As usual, I was the youngest on the course. It really shouldn’t have been that much of a surprise as I was diagnosed with Type 2 Diabetes at quite a young age. Usually, people aren’t diagnosed until after they turn 40, but I was only 33 when I developed Gestational Diabetes (diabetes in pregnancy) and 35 when I was diagnosed with type 2. Now whilst it is more common in those over 40, it is starting to become more common in children and young adults and those under 40, like myself.
What is Diabetes?
Diabetes is a common condition in which the amount of glucose in the blood is too high. Yet it’s not the sugar that you add to your tea or cereal that we’re talking about, it’s the sugar that your body turns the food that you eat into, this sugar is known as glucose. Your body needs glucose as this is the energy that your cells use and the fuel that your body runs on. When you eat, your body turns the food into glucose and its then absorbed into your blood to be carried to the cells that need the energy. When it reaches the cell it needs help to pass into the cells. To try and explain it in an easy way, the glucose arrives at the cell door via the bloodstream, but it needs insulin to unlock the door to let it in. Insulin is created in your pancreas and without insulin, the glucose is trapped in your bloodstream and can’t to your cells to power them up. But why does this happen?
This wonderful film from Diabetes.org explains all about it and the differences between the two types of Diabetes.
The Two Types of Diabetes
There are more than two types of diabetes, such as gestational diabetes which only occurs during pregnancy, but when you are talking about diabetes, it is usually either type 1 or type 2 you are talking about.
- Type 1 Diabetes is when the pancreas, for whatever reason, doesn’t create any insulin at all. This type of diabetes usually appears in people under the age of 40 and children and must be treated with insulin injections.
- Type 2 Diabetes is when the pancreas does create insulin, but for whatever reason, it either doesn’t create enough insulin or the insulin it does create is of poor quality and doesn’t work properly (known as insulin resistant). Type 2 diabetes is usually, but not always, seen in people over the age of 40. Type 2 diabetes can be treated by lifestyle changes (such as changing your diet, increasing your physical activity etc) as well as, in some cases, medication and insulin.
What Happens If Your Blood Glucose Drops Too Low
Low blood sugar is classed as below 4mmol/l. (mmol/l stands for millimoles per lire) in the UK or mg/dL (milligrams per deciliter) which is used in the USA and continental Europe. If your blood glucose level drops below that level, what is known as Hypoglycemia, it may result in a variety of symptoms. These can include clumsiness, trouble talking, confusion, loss of consciousness, seizures, or death. A feeling of hunger, sweating, shakiness, and weakness may also be present. Yet before our glucose levels get too low, our bodies (which are amazing) will try to deal with the situation itself. This is the same whether you suffer from type 2 diabetes or not and includes if you are taking certain medications such as metformin. When your body feels that your glucose levels are getting too low, your body will slow down its production of insulin and it will also use the stored glucose which is found in your liver. This will stop your glucose levels become dangerously low and a feeling of intense hunger will encourage you to eat something to raise your glucose levels. Yet for those who have type 1 diabetes and for those who have type 2 and take insulin and other glyceride medications hypoglycemia can be very dangerous because there is still too much insulin in the body and the normal reactions such as taking glucose from your muscles, doesn’t create enough glucose to combat the hypo. In those cases, the diabetic will need to take something very sugary such as glucose tablets or fruit juice, even lucazade (although changes to the lucazade recipe means that you need to take more lucazade than was usually recommended) and full coke (not diet).
What Happens If Your Blood Sugar Gets Too High
High blood glucose is classed as above 10 mmol/l and is known as hyperglycemia and if high levels continue for a long period of time, it can lead to complications. However, just like with hypoglycemia, your body will try to get rid of the excess glucose from the bloodstream. This is where the signs and symptoms of diabetes come from as your body will make you thirsty and urinate more as it tries to flush the excess glucose from your bloodstream
Signs and Symptoms of Diabetes
- Going to the toilet a lot, especially at night.
- Being really thirsty.
- Feeling more tired than usual.
- Losing weight without trying to.
- Genital itching or thrush.
- Cuts and wounds take longer to heal.
- Blurred vision.
7 Lifestyle Factors
There are 7 changes you can make to your lifestyle to try and manage your diabetes successfully. These are;
- Eating a healthy diet
- Losing weight
- Lowering your alcohol intake
- Remembering to take your medication
- Stopping smoking
- Managing stress and sleeping well
Diabetes Health Profile
As a diabetic, you should be having regular check-ups to check how well you are managing your blood glucose levels and to check for any diabetic complications that can arise. To help you manage your diabetes successfully you need to understand what the results mean and what you can do to improve your overall health. These are:
- BMI – Body Mass Index is an assessment of your weight for height and gives you an idea of whether you are underweight, ideal weight, overweight or obese. A BMI of 18.5 to 24.9 is classed as healthy, 25 to 29.9 is classed as overweight. More than 30 is classed as obese.
