To understand what diabetes is we need to understand the function of glucose and insulin on the body.
Glucose is an essential source of energy for the brain and for the body. Our body converts the carbohydrates we eat into glucose. The liver converts fat and protein into glucose to ensure there is a constant supply of energy when we aren't eating.
Insulin is produced in the pancreas and has two jobs in the body. The first is to transport glucose from the blood supply into fat and muscle cells where it can be used for energy. The second is to switch off the liver once the level of glucose in the blood has reached a certain level.
If the pancreas does not create enough insulin to work in your body to keep blood glucose levels in the normal range of between 4-7 mmol/L you develop diabetes - too much glucose in the blood.
If the pancreas does not create enough insulin to work in your body to keep blood glucose levels in the normal range of between 4-7 mmol/L you develop diabetes - too much glucose in the blood.
Diabetes - Three Main Types
Type 1
People with Type 1 diabetes do not have any insulin being produced in their bodies. The immune system has destroyed the beta cells in the pancreas and they have stopped making insulin so the body is unable to use glucose produced for energy. People who develop Type 1 diabetes tend to lose weight very quickly because their body is actually being starved. Their health rapidly deteriorates and without the required insulin they will die. Insulin needs to be administered (traditionally by injection but also via pump therapy) in order to stay alive.
Type 2
People with Type 2 diabetes are still making insulin but the production is sluggish or their body is resistant to insulin. Becoming overweight is almost always the cause of the body becoming resistant to insulin and can trigger Type 2 diabetes. Type 2 diabetes can be treated with weight loss and regular physical activity. Medication in the form of tablets is often required to reduce the resistance to insulin or to stimulate the pancreas to make more insulin. This is a progressive condition in that the pancreas continues to get more sluggish over time. People with Type 2 diabetes may eventually require insulin injections.
Gestational Diabetes
During pregnancy a woman's insulin requirements can double or even treble. If a pregnant woman is unable to produce enough insulin she will get gestational diabetes (high levels of glucose in the blood). This is detrimental to both mother and baby and requires monitoring and treatment. Gestational diabetes usually ends after delivery of the baby however; it can lead to the development of type 2 diabetes later in life.
More Info on Diabetes
Blood Glucose TestingIt is important for all diabetics to frequently test their blood glucose levels. Blood Glucose Meter Testing: A daily function performed by the individual. The finger is pricked with a lancet and the droplet of blood is transferred to a blood test strip that is inserted into an electronic device which gives a reading of the glucose levels in the blood. This test measures the blood glucose at the moment the test is performed and the result is important for making immediate and day to day adjustments to diabetes management.
Haemoglobin A1C (HbA1C) test is requested by medical professionals and is carried out via a laboratory blood test. The results show the average blood glucose over the last 60 to 90 days.
It has been proven that an HbA1C level of 7.2 or less greatly reduces the risk of complications from diabetes.
DCCT Study - Benefits of Good Diabetes Control
Better blood glucose control has been the focus of a lot of attention since the release of the results of the landmark Diabetes Control and Complications Trials (DCCT) in 1993. The DCCT is the largest long-term research study on the effects of glucose control ever conducted. There were two groups in the study. One group managed their diabetes using "conventional" methods (1 - 2 injections per day and 1 - 2 daily blood glucose tests), while the other group used "intensive" methods with frequent blood glucose monitoring and daily adjustments of food and insulin to keep blood glucose as near to the normal range as possible. Nearly half those in the intensively treated group used insulin pumps to help them achieve that level of control. The chart below shows the glucose differences for the two groups.
Average Blood Glucose
Average HbA1C
DCCT Intensive Treatment Group
8.6 mmol
7.1%
DCCT Standard Treatment Group
12.8 mmol
8.9%
The DCCT study clearly showed that those who achieved better blood sugar control, with an average 2% lower glycohemoglobin value, tremendously reduced health risks for Type 1 diabetics.
- Reduced long-term complications of diabetes.
- 76% decrease in diabetic eye disease.
- Highly reduced risk of kidney and nerve damage.
- 76% decrease in diabetic eye disease.
- Highly reduced risk of kidney and nerve damage.
Obviously, with diabetes, control matters. In fact, the results were so significant that the DCCT investigators felt compelled to end the study one year early so the conventionally treated patients could have the opportunity to realise the benefits of intensive diabetes management (MDI regimes and Pumps).