and in some cases curable. GDM is most definitely manageable and all pregnant women who undertake shared care with their GP will be tested for this.

But prevention is always key. Keeping a healthy weight, healthy waist circumference, regular physical activity and eating a well balanced healthy diet will keep it at bay, but also make you feel great and get the most out of all your days.

For any questions book in with your doctor at GS Health to have a chat.

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