So. Diabetes. What is it? What are the symptoms? Are there different types? Will I need insulin? In this capsule, we'll give you an overview of diabetes and help answer the most common questions we get asked as doctors.
Diabetes mellitus is when the sugar levels in your blood are too high- "mellitus" means honeyed or sweet in Latin, and diabetes means passing through. This occurs when either you’re not producing enough of a hormone called insulin, or your insulin is not working properly. Insulin is made by your body and it helps move glucose (sugar) from the bloodstream into the cells of your body so it can be used as energy.
The typical symptoms of diabetes are feeling very thirsty and needing to urinate more than normal, having to get up a lot in the night to go pee is a common complaint in people with undiagnosed diabetes. Other symptoms can include losing weight, feeling particularly tired, changes to your vision or sensations in your hands and feet, cuts or wounds taking longer to heal than normal or getting more infections than usual such as thrush. If you have any symptoms that could be diabetes you should see your doctor, who will send you for a blood test.
The three most common types of diabetes are type 1, type 2 and gestational diabetes. In Type 1 diabetes your body's immune system attacks the pancreas where insulin is made so your body is unable to make insulin. It can start at any age but it usually starts when you’re young, in childhood or in teens. Type 1 diabetes is more likely than the other types to cause weight loss. Symptoms progress quickly and you may get quite unwell. It can be life-threatening if not treated, and this requires insulin injections. Type 2 diabetes usually causes very mild symptoms to start with. These worsen slowly over months to years. It is usually found in older people or people who are overweight. Type 2 diabetes occurs when your pancreas doesn’t produce enough insulin or the insulin is not working to move the sugar from the blood into your body's cells. It can be treated with diet changes and weight loss if mild, or medications – if severe and not responding to medications, it may require insulin injections. Gestational diabetes is diabetes can develop in pregnancy. It doesn’t usually cause symptoms but it's one of the checks at your antenatal appointment. A close eye will be kept on you and your growing baby during pregnancy, and treatment is sometimes started to protect you both from complications. The diabetes usually improves some weeks after giving birth, but you’re at a higher risk of it coming back for future pregnancies and of developing Type 2 diabetes in the future.
There is no cure for diabetes, however, there are ways to manage it so that it is controlled the best it can be in order for it to have as little impact on your life as possible. You will have regular checks with your doctor, medication may be introduced, depending on the type of diabetes and the severity. You will need to make lifelong lifestyle changes – regular exercise and weight loss, if appropriate, and following a healthy diet. Type 1 diabetes needs careful management with insulin – your specialist diabetes team will teach you to match insulin doses to what you’re eating and when you’re exercising, and they’ll teach you how to make the best food choices. This is immediately life-threatening if left untreated. It’s important to keep both Type 1 and Type 2 diabetes under control to avoid health problems further down the line. Diabetes carries a risk to blood vessels, especially those to the heart, brain and kidneys. Left poorly treated, you increase your risk of heart attacks, strokes and kidney disease. It can also affect your eyesight, and this will be checked every year. It’s similar to looking after your blood pressure if this runs high – it carries the same risks to your blood vessels.