Diabetes has been a recognised condition for more than 3,500 years.
It is the condition in which there is too much sugar in the blood
The disease occurs because the body cannot use glucose properly, either owing to a lack of the hormone insulin, or because the insulin available doesn’t work effectively.
According to the charity Diabetes UK, more than 2 million people in the UK have the condition, and up to 750,000 more are believed to have it without realising they do.
The majority of diabetics have type 2 diabetes, whereas the remainder have type 1.
In type 1, the body’s unable to produce any insulin. This usually starts in childhood or young adulthood. It’s treated with diet control and insulin injections.
In type 2, not enough insulin is produced or the insulin that is made by the body doesn’t work properly. This tends to affect people as they get older, and usually appears after the age of 40.
The body uses glucose from food to produce energy. It can be found in sweet foods such as sweets and cakes, or from starchy foods, such as potatoes, pasta or bread, once they’re digested. The liver is also able to manufacture glucose.
Normally, the pancreas produces insulin and monitors how much glucose is in the blood. Insulin encourages cells to absorb enough glucose from the blood for the energy, or fuel that they need. Insulin also stimulates the liver to absorb and store any glucose that’s left over.
After somebody has eaten, the amount of glucose in the blood increases, which causes the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too.
The pancreas also produces a second hormone manufactured by the pancreas called glucagon. It stimulates the liver to release glucose when it’s needed, and this also raises the level of glucose in the blood.
In type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas.
There is no medical reason for the destruction, but a number of explanations and possible triggers have been proposed. These include: infection with a specific virus or bacteria, exposure to food-borne chemical toxins and exposure as a very young infant to cow’s milk
However, these are only suggestions, and have never been confirmed.
In type 2 diabetes the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it – this is known as insulin resistance.
As a result, more insulin may be produced, and this overproduction exhausts the insulin-manufacturing cells in the pancreas. There is simply insufficient insulin available and the insulin that is available may be abnormal and so doesn’t work properly.
The following risk factors increase the chances of someone developing type 2 diabetes: increasing age, obesity and physical inactivity
Rarer causes of diabetes include: certain medicines, pregnancy and any illness or disease that damages the pancreas and affects its ability to produce insulin, such as pancreatitis
It is important to point out that there are many myths surrounding the causes of diabetes, and it is necessary to be aware of what does not cause the disease. For example, eating too much sugar does not cause diabetes. However, it may cause obesity and this is associated with people developing type 2 diabetes.
Stress does not cause diabetes, although it may be a trigger for the body turning against itself, as in type 1 diabetes. But it does make the symptoms worse for people who already have diabetes.
Diabetes is not contagious. Someone with diabetes can’t pass it on to anyone else.
Type 1 can be treated with insulin and by eating a healthy diet. Insulin has to be injected because taking it orally would lead to the digestive juices in the stomach destroying it. Most people find giving the injections simple and relatively painless, since the needle is so fine.
How often someone needs to inject depends on what their diabetes specialist has recommended, and which type of insulin they’re using. Insulin is given at regular intervals throughout the day, usually two to four times.
Injections can be given using either a traditional needle and plastic syringe, but some people find an injection pen device more convenient.
Another option is an automatic insulin pump. A needle is placed under the skin, and connected to a small electrical pump carried around the waist and is about the size of a pager. Inside is a reservoir of fast-acting insulin which is delivered continuously at an adjustable rate.
Inhaled insulin has recently become available for treating people with a proven needle phobia or people who have severe trouble injecting.
Type 2 was once thought to be the milder form of diabetes in the past, but this is no longer the case. For many people, type 2 diabetes can be controlled by diet alone but medication is also available when necessary. The different types of tablets work by one of these methods: helping the pancreas to make more insulin increasing the use of glucose and decreasing glucose production, slowing down the absorption of glucose from the intestine stimulating insulin release from the pancreasenabling the body to use its natural insulin more effectively.
Over time, a careful diet, along with medication may not be enough to control the condition. It is possible that a doctor may eventually recommend insulin injections.
1. Phoebe
Unfortunately, inhaled insulin is no longer an option for people relying on the NHS: due to the NHS’s strict guidelines on who is allowed it, Pfizer found demand was too low to continue production, and stopped in January 2008. Inhalors were denied to those already injecting on the basis that anyone already injecting must be magically over their needlephobia, despite how much easier inhaled insulin would make the lives of many diabetics.