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First published: December 3, 2006
Diabetes may be detected in a routine urine test where excess glucose is present. In the case of type 1 diabetes, people often develop symptoms over a short period of time, usually weeks. They may feel thirsty all the time and need to urinate a lot, and they may feel tired and lose weight.
A blood test that measures the level of glucose in the blood will confirm whether or not the underlying cause is, indeed, diabetes.
Causes of diabetes
Find out what's at the root of type 1 and type 2 diabetes (case of find the cause=treatment)
In type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.
It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:
- infection with a specific virus or bacteria
- exposure to food-borne chemical toxins
- exposure as a very young infant to cow's milk, where an as yet unidentified component triggers the autoimmune reaction
However, these are only hypotheses and are by no means proven causes.
In this type of diabetes the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance.
In response to this more insulin may be produced, and this overproduction exhausts the insulin-manufacturing cells in the pancreas. There is simply insufficient insulin available and the insulin that is available may be abnormal and therefore doesn't work properly.
The following risk factors increase the chances of someone developing type 2 diabetes:
- increasing age
- physical inactivity
Rarer causes of diabetes include:
- certain medicines
- pregnancy (gestational diabetes)
- any illness or disease that damages the pancreas and affects its ability to produce insulin, such as pancreatitis
What doesn't cause diabetes?
It's important to be aware of the myths that have arisen about the causes of diabetes. Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing type 2 diabetes.
Stress does not cause diabetes, although it may be a trigger for the body turning against itself, as in the case of type 1 diabetes. It does, however, make the symptoms worse for those who already have diabetes.
Diabetes is not contagious. Someone with diabetes can't pass it on to anyone else.
Types of diabetes
There are two main types of diabetes:
- In type 1, the body's unable to produce any insulin. This usually starts in childhood or young adulthood. It's treated with diet control and insulin injections. Type 1 diabetes used to be called 'insulin-dependent diabetes'.
- In type 2 diabetes, not enough insulin is produced or the insulin that is made doesn't work properly. This tends to affect people as they get older, and usually appears after the age of 40. It used to be known as maturity-onset diabetes or non-insulin dependent diabetes (NIDDM). As the lifestyles of Ugandans continue to improve in some sectors, I believe this is soon to become more common.
Normal blood sugar control
In the body, glucose is converted into energy. This glucose comes ready-made in sweet foods such as sweets and cakes; from starchy foods such as potatoes, cassava, yam, pasta or bread or even certain fruits such as bananas, mangoes, jackfruits and even sugarcane, when they're digested. The liver is also able to manufacture glucose.
Under normal circumstances the hormone insulin, which is made by the pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells to absorb enough glucose from the blood for the energy, or fuel, that they need. Insulin also stimulates the liver to absorb and store any glucose that's left over.
After a meal the amount of glucose in the blood rises, and this triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too. A second hormone manufactured by the pancreas is called glucagon. It stimulates the liver to release glucose when it's needed, and this raises the level of glucose in the blood.
Insulin is manufactured and stored in the pancreas, which is a thin gland about 15cm (6in) long that lies crosswise behind the stomach. It's often described as being two glands in one, since in addition to making insulin it also produces enzymes that are vital for digestion of food. These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.
Who is at risk?
Diabetes may run in families (sometimes referred to as a genetic or hereditary gene) but many people can't necessarily avoid the condition because it affects so many in old age.
It's predicted that over the next ten years the number of people with diabetes will double.
There are two main aims when considering the prevention of diabetes:
- to try to prevent people developing diabetes at all
- if someone does develop diabetes, to help them avoid the possible complications of the condition
Those people with a family history of type 1 diabetes are at an increased risk of developing the condition.
Things that put a person at greater risk of developing type 2 diabetes are:
- getting older
- being of Asian or African (+Afro-Caribbean) origin
- being a woman who has given birth to a large baby
- being overweight
- being inactive
Because of these last two factors it's important to:
- eat meals regularly during the day
- eat foods that are low in fat and salt
- eat lots of fruit, vegetables and pulses such as beans, lentils and peas
- cut down on sugar and have reduced sugar foods and drinks
A healthy diet needs to be combined with regular exercise to help the weight stay off ('exercise' refers to anything that gets the heart rate up). Ideally you should exercise for at least 30 minutes at least five times a week. Walking, cycling, dancing and swimming are fun and easy for most people to do.
In the past, people with diabetes weren't encouraged to take part in sporting activities. Nowadays, diabetes should not hinder anyone's desire to keep fit.
Blood sugar levels
If blood sugar levels fall or rise abnormally in someone with diabetes, they will experience a variety of symptoms.
A 'hypo' is the name given to those times when the blood sugar level falls below normal. It's short for hypoglycaemia, which means low blood sugar.
A 'hypo' may occur:
- after an insulin injection
- after taking oral diabetes medication
- if a meal is missed or delayed
- after strenuous exercise
- if alcohol is taken on an empty stomach
The symptoms of a 'hypo' vary from person to person. Mild 'hypo' may cause:
- mood swings
A mild 'hypo' can usually be treated with some form of sugar. Types of sugar to use during mild 'hypo':
- dextrose tablets (that the person with diabetes should carry with them)
- three sugar lumps
- two teaspoons of sugar
- chocolate or sweet biscuits
- a sweet drink
When the blood glucose level falls even lower, then the person may behave strangely and become confused (often mistakenly interpreted as drunkenness). Under these circumstances it may be easier and quicker to give sugar in liquid form, such as a sweet drink.
In severe hypoglycaemia the person loses consciousness. Under these circumstances an injection of glucagon is given, which temporarily raises the level of blood glucose. Once the person is conscious they can be given some sugar and a good snack to prevent the 'hypo' from recurring. People with diabetes and those close to them are taught to look out for signs that their sugar level may be low, and are advised to always have some sugar tablets or another form of sugar available to quickly raise the level. This solves the problem quickly and prevents serious consequences.
People with diabetes are advised to carry some form of identification saying that they have diabetes, so that people will realise their condition should they get into difficulty and need help.
Hyperglycaemia means that the blood glucose level is too high. When the levels are mildly raised then symptoms of uncontrolled diabetes occur, namely excessive thirst, passing urine frequently, tiredness, weakness and lethargy.
If the blood glucose level becomes dangerously high then the person becomes dehydrated and may fall comatose. This is a medical emergency needing hospital treatment.
Next... Related Illnesses.
The above information is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Please ensure you check with your physician as the above may also be indicative of other underlying causes or sometimes due certain types of medication.
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First published: December 3, 2006