13/11/2023
Diabetes is one of those conditions we’ve all heard of, and many of us are living with it. In fact, 529 million people globally, with estimates expected to exceed 1.3 billion by 20501. In 2019, 1.5 million deaths were directly attributed to diabetes2. Most people with diabetes, with the right medication and management, can live completely unencumbered lives and new technologies are making it even simpler. However, if the right care is not provided, diabetes can increase your risk of several serious complications. Estimates claim that diabetes is responsible for 770 strokes, 590 heart attacks and over 2000 cases of heart failure every week3 – justifying Diabetes reputation as one of the world’s largest silent killers.
Since 1991, every year on November 14th we recognise World Diabetes Day allowing us to raise awareness of the signs of diabetes and encourage people to take measures to reduce their risk of developing this increasingly common disease.
What is Diabetes?
Insulin signalling is a crucial process that helps our bodies manage glucose (sugar) levels in the blood. When we eat, the pancreas releases insulin, which acts like a key, allowing cells to absorb sugar from the bloodstream. This sugar can then be used for energy or stored for later use. As cells take in the sugar, the overall blood sugar levels decrease, maintaining a healthy balance4.
Glucose
Glucose is a vital source of energy for the body's cells, serving as the primary fuel for various bodily functions. It plays a crucial role in powering the brain, muscles, and other tissues, enabling them to carry out essential tasks such as thinking, moving, and repairing themselves. Moreover, glucose serves as a building block for larger molecules like carbohydrates and helps maintain the body's overall energy balance. Despite its importance, it's crucial to regulate glucose levels to prevent complications associated with high or low blood sugar, ensuring the proper functioning of the body's intricate systems..
What forms of Diabetes are there?
The main forms of diabetes are type 1 and type 2 Diabetes. These diseases may be similar in name but arise for different reasons and require distinct therapeutic strategies. Therefore, it is paramount that the correct form is diagnosed, otherwise, there's a chance of serious complications.
What is the difference between Type 1 & Type 2 Diabetes
You’ve probably heard people discussing type 1 and type 2 diabetes, but the differences are not as commonly known. In brief, type 1 diabetes is an autoimmune reaction, whereas type 2 is a combination of factors resulting in insulin resistance. Let’s look at each of them in a little more detail.
Type 1 diabetes is defined as a lack of insulin secretion by cells in the pancreas which can affect people of any age, however, it is most diagnosed in childhood, in early teenage or early adult years5.
Simply put, an autoimmune reaction causes cells of the immune system to attack cells in the pancreas called β-cells, those responsible for producing insulin. This autoimmune reaction causes the selective destruction of the β-cells and therefore, insulin is not produced. No insulin means the body cannot break down and process glucose6. Accumulations of glucose can have some serious consequences such as the development of problems with the eyes, heart, kidneys, nerves and more7.
Genetics play a major role in Type 1 diabetes, but that doesn’t mean you’ll definitely inherit it from your parents. There are several genes involved in giving rise to Type 1 diabetes and while having these genes doesn’t mean you will develop Type 1 diabetes; it does mean you’re at increased risk8. There are also other factors at play. If it was simply a genetic disease, the number of people developing this condition wouldn’t be rising as fast as it is. Some of the other factors scientists think might be contributing to the increased incidence of this form of diabetes are viral infections, particularly of human enteroviruses, changes in the gut microbiome and possibly diet8.
Type 2 diabetes is the more common type: around 90% of diabetes diagnosis3. It is a metabolic disorder where the body doesn’t produce enough insulin to maintain normal blood sugar levels or the insulin it does produce doesn’t work properly (insulin resistance)6. This results in high levels of sugar in the bloodstream, leading to various health complications.
Factors such as excess body weight, unhealthy diet, and a sedentary lifestyle can contribute to the development of type 2 diabetes. It can affect people of all ages; however, most people have a family history and are diagnosed after the age of 25. People from Black African, African Caribbean, and South Indian backgrounds are at a higher risk of developing type 2 diabetes9. Other important risk factors are increasing age, being overweight and having a close relative with diabetes9.
Symptoms
Diabetes manifests with a range of symptoms that can vary in severity and presentation. Common signs include increased thirst and hunger, frequent urination, unexplained weight loss, and fatigue. Individuals might also experience blurred vision, slow wound healing, and recurring infections10. In more severe cases, diabetes can lead to complications such as cardiovascular disease, kidney damage, and eye problems. Early detection and management of these symptoms are crucial in controlling the condition and preventing further health complications10.
Failing to control glucose levels may result in diabetic ketoacidosis. Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body can't use glucose as a fuel source because of a lack of insulin. To compensate, the body starts to break down fat for energy, leading to the production of acidic compounds called ketones. As ketone levels rise, the blood becomes more acidic, which can cause nausea, vomiting, fruity-smelling breath, confusion, and even loss of consciousness. Diabetic ketoacidosis requires immediate medical attention to restore the body's acid-base balance and prevent potentially life-threatening complications11.
Prevention
Unfortunately, there is no cure for diabetes. However, some people have been known to put their diabetes into remission through significant weight loss and lifestyle changes9. There are steps you can take to reduce your risk of developing type 2 diabetes. Staying active is crucial; walking, jogging, or working out in the gym – it all helps. Making healthier food choices is also top of the list of changes you can make. Eating more fruits and vegetables, choosing wholegrain alternatives, and reducing your intake of processed foods can help reduce your risk of developing type 2 diabetes 9.
When it comes to type 1 diabetes, we don’t know how to prevent it, however, we can successfully treat it. Your doctor will recommend changes you can make, like those above, and provide you with a therapeutic strategy for your insulin management – insulin management is simpler than ever, thanks to new technologies such as a glucose monitor you can link with your phone and automated insulin delivery systems which monitor your blood sugar levels and delivery insulin to your bloodstream when it is required 13.