diabetes
Definitions
Diabetes definitions
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.
Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.
Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious.
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
Diabetes occurs when there’s too much glucose in your blood. This happens when your body cannot produce enough insulin or use it properly.
Glucose the main source of energy for our bodies.
To ensure our bodies are working properly, we need to maintain healthy levels of glucose in our blood.
When we eat foods containing carbohydrate such as bread, pasta, rice, cereals, fruits, starchy vegetables, milk and yoghurt, they are broken down to glucose, which moves into our blood supply.
This is where ‘blood glucose’ or ‘blood sugar’ comes from. Glucose is also stored and released in your body by the liver.
The level of glucose in the blood is normally controlled by a hormone called insulin which is made by special cells in the pancreas, called beta cells.
Insulin acts as a key to unlock cells in the body and allow glucose to enter. Only then can it be used as a source of energy for our bodies.
Diabetes develops when glucose cannot enter the body’s cells, preventing it from being used for energy.
This is why blood glucose levels are higher in people with diabetes. High blood glucose can cause short and long term damage to the body.
Complications can impact many areas of the body including heart, brain, kidneys, eyes and feet.
Diabetes is a serious complex condition which can affect the entire body. Diabetes requires daily self care and if complications develop, diabetes can have a significant impact on quality of life and can reduce life expectancy. While there is currently no cure for diabetes, you can live an enjoyable life by learning about the condition and effectively managing it.
There are different types of diabetes; all types are complex and serious. The three main types of diabetes are type 1, type 2 and gestational diabetes.
How does diabetes affect the body?
When someone has diabetes, their body can’t maintain healthy levels of glucose in the blood. Glucose is a form of sugar which is the main source of energy for our bodies. Unhealthy levels of glucose in the blood can lead to long term and short term health complications.
For our bodies to work properly we need to convert sugars from food into energy. Sugars from food are converted into glucose. A hormone called insulin is essential for the conversion of glucose into energy. In people with diabetes, insulin is no longer produced or not produced in sufficient amounts by the body. When people with diabetes eat foods that contain sugars or starches, such as breads, cereals, fruit and starchy vegetables and sweets, it can’t be converted into energy and the level of glucose in their blood rises and is harmful to them.
Instead of being turned into energy the glucose stays in the blood resulting in high blood glucose levels. After eating, the glucose is carried around your body in your blood. Your blood glucose level is called glycaemia. Blood glucose levels can be monitored and managed through self care and treatment.
Three things you need to know about diabetes:
It is not one condition- there are three main types of diabetes: type 1, type 2 and gestational diabetes
All types of diabetes are complex and require daily care and management
Diabetes does not discriminate, anyone can develop diabetes
Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy.
Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.
If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
There isn’t a cure yet for diabetes, but losing weight, eating healthy food, and being active can really help. Taking medicine as needed, getting diabetes self-management education and support, and keeping health care appointments can also reduce the impact of diabetes on your life.
Type 1 Diabetes
Type 1 diabetes is an autoimmune disease.
This means that the body’s own immune
system has attacked the insulin producing
cells of the pancreas. The pancreas can no
longer produce insulin when this occurs.
Although often diagnosed in childhood or
adolescence, it can occur at any age.
Type 2 Diabetes
Type 2 diabetes occurs when the pancreas
does not produce enough insulin or the
insulin being produced does not work
effectively (this is called insulin resistance).
Although often diagnosed in adulthood,
more and more children and teens are
being diagnosed
Gestational Diabetes
Mellitus (GDM)
GDM occurs during pregnancy when the
pregnancy hormones block the action of
insulin. This leads to insulin resistance and
high blood glucose levels.
Diabetes from other causes
In addition to type 1, type 2, and gestational diabetes, a small minority of people develop specific types of diabetes due to other causes. This includes:
Monogenic diabetes syndromes, such as neonatal diabetes and maturity-onset diabetes of the young (MODY)
Diseases of the exocrine pancreas, such as cystic fibrosis and pancreatitis
Drug or chemical-induced diabetes, such as with glucocorticoid use, in the treatment of HIV/AIDS or after organ transplantation
Because these types of diabetes are rare, they are often misdiagnosed as other types of diabetes. You can learn more about these types of diabetes in the Classification and Diagnosis of Diabetes section in the Standards of Medical Care in Diabetes.
‘Other’ diabetes is a name for diabetes resulting from a range of different health conditions or circumstances.
Diabetes resulting from specific health conditions and diseases
Some people may develop ‘other’ diabetes because of a different health condition or disease. This type of ‘other’ diabetes includes:
diseases affecting the pancreas, for example, cystic fibrosis, cancer, pancreatitis, pancreatectomy
endocrine diseases, for example, Cushing’s syndrome, acromegaly
genetic syndromes, for example, Down syndrome, Friedreich ataxia and Turner syndrome
viral infections, for example, congenital rubella and cytomegalovirus.
Diabetes resulting from medications
‘Other’ diabetes can also be triggered from medications that people may need to manage or treat certain health conditions. This type of ‘other’ diabetes may be a temporary condition, but it can also be permanent. Examples of medications that can trigger this type of ‘other’ diabetes are:
glucocorticoids, for example, cortisone (prednisone)
medication prescribed for a cancer or to stop an organ-transplant rejection
medication used to treat high blood pressure (thiazides)
medication used to treat hypothyroidism
medication used to treat high cholesterol (statins)
medication used to treat epilepsy
medication used to treat certain mental health problems.
https://www.ndss.com.au/about-diabetes/other-types-of-diabetes/
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all deaths due to diabetes occurred before the age of 70 years.
Between 2000 and 2016, there was a 5% increase in premature mortality rates (i.e. before the age of 70) from diabetes. In high-income countries the premature mortality rate due to diabetes decreased from 2000 to 2010 but then increased in 2010-2016. In lower-middle-income countries, the premature mortality rate due to diabetes increased across both periods.
By contrast, the probability of dying from any one of the four main noncommunicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases or diabetes) between the ages of 30 and 70 decreased by 18% globally between 2000 and 2016.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. More than 95% of people with diabetes have type 2 diabetes. This type of diabetes is largely the result of excess body weight and physical inactivity.
Symptoms may be similar to those of type 1 diabetes but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen.
Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Gestational diabetes
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Impaired glucose tolerance and impaired fasting glycaemia
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
Health impact
Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.
Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes(1).
Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.
Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Close to 1 million people are blind due to diabetes(2).
Diabetes is among the leading causes of kidney failure(3).
Prevention
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
achieve and maintain a healthy body weight;
be physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
eat a healthy diet, avoiding sugar and saturated fats; and
avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.
Diagnosis and treatment
Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar.
Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications.
Interventions that are both cost-saving and feasible in low- and middle-income countries include:
blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin;
blood pressure control; and
foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
Other cost saving interventions include:
screening and treatment for retinopathy (which causes blindness);
blood lipid control (to regulate cholesterol levels);
screening for early signs of diabetes-related kidney disease and treatment.