DIABETES AFFECTS AN ESTIMATED 537 MILLION PEOPLE AROUND THE GLOBE.

Out of those 537 million people, 45% of people living with diabetes are undiagnosed.

So, what is diabetes?

In short, diabetes is a chronic disease occurring when the pancreas fails to make insulin or the body cannot use the insulin created. As a result, glucose levels in the bloodstream become too high and the body becomes susceptible to developing serious health problems.
Most of the food we eat is turned into glucose for our body to use for energy. Our pancreas makes a hormone called insulin to help glucose get into the cells of our body and removes it out of the bloodstream. Diabetes is a common life-long condition where the amount of glucose in our blood is too high as our body cannot use it properly. This is because our pancreas does not produce any or not enough insulin, or the insulin that is produced doesn’t work properly.

Diabetes Types & Symptoms

Type 1 diabetes

develops when the insulin-producing cells are destroyed and the body is unable to produce any insulin. Usually it appears before the age of 40, and in childhood. It is treated with daily administration of insulin either by injection or pump, a healthy diet and regular physical activity. Symptoms include frequent urination, excessive thirst, extreme hunger, unusual weight loss, vision changes, fatigue and irritability.

Type 2 diabetes

develops when the body does not produce enough insulin or the insulin that is produced does not work properly. Usually it appears in people aged over 40 as a result of excess body weight and physical inactivity, though in South Asian and Black communities it can appear from the age of 25. It is becoming more common in children and young people of all ethnicities. This condition is treated with a healthy diet and regular physical activity, but medication and/or insulin is often required. Symptoms may be similar to those of Type 1 diabetes (others include frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in the hands/feet, recurring skin, gum or bladder infections) but are often less marked. As a result, the disease may be diagnosed several years after onset once complications have already arisen.

Gestational diabetes

is hyperglycaemia (abnormally high blood sugar levels) with onset or first recognition during pregnancy. This condition is most often diagnosed through prenatal screening rather than reported symptoms (similar to Type 2 diabetes).

Who is at Greater Risk for Type 2 Diabetes?

• Individuals with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)
• People over 45 years or with a family history of diabetes
• Those who are overweight, do not exercise regularly, have low HDL cholesterol or high triglycerides, high blood pressure
• Certain racial and ethnic groups
• Women who had gestational diabetes, or who have had a baby weighing 4.5kg or more at birth.

Diabetes Prevention

To delay the onset of type 2 diabetes and its complications, it is important to:
• achieve and maintain normal body weight
• be physically active – at least 30 minutes of regular, moderate-intensity activity on most days (more activity is required for weight control)
• eat a healthy diet of between three and five servings of fruit and vegetables a day, and reduce sugar and saturated fats intake
• avoid tobacco use as smoking increases the risk of cardiovascular diseases.

Diabetes Treatment

The main aim when treating diabetes is to achieve blood glucose, blood pressure and blood fat levels (including cholesterol) as near to normal as possible. Other interventions include:
• foot care
• screening for retinopathy (which causes blindness)
• blood lipid control (to regulate cholesterol levels)
• screening for early signs of diabetes-related kidney disease.
These, together with a healthy lifestyle, will help to improve your wellbeing and reduce the risk of developing long-term complications such as heart disease, stroke, lower-extremity amputation, blindness, kidney failure and nerve damage.

Blood Glucose Monitoring

Knowing the level of glucose in your blood is useful to maintain day to day control of diabetes, detect hypoglycaemia (abnormally low blood sugar levels), assess diabetes control during any illness, and helps to provide your healthcare teams with information to alter treatment to prevent any long-term complications from developing.
Checking blood sugar level can tell you how well the treatment plan is working. It is a two-part process:
Self testing of blood sugar at home gives your blood sugar level at the exact time of the test.
A CGM Continuous Glucose Monitor measures glucose 24-7 and you read it on an app on your phone. It will alarm when high or low.
Type 1 & Type 2 diabetics: Use a blood glucose monitoring system and see how it fast becomes a key part of your diabetes plan!
The HbA1c (glycated haemoglobin; more of it is produced in the body by high blood glucose levels) test is done at clinics. It shows average blood sugar over a sustained period of time, usually 90 days. The recommended goal is less than 7.0mmol/L. However, you can have a good HbA1c and still have highs and lows since the level is an average.
Time in Range is a new way of managing diabetes and is the time spend in the desired range of glucose levels and can only be determined by using a CGM. 70% of the readings should be in range meaning 17 out of 24 hours should not be high or low.