Explaining Diabetes

• Publisher: Straightforward Publishing Digital
• Year: 2016
• ISBN:
  9781847166661
• Topic: Medicina
• Subtopic: Endocrinologia e metabolismo

Diabetes, particularly Type 2 Diabetes, is perhaps one of the biggest health threats we face today. There are a number of factors, creating a 'perfect storm' which come together to create diabetes, not least the diet we eat and the lifestyles adopted generally in the 21st century. Explaining Diabetes is a comprehensive guide to diabetes whether type 1 or type 2 and offers the reader guidelines which will help to either avoid the onset or, if already diagnosed, to manage the condition.

Chapter 1

What is Diabetes?

Without a doubt, diabetes (full name Diabetes Mellitus) is one of the most widespread conditions affecting people today, in the United Kingdom and elsewhere. It is one of the oldest known human diseases, and there are several types, one slightly more severe and needing greater control than the other:

• Diabetes 1 (where insulin injections are needed) which most commonly starts in younger patients who need to have regular doses of insulin to stay healthy and:

• Diabetes 2, commonly controlled through the use of tablets, which is usually age related and can be brought on through lifestyle, i.e. lack of exercise and bad diet.

Diabetes is caused through having too much glucose in your blood which results in a change in your internal chemistry. Ultimately, the cause of diabetes is a deficiency of the hormone insulin.

Type 1 diabetes

Who gets diabetes?

Over 4 per cent of people in the UK have diabetes, with many people not realising that they have it. The number is increasing. The vast majority have type 2, and more women than men are affected. This is possibly because diabetes, particularly type 2, occurs later in life and women tend to live longer. However, as the age of the population is rising, type 2 diabetes is likely to become more common as time goes by.

In addition to the UK statistics, the incidence of diabetes is rising worldwide. the numbers of children with type 1 diabetes is on the rise and the numbers of young people with type 2 diabetes is also rising because of the rise in obesity. As the food industry won’t really change radically, with fast food just as prevalent, a growing awareness of the damaging effects of food has been promoted. Unfortunately, like a lot of illness, people don’t actually sit up and take notice until it happens to them!

Type 1 diabetes and insulin

In the later part of the 19th century, two doctors in Germany discovered the fact that the pancreas-a large gland behind the stomach-produced a substance that regulated the level of blood glucose, stopped it rising. Later in the 20th century scientists isolated this substance and named it insulin. This came from a small group of cells within the pancreas, which were called the Islets of Langerhans.

Insulin became available as a treatment from 1922 onwards and was heralded as a life-saving miracle helping people who otherwise might have died from the condition.

Insulin is a hormone. It works as a chemical messenger that helps your body use the glucose in your blood to give you energy.

You can think of insulin as the key that unlocks the door to the body’s cells. Once the door is unlocked, glucose can enter the cells where it is used as fuel. In Type 1 diabetes the body is unable to produce any insulin so there is no key to unlock the door, and the glucose builds up in the blood. In essence, what happens is:

• The body can’t use glucose to provide energy and tries to get it from elsewhere and starts to break down stores of fat and protein instead. This can cause weight loss. Because the body doesn’t use the glucose it ends up passing into the urine. This may be triggered by a virus or other infection.

Type 2 diabetes

Type 2 diabetes usually appears in people over the age of 40, though in South Asian people, who are at greater risk, it often appears from the age of 25. It is also increasingly becoming more common in children, adolescents and young people of all ethnicities. Type 2 diabetes accounts for between 85 and 95 per cent of all people with diabetes and is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin are often required, particularly in the early stages.

With type 2 diabetes there is not enough insulin (or the insulin isn’t working properly), so the cells are only partially unlocked and glucose builds up in the blood.

Other mechanisms in the body work together with insulin to help maintain the correct levels of glucose, although it is a fact that insulin is the only means that the body has of actually lowering blood glucose levels. After a meal, if there is an insulin deficiency then there will be no brake on the glucose absorbed from what you have eaten and the levels in your blood will carry on rising. When the concentration of glucose rises above a certain level, the glucose will spill out of the bloodstream and into the urine, which can lead to infections.

In addition, excess glucose will lead to the passing of more urine because the glucose in the blood is filtered out by the kidneys, which try to dispose of it by excreting more salt and also water. This is called polyuria and is often the earliest sign of diabetes. If nothing is done to stop or prevent this process dehydration will occur. Insulin also acts to prevent weight loss. Lack of insulin will inevitably lead to weight loss.

There are a number of early indicators of diabetes in a person, the severity of which will depend on the type of diabetes that they have, either type 1 or type 2.

The main symptoms are:

• Thirst

• Dehydration

• Passing large quantities of urine

• Infections in the urinary tract, such as cystitis or thrush

• Tiredness and lethargy

• Blurred vision resulting from a dehydrated lens in the eye.

Genetics of Diabetes

Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to develop diabetes than others.

What leads to genetic diabetes?

Type 1 and type 2 diabetes have different causes. Yet two factors are important in both. You inherit a predisposition to the disease then something in your environment triggers it.

Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other’s risk is at most 3 in 4.

Type 1 Diabetes

In most cases of type 1 diabetes, people need to inherit risk factors from both parents. Because most people who are at risk do not get diabetes, researchers want to find out what the environmental triggers are.

One trigger might be related to cold weather. Type 1 diabetes develops more often in winter than summer and is more common in places with cold climates. Another trigger might be viruses. Perhaps a virus that has only mild effects on most people triggers type 1 diabetes in others.

Early diet may also play a role. Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages.

In many people, the development of type 1 diabetes seems to take many years. In experiments that followed relatives of people with type 1 diabetes, researchers found that most of those who later got diabetes had certain autoantibodies in their blood for years before.

Type 2 Diabetes

Type 2 diabetes has a stronger link to family history and lineage than type 1, although it too depends on environmental factors.

Studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.

Lifestyle also influences the development of type 2 diabetes. Obesity tends to run in families, and families tend to have similar eating and exercise habits.

If you have a family history of type 2 diabetes, it may be difficult to figure out whether your diabetes is due to lifestyle factors or genetic susceptibility. Most likely it is due to both. However, don’t lose heart. Studies show that it is possible to delay or prevent type 2 diabetes by exercising and losing weight. See chapter 4 for an outline of the ideal diet for those with diabetes and also chapter 4 for exercises.

Type 1 Diabetes: Your Child’s Risk

In general, if you are a man with type 1 diabetes, the odds of your child developing diabetes are 1 in 17. If you are a woman with type 1 diabetes and your child was born before you were 25, your child’s risk is 1 in 25; if your child was born after you turned 25, your child’s risk is 1 in 100.

Your child’s risk is doubled if you developed diabetes before age 11. If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.

There is an exception to these numbers. About 1 in every 7 people with type 1 diabetes has a condition called type 2 Polyglandular autoimmune syndrome. In addition to having diabetes, these people also have Thyroid disease and a poorly working Adrenal gland. Some also have other Immune system disorders. If you have this syndrome, your child’s risk of getting the syndrome — including type 1 diabetes — is 1 in 2.

Tests can also make your child’s risk clearer. A special test that tells how the body responds to glucose can tell which School-aged children are most at risk.

Another more expensive test can be done for children who have siblings with type 1 diabetes. This test measures antibodies to insulin, to islet cells in the pancreas, or to an enzyme called glutamic acid decarboxylase. High levels can indicate that a child has a higher risk of developing type 1 diabetes.

Type 2 Diabetes: Your Child’s Risk

Type 2 diabetes runs in families. In part, this tendency is due to children learning bad habits-eating a poor diet, not exercising-from their parents. But there is also a genetic basis. In general, i...