Diabetes is a condition where the amount of glucose in the blood is too high because the body cannot use it properly.
What all types of diabetes have in common is that they cause people to have too much glucose in their blood.
But we all need some glucose. It’s what gives us our energy. We get glucose when our bodies break down the carbohydrates that we eat or drink, and that glucose is released into our blood.
We also need insulin. It’s made by our pancreas, and its insulin that allows the glucose in our blood to enter our cells and fuel our bodies.
If you don’t have diabetes, your pancreas senses when glucose has entered your bloodstream and releases the right amount of insulin, so the glucose can get into your cells.
But if you have diabetes, this system doesn’t work.
This can be because your pancreas doesn’t produce any insulin, or not enough insulin, to help the glucose enter your body’s cells – or the insulin that is produced does not work properly (known as insulin resistance).
What is the difference between type 1 & type 2 diabetes?
Type 1 is characterised by insulin deficiency.
If you have type 1 diabetes, you can’t make any insulin. Injected insulin is used to replace the deficiency. It is therefore known as insulin dependent diabetes mellitus (IDDM).
Type 1 diabetes can develop quickly over weeks or even days.
Getting Type 1 diabetes cannot be prevented and there is no way to predict who will get it. It can appear at any time in someone’s life after the destruction of the pancreas cells, which produce insulin - it is often not clear why these cells are damaged.
Type 2 is characterised by insulin resistance.
This is where the insulin you make either can’t work effectively, or you can’t produce enough of it. Sometimes it can be treated with oral medication, without the requirement for insulin.
Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2. Many people have type 2 diabetes for years without realising because the early symptoms tend to be general.
You can’t change some of the risk factors of type 2 diabetes - but others you can. The risk can be reduced significantly by reducing weight, increasing physical activity and improving your diet.
You're more at risk of developing type 2 diabetes if you:
- are over 40 (or 25 for south Asian people)
- have a close relative with diabetes (such as a parent, brother or sister)
- are overweight or obese
- are of Asian, African-Caribbean or black African origin (even if you were born in the UK)
You may also have heard of prediabetes. This is a term used to describe people who are at high risk of type 2 diabetes. It means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with type 2 diabetes. It also means that you are at high risk of developing type 2 diabetes.
Signs & symptoms
Having any of the signs or symptoms of diabetes does not mean you definitely have it, but you should always contact your GP, just to make sure.
- feeling very thirsty
- peeing more frequently than usual, particularly at night
- feeling very tired
- weight loss and loss of muscle bulk
- itching around the penis or vagina, or frequent episodes of thrush
- cuts or wounds that heal slowly
- blurred vision
The symptoms for type 1 or type 2 diabetes are similar. However, it is hard to ignore the symptoms of type 1 diabetes as they come on rapidly. Type 2 diabetes can be easier to miss as it develops more slowly, especially in the early stages.
But not everyone gets symptoms. In fact, 6/10 people have no symptoms when diagnosed with type 2 diabetes.
If you're diagnosed with diabetes, you'll need to eat healthily, take regular exercise and carry out regular blood tests to ensure your blood glucose levels stay balanced.
What are the complications of having diabetes?
Uncontrolled diabetes can lead to short and long-term health complications.
The short-term/acute complications include:
- hypoglycaemia - when the blood sugars are too low.
- hyperglycaemia - when the blood sugars are too high.
- hyperosmolar hypoglycaemic state (hhs) - a life-threatening emergency that only happens in people with type 2 diabetes, brought on by severe dehydration and very high blood sugars.
- Diabetic ketoacidosis (DKA) - a life-threatening emergency caused by a lack of insulin and high blood sugars.
The long-term/chronic complications include:
- eye problems (retinopathy)
- foot problems
- heart attack and stroke
- kidney problems (nephropathy)
- nerve damage (neuropathy)
- gum disease and other mouth problems
- related conditions, like cancer
- sexual problems in women and men
Keeping your blood sugar, blood pressure and blood fats (cholesterol) under control will hugely help to reduce your risk of developing complications.
However, if you have had less well controlled diabetes, have led a less healthy lifestyle, or had undiagnosed diabetes for a number of years, the complications of diabetes are more likely to develop earlier.
Regardless of whether you have diabetes or not, the take-home messages are: eat well, move more, and maintain a healthy weight.
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