- Weight Size – This is a measurement midway between the lower rib and hip bone. If you gain weight around your middle, it will become harder to control your blood glucose levels and it will increase your risk of developing heart disease. For Women a healthy waist measurement is less than 80cm (94cm for men), an increased risk is 80cm-88cm (94cm-102cm for men) and a greater risk is above 88cm (above 102cm for men).
- Blood Glucose – Blood glucose tests give an indication of the amount of glucose in the blood, but only at the time when the blood sample is taken. It involves pricking your finger and placing a drop of blood on a test strip. The blood is then analysed by the glucose meter and will give you a result. For a pre-meal blood glucose result, you want it to be between 4 – 7 mmol/l. You need to test your blood again 2hr after eating and you want to have a blood glucose level of less than 8.5 in type 2 and less than 9.0 in type 1.
- Glycated Haemoglobin HbA1c – This blood test measures the amount of glucose that is being carried by the red blood cells in the body. It indicates the average level of glucose in your blood over the last 2 to 3 months. It is the most important tool to help you and your diabetes care team understand how well your diabetes is controlled. A sample is taken from the vein in your arm and sent to a laboratory to be analysed. Normal is less than 6.3% or 45 mmol/mol. Healthy is 6.5-7% or 48-53 mmol/mol. Increased risk is 7.0-7.5% or 53-39 mmol/mol. Greater risk is above 7.0% or 59mmol/mol
- Blood Pressure – This is the amount of force your blood exerts against the walls of your blood vessels. The first and larger number (systolic BP) is the pressure when the heart pumps the blood into the vessel. The second and smaller number (diastolic BP) is the pressure when the heart is at rest. Healthy is below 130/80 mmHg, Increased risk is below 140/80 mmHg and Greater Risk is above 140/80 mmHG.
- Total Cholesterol – Cholesterol is essential for life and it is transported in our blood. If the transporter particles become damaged the cholesterol can spill out causing fatty plaques to develop in blood vessels. People with diabetes have a greater risk of fatty plaque development and heart disease. Healthy cholesterol is less than 4.0 mmol/l, Increased risk is less than 5.0 mmol/l.
- HDL Cholesterol – HDL particles mop up cholesterol from the blood and take it back to the liver where it is reused or excreted from the body. The levels of HDL may be increased by regular physical exercide and a small quantity of alcohol (less or equal to 1 unit a day). Healthy is classed as 1.0 mmol/l or above for men and 1.2 mmol/l or above for women.
- LDL Cholesterol – Cholesterol is needed in every cell in the body and it is carried there by particles called LDS. If these particles become damaged there is a build up of fatty deposits on the lining of the blood vessels. This increases the risk of blockages leading to heart disease and strokes. LDL may decrease through diet, taking medication and weight loss. Healthy is less than 2.0 mmol/l, Increased risk is less than 3.0 mmol/l
- Triglycerides – These are the end product of breaking down fats in food. Some are made in the body from carbohydrates. High levels have been linked to heart disease. You can reduce levels by being more active, eating oily fish and reducing calories from food and alcohol. Healthy is less than 1.7 mmol/l. Increased risk is less than 2.3 mmol/l
- Kidney Function Tests – The kidneys filter the blood, removing waste and water to make urine. Tests check how well the kidneys are functioning. The ACR (Albumin to Creatinine Ratio) test assesses whether too much protein is leaking into the urine and the eGFR (Estimated Glomerular Filtration Rate) test measures how much blood the kidneys are filtering. A Healthy AGR is less than 2.5 in men and less than 3.5 in women. A healthy eGFR is 60 or more, an Increased risk is 30 to 59 and Greater risk is less than 30.
- Prescribed Diabetes Medication – Diabetes medication is needed if blood glucose levels are not controlled with diatary changes and physical activity. Common medications include; Metformin which improves insulin action and reduces glucose release from the pancreas to make more insulin. Prandial Glucose Regulator which stimulates the pancreas. Glitazone which reduces insulin resistance. Incretin Mimetic (injectable) which acts like a natural occuring gut hormone that controls blood glucose. DPP-4 Inhibitor which allows the gut hormone to carry on working for longer. SGLT2 Inhibitor which removes excess glucose from the body in the urine. Insulin (injectable) there are different insulins with varying speeds of action.