Also known as diabetes mellitus, diabetes is a group of metabolic disorders in which a person has abnormally high blood sugar, either because their pancreas does not produce enough insulin (essential for certain cells to be able to absorb glucose from the blood), or because these cells do not respond to the insulin that the body produces.
We all need insulin to survive because it enables the glucose in our blood to enter our cells and fuel our bodies. For those who aren’t able to produce insulin, or the amounts are insufficient, a number of problems can occur.
There are three main types of diabetes
Type 1 diabetes
This is a life-long condition and affects about 8% of adults with diabetes. The causes of type 1 diabetes are not yet clear, but it isn’t related to diet or lifestyle (although healthy habits can help to manage the condition). In this type of diabetes, the body’s own immune system inappropriately attacks cells in the pancreas, making the production of insulin impossible.
With type 1 diabetes, the body is still able to break down the carbohydrate found in food and drink and turn it into glucose (sugar). However, when the glucose enters the bloodstream, there is no insulin to allow it into the body’s cells.
Type 1 diabetes tends to develop in younger people, usually before the age of 40.
Type 2 diabetes
This is the most common form of the condition and accounts for 90% of cases of diabetes. Like type 1 diabetes, the body is able to break down the carbohydrate in food and drink and turn it into glucose. However, in type 2 diabetes, the pancreas responds by releasing insulin but the process doesn’t work normally, and blood glucose levels keep rising. More and more insulin is released but the body’s cells become resistant to its effect. For some people with type 2 diabetes this process can eventually tire the pancreas out, meaning their body then begins to make less and less insulin. This causes even higher blood sugar levels.
Use this tool from Diabetes UK to determine your risk of developing type 2 diabetes. The earlier the condition is identified, the better the outcome.
This occurs when a pregnant woman, with no prior history of diabetes develops a dangerously high blood glucose level. Gestational diabetes is a condition in which high blood sugar (glucose) develops during pregnancy although it usually resolves after giving birth. While it can develop at any stage of pregnancy, it is more common in the second or third trimester.
Women at high risk of developing the condition include those whose blood sugar has been high in the past, if not high enough for a diagnosis of diabetes. Individuals should be carefully monitored throughout their pregnancy so that the condition can be managed, and the risks to both the mother and baby reduced.
Risk factors for gestational diabetes
Any woman can develop gestational diabetes during pregnancy, but you’re at an increased risk if:
- You are overweight and your BMI is above 30 – use the healthy weight calculator to work out your BMI.
- You have previously had a baby who weighed 4.5kg (10lb) or more at birth.
- You had gestational diabetes in a previous pregnancy.
- One of your parents or siblings has diabetes.
- You are of south Asian, Black, African-Caribbean or Middle Eastern origin (even if you were born in the UK).
If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.
What is prediabetes?
Also known as borderline diabetes, prediabetes is a pre-diagnosis of type 2 diabetes, and it can be useful to think of it as a warning sign. This condition arises when your blood glucose level (blood sugar level) is higher than normal but it’s not high enough to be considered diabetes. One of the challenges with prediabetes is that there are few, if any, symptoms before it progresses to diabetes. It’s thought that about 35% of the UK’s adult population who have prediabetes are unaware of it.
Risk factors for developing prediabetes
You may be at a higher than average risk of developing prediabetes if any of the following apply to you:
- You are overweight with a BMI of 25 or higher. Carrying extra weight around your abdomen can also cause your body to become more insulin resistant.
- You are not physically active.
- You have a family history of prediabetes.
- You identify as Afro-Caribbean or Asian (even if you were born in the UK).
- You are aged over 45.
- You have high blood pressure (hypertension) and/or high LDL cholesterol.
The good news is that prediabetes can be reversed in the early stages with lifestyle changes. It’s therefore important to ask your doctor to test you, and follow all of their advice.
Symptoms of diabetes
In general, someone with diabetes may experience some, or all, of the following symptoms, although there can be other causes for these. It’s important that you see your GP as soon as possible if you notice that you:
- Need to urinate more than usual – especially at night
- Feel hungrier than usual
- Feel very thirsty
- Feel more tired than usual
- Lose weight without trying to
- Have genital itching or thrush
- Have cuts or wounds that take longer to heal than expected
- Your vision is blurry or you have other visual disturbances.
What happens if diabetes is untreated?
Regardless of the type of diabetes someone has, health complications are inevitable if the condition is left untreated. Some of the conditions that may occur include, but are not limited to:
- Heart attack or other heart problems
- Impaired vision or blindness
- Circulation problems
- Nerve and/or blood vessel damage
- High blood pressure
- Kidney damage
- Ketoacidosis – a condition where, in the absence of insulin, the body uses other hormones to supply the body with energy. This can produce toxic levels of acids called ketones which, untreated, can be life-threatening.
How is diabetes treated?
The treatment recommended depends on the type of diabetes diagnosed but in any case, it’s important to follow the advice of your GP to reduce the risks associated with untreated diabetes.
Treatments for prediabetes
Depending on the stage of disease, this condition can be reversed with lifestyle changes which can include the following:
- Stopping smoking
- Cutting back on alcohol
- Losing weight if you need to
- Staying active
- Dietary changes.
Remember that your GP is there to advise you on the best course of action.
Treatments for type 1 diabetes
This type requires insulin injections (or sometimes insulin administered by a pump), which may be combined with oral medication. Keeping track of your blood sugar on a daily basis is essential and your GP will guide you on how to do this. People with type 1 diabetes are also encouraged to eat healthily, stop smoking, cut back on alcohol, stay active, and monitor their wellbeing on a daily basis.
Treatments for type 2 diabetes
While many people with type 2 diabetes require oral medication to manage the condition, some will not. Healthy eating, exercise, and maintaining a healthy weight may be sufficient. Your GP will recommend the best course of action for you, and will also encourage you to stay active, eat healthily, stop smoking, cut back on alcohol, and make other lifestyle changes.
Treatments for gestational diabetes
Your doctor will aim to keep your blood glucose levels at a normal level, which may require a specific diet plan for the duration of your pregnancy, physical activity, daily blood glucose testing, and in some cases, insulin injections until the baby is born.