What is Diabetes?
Diabetes is a condition where there is an abnormally high level of sugar (glucose) in the blood. This arises because the body produces little or insufficient insulin.
Insulin and blood glucose in your body
In your digestive system, most of the food you eat is broken down into glucose, a type of sugar. The glucose will be used by your body cells for growth and energy. To enable the glucose to enter into the cells, you need insulin.
Insulin is a hormone which is produced in the pancreas. Every time you eat, your pancreas releases more insulin. However, in people with diabetes, glucose cannot get into their cells because there is not enough insulin, either because the pancreas is damaged (type 1) or resistance to insulin action (type 2).
- Previously known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes).
- The majority of people with Type 1 diabetes are young - children, teenagers and young adults.
- Most people with Type 1 diabetes are young - children, teenagers and young adults (but it can also affect older people).
- In Type 1 diabetes, the pancreas produces little or no insulin at all because the insulin-producing cells in the pancreas have been destroyed.
- Onset of symptoms is sudden, the most common being increased thirst and constant hunger, frequent urination, excessive weight loss and constant tiredness.
- Management is by taking insulin injections, following a healthy diet, exercise and regular monitoring of blood glucose.
- Previously referred to as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes, and accounts for about 90% of people with diabetes, usually over the age of 40.
- The pancreas produces enough insulin but the insulin cannot help the glucose enter into the cells because the cells are resistant to insulin action.
- Tendency to develop Type 2 diabetes increases if you:
- have close relatives with the disease
- are overweight (the cells of fat people make it more difficult for insulin to function properly - called insulin resistance).
- lack of physical activity
- diagnosed to have
- high blood pressure (hypertension)
- high blood cholesterol (hyperlipidaemia)
- have frequent miscarriages or history of delivering big babies
- The most common signs are frequent urination, constant thirst and hunger, weight loss, tiredness. It is important to note that most people with type 2 diabetes do not know that they have the disease because of lack of symptoms. These people may discover that they have diabetes through routine blood sugar check or when they are admitted to hospital with complications.
- Management of Type 2 diabetes is by following a healthy diet and regular exercise. Medication(s) may be prescribed if lifestyle adjustments are not sufficient to control blood sugar levels.
- Develops temporarily during pregnancy due to hormonal changes during pregnancy. If not well-controlled, there may be problems with the pregnancy and the baby.
- To maintain a nearly normal blood glucose level, dietary control may be sufficient, but if it is not, then the most effective way to regulate the blood glucose level is by insulin injection.
- The mother is at risk of developing Type 2 diabetes later in life.
Many people are unaware that they have diabetes until complications set in. The signs and symptoms of diabetes are:
- constant tiredness
- excessive thirst
- frequent urination, especially at night
- unexplained weight loss
- blurred vision
- skin infections and itching in the genital areas
- slow healing of cuts and wounds
- numbness or burning sensations in the limbs.
Diabetic RetinopathyDiabetic Retinopathy is essentially damage to the retina of the eye. This occurs in patients who have been diagnosed with diabetes in the past and has some serious side effects. It can lead to problems with vision and in some extreme cases can even lead to blindness. It’s been estimated that more than 70% of patients diagnosed with diabetes with have vision problems after ten years.
Diabetic retinopathy often doesn’t have any symptoms or warning signs early on. At times the person may suffer from macular edema, which causes the vision to rapidly deteriorate in a short period of time. Others experiences problems with blurred vision where they see a halo around certain objects. The patient typically notices that they have problems driving or reading print even with eyeglasses. Many people notice that their vision worsens at night, while others claim they have the hardest problems seeing during the day, especially in bright sunlight.
There are also extreme cases where blood vessels in the eye begin to hemorrhage or bleed because of the diabetic retinopathy. The person will notice that they see spots in front of their eyes or spots that appear on the sides of their vision. These spots may appear to float or dance around and usually disappear and reappear throughout the day. The blood continues to leak out of the vessel, which leads to the person experiencing severe cases of blurred vision.
The condition arises as the result of changes happening inside the retina. As the membrane thickens, it causes damage to the retina and forms blood vessels along the edges. It’s especially prevalent in those who practice poor glucose control because as the blood sugar levels build up, it further impairs the blood vessels and can cause them to burst or bleed. It also deprives the retina of oxygen, which allows new blood vessels to develop.
The biggest risk factor associated with diabetic retinopathy is the length of time the individual has had diabetes. The longer they have the disease, the greater their chances are of developing the condition. Those taking more medication to control their diabetes and those who can’t control their blood sugar levels also have a greater chance of developing the problem.
The treatment of diabetic retinopathy is usually done through laser surgery. Another option is a vitrectomy and a third option is to inject triamcinolone into the eye, which is the top choice of doctors. Doctors also recommend that patients diagnosed with the condition stop smoking, which can cause hypertension and aggravate the condition. The eyes are then monitored closely to look for signs that the retinopathy is returning.