Diabetes is a disease that develops when the pancreas stops
producing insulin. Insulin is a hormone that is necessary for moving
glucose (blood sugar) from the blood to the cells of the body.
Without insulin, the glucose remains in the blood and the body does
not receive fuel for energy. The human body cannot function without
insulin. High glucose is unsafe and, if left untreated, can cause a
life–threatening complication known as diabetic ketoacidosis.
Type
I
- typically arises in childhood or early adulthood and
occurs when the pancreas is unable to produce a
sufficient amount of insulin. Most cases are diagnosed
before the age of 30. This population must receive
insulin via injection or an insulin pump.
Type II
- often referred to as adult onset diabetes, usually
occurs after the age of 30. This type may produce some
insulin, however the body's cells have become resistant
to insulin and this prevents glucose from entering the
cells. Metaphorically speaking, the insulin in a person
with type II diabetes is trying to open the doors of the
cells, but the cells won't let it in. This is what
scientists refer to as "insulin resistant". When cells
become insulin resistant, blood glucose and insulin
levels rise and eventually lead to many complications.
For instance, uncontrolled glucose levels can damage the
large blood vessels leading to the heart (coronary heart
disease) and the extremities (peripheral vascular
disease), the eyes retinopathy, nerves (neuropathy) and
the kidneys (nephropathy). Ultimately, the pancreas
wears out after years of being in overdrive, pumping out
more and more insulin to get through the cell doors.
Eventually production of insulin will stop and insulin
shots will need to be given
Symptoms are similar for both types of diabetes.
However, type 1 diabetes may develop in a matter of
weeks where as type 2 diabetes can develop gradually,
and symptoms may be put down to increasing age. Symptoms
you may experience include:
Constant thirst and dry mouth.
The
need to urinate more than usual (especially at
night).
Weight loss.
Genital itching.
Tiredness and weakness.
Tendency to get minor infections e.g. boils or
thrush.
There is currently no cure for diabetes, once present it
is there for life. The good news is that it can be
controlled by proper treatment and self care, then once
you get used to testing your glucose levels/ taking
medication it will become part of your every day life,
like brushing your teeth
Whatever diabetes you have, it is very important that
you come to terms with it and take responsibility for
your every day care. The more you understand your
condition and how it affects you, the better you will be
able to control it.
Much of
the daily care involves trying to keep blood sugar
levels from going too high (hyperglycaemia) or too low (hypoglycaemia,
see below). If left untreated hyperglycaemia can lead to
a condition called ketoacidosis, which can be fatal.
Ketoacidosis occurs when you start to produce harmful
substances called ketones, which appear in your blood
and urine. Symptoms of hyperglycaemia include vomiting,
drowsiness, abdominal pain and pains in the legs.
Hyperglycaemia can develop if you stop taking your
insulin or if you are ill. Your doctor will show you how
to test your urine for ketones.
Most
diabetics can now monitor their own blood sugar levels
with one of the many systems available (your doctor will
show you how these work) which provide fast and accurate
results for dependable, worry-free testing.
On
average you should test your blood glucose levels 3-4
times a day, and it is highly recommended to test your
levels before meals, then 2 hours afterwards, this will
indicate how the meal has affected your levels. If you
are ill, under stress or you have changed your diet or
exercise levels then you should carry out additional
glucose tests. If you don't fell quite right and you’re
not sure why you should carry out a test as well.
Your
doctor will help and advise you find a blood
glucose-testing regime, which is best, suited for you.
As
diabetes can cause poor circulation and/or numbness in
the feet, it is important that you maintain good foot
care and always wear comfortable shoes. If you develop
any ulcers, corns or calluses on your feet you should
seek advice from your doctor or chiropodist, never treat
them yourself.
A World
Health Organisation (WHO) report predicts that deaths
from diabetes will increase by 25 per cent in the next
decade due to Britain's escalating weight problem. The
report, ‘Preventing Chronic Diseases, a Vital
Investment’ shows by 2015, 80 per cent of men and 73 per
cent of women over 30 will be overweight. This compares
to 76 per cent of men and 69 per cent of women being
overweight in 2005. By 2015, it is estimated that there
could be 8,000 more diabetes related deaths every year
Diabetes can be controlled by Regular exercise, Healthy
diet, Quitting smoking, Weight loss, avoiding excessive
drinking. Using your own blood glucose monitor can help
you plan towards a healthier lifestyle and provide you
with immediate and accurate results.
The cause of childhood
diabetes is not understood like adult person. It
probably involves a combination of genes and
environmental triggers. The majority of children who
develop Type 1 don't have a family history of diabetes.
The symptoms of diabetes in children can be very similar
to some adults with excess drinking, going to the toilet
more frequently, either increased or decreased appetite
or weight loss. Bedwetting, irritability and tiredness
can be present.
The vast majority of
children with diabetes has type-1 diabetes or insulin
dependent diabetes and will need to have insulin
injections. This is in contrast to many adults with the
condition who may be able to alter their diet and take
tablets. Most now use frequent daily dosage regimes of
fast-acting insulin during the day and slow-acting
insulin at night. Very small children normally don't
need an injection at night, but will need one as they
grow older.
With diabetes, the small
blood vessels in the body are injured. When the blood
vessels in the kidneys are injured, your kidneys cannot
clean your blood properly. Your body will retain more
water and salt than it should, which can result in
weight gain and ankle swelling. You may have protein in
your urine. Also, waste materials will build up in your
blood. Diabetes also may cause damage to nerves in your
body. This can cause difficulty in emptying your
bladder. The pressure resulting from your full bladder
can back up and injure the kidneys.
What are the early signs of kidney disease in patients
with diabetes?
The earliest sign of
diabetic kidney disease is an increased excretion of
albumin in the urine. This is present long before the
usual tests done in your doctor's office show evidence
of kidney disease, so it is important for you to have
this test on a yearly basis. Weight gain and ankle
swelling may occur. You will use the bathroom more at
night. Your blood pressure may get too high. As a person
with diabetes, you should have your blood, urine and
blood pressure checked at least once a year. This will
lead to better control of your disease and early
treatment of high blood pressure and kidney disease.
Maintaining control of your diabetes can lower your risk
of developing severe kidney disease.
What are the late signs
of kidney disease in patients with diabetes?
As your kidneys fail, your
blood urea nitrogen (BUN) levels will rise as well as
the level of creatinine in your blood. You may also
experience nausea, vomiting, a loss of appetite,
weakness, increasing fatigue, itching, muscle cramps
(especially in your legs) and anemia (a low blood
count). You may find you need less insulin. This is
because diseased kidneys cause less breakdown of
insulin. If you develop any of these signs, call your
doctor.
Signs of Kidney Disease in
Patients with Diabetes
Albumin/protein in the urine
High blood pressure
Ankle and leg swelling, leg cramps
Going to the bathroom more often at night
High levels of BUN and creatinine in blood
Less need for insulin or antidiabetic medications
Morning sickness, nausea and vomiting
Weakness, paleness and anemia
Itching
How is kidney failure treated
in diabetic patients?
Three types of treatment can
be used once your kidneys have failed: kidney
transplantation, hemodialysis and peritoneal dialysis.
Can a
patient with diabetes have a kidney transplant?
Yes. Once you get a new kidney, you may need a higher
dose of insulin. Your appetite will improve so your new
kidney will break down insulin better than your injured
one. You will use steroids to keep your body from
rejecting your new kidney. If your new kidney fails,
dialysis treatment can be started while you wait for
another kidney.
How many diabetic patients
will develop kidney disease?
About 30 percent of patients
with Type 1 diabetes and 10 to 40 percent of those with
Type 2 diabetes eventually will suffer from kidney
failure.
