Diabetes

What is diabetes?

Diabetes is a chronic, often debilitating and sometimes fatal disease, in which the body either cannot produce insulin or cannot properly use the insulin it produces. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. Diabetes leads to high blood sugar levels, which can damage organs, blood vessels and nerves. The body needs insulin to use sugar as an energy source.

What is the pancreas and what does it do?

The pancreas is an organ that sits behind the stomach and releases hormones into the digestive system. In the healthy body, when blood sugar levels get too high, special cells in the pancreas (called beta cells) release insulin. Insulin is a hormone and it causes cells to take in sugar to use as energy or to store as fat. This causes blood sugar levels to go back down.

What are the complications of diabetes?

Having high blood sugar can cause diabetes-related complications, like chronic kidney disease, foot problems, non-traumatic lower limb (leg, foot, toe, etc.) amputation, eye disease (retinopathy) that can lead to blindness, heart attack, stroke, anxiety, nerve damage, and erectile dysfunction (men).

Diabetes-related complications can be very serious and even life-threatening. Properly managing blood sugar levels reduces the risk of developing these complications.

Types of Diabetes

What is type 1 diabetes?

Type 1 diabetes occurs when the immune system mistakenly attacks and kills the beta cells of the pancreas. No, or very little, insulin is released into the body. As a result, sugar builds up in the blood instead of being used as energy. About five to 10 percent of people with diabetes have type 1 diabetes. Type 1 diabetes generally develops in childhood or adolescence but can develop in adulthood.

Type 1 diabetes is always treated with insulin. Meal planning also helps with keeping blood sugar at the right levels.

Type 1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with apparent type 2 diabetes who appear to have immune-mediated loss of pancreatic beta cells.

What is type 2 diabetes?

Type 2 diabetes occurs when the body can’t properly use the insulin that is released (called insulin insensitivity) or does not make enough insulin. As a result, sugar builds up in the blood instead of being used as energy. About 90 percent of people with diabetes have type 2 diabetes. Type 2 diabetes more often develops in adults, but children can be affected.

Depending on the severity of type 2 diabetes, it may be managed through physical activity and meal planning, or may also require medications and/or insulin to control blood sugar more effectively.

What is gestational diabetes?

The third type of diabetes, gestational diabetes, is a temporary condition that occurs during pregnancy. It affects approximately two to four percent of all pregnancies (in non-Aboriginal population) and involves an increased risk of developing diabetes for both mother and child.

Prediabetes

It is estimated that more than 5.7 million have prediabetes.

Prediabetes refers to blood glucose levels that are higher than normal, but not yet high enough to be diagnosed as type 2 diabetes (i.e. a fasting plasma glucose level of 7.0 mmol/L or higher). Nearly 50 per cent of those with prediabetes will go on to develop type 2 diabetes.

It is important to know if you have prediabetes because research has shown that some long-term complications associated with diabetes—such as heart disease and nerve damage—may begin during prediabetes.

Risk factors

What are the risk factors for type 1 diabetes?

Researchers continue to work hard to find out what causes type 1 diabetes. It is known that having a family member (parent, sibling) with type 1 diabetes slightly increases the risk; however, definite risk factors are currently not known.

What are the risk factors for type 2 diabetes?

Anyone over the age of 40 should be tested for diabetes every three years. Anyone who has one or more risk factors should be tested more frequently.

Risk factors are:

• Having a parent, brother, or sister with diabetes;Being a member of a high-risk group (Aboriginal, Hispanic, South Asian, Asian, or African descent);

• Having health complications that are associated with diabetes;

• Having given birth to a baby that weighed more than four kilograms (nine pounds) at birth or having had gestational diabetes (diabetes during pregnancy);

• Having been diagnosed with prediabetes (impaired glucose tolerance or impaired fasting glucose);

• Having high blood pressure;Having high cholesterol or other fats in the blood;Being overweight, especially if that weight is mostly carried around the tummy;

• Having been diagnosed with polycystic ovary syndrome;

• Having been diagnosed with Acanthosis nigricans (darkened patches of skin);Having been diagnosed with psychiatric disorders: schizophrenia, depression, bipolar disorder;Having been diagnosed with obstructive sleep apnea;

• Having been prescribed a glucocorticoid medication by a doctor.

Symptoms

Signs and symptoms can include the following:

• Unusual thirst

• Frequent urination

• Weight change (gain or loss)

• Extreme fatigue or lack of energy

• Blurred vision

• Frequent or recurring infections

• Cuts and bruises that are slow to heal

• Tingling or numbness in the hands or feet

• Trouble getting or maintaining an erection

If you have any of these symptoms, it is important to contact your health-care provider right away. Even if you don’t have symptoms, if you are 40 or older, you should still get checked. It is important to recognize, however, that many people who have type 2 diabetes may display no symptoms.

Symptoms of diabetes in children

Diabetes affects children of all ages. Most children who develop diabetes do not have a family history of diabetes.

Symptoms of diabetes in your child could include:

• Drinking and going to the bathroom more frequently than usual

• Starting to wet the bed again

• Lack of energy

If you think your child might have diabetes, see a doctor today.

Diagnosis of diabetes

Speak with your doctor and ask him or her to test you for diabetes using one of the following tests. The amount of glucose (sugar) in your blood is measured in mmol/L.

Fasting blood glucose

You must not eat or drink anything except water for at least eight hours before this test. A test result of 7.0 mmol/L or greater indicates diabetes.

Random blood glucose

This test may be done at any time, regardless of when you last ate. A test result of 11.0 mmol/L or greater, plus symptoms of diabetes, indicates diabetes.

A1C

This test may be done at any time, regardless of when you last ate. A test result of 6.5 % or greater (in adults) and in the absence of factors that affect the accuracy of the A1C indicates diabetes.

Oral glucose tolerance test

You will be given a special sweetened drink prior to this blood test. A test result of 11.1 mmol/L or greater taken two hours after having the sweet drink indicates diabetes.

A second test must be done in all cases (except if you have acute signs and symptoms). Once diabetes has been diagnosed, ask your doctor to refer you for diabetes education. Diabetes Canada also has many resources to help you understand diabetes better and live a long and healthy life.

Diabetes Management Tips

People with diabetes can expect to live active, independent and vital lives if they make a lifelong commitment to careful diabetes management.

Key elements in diabetes management

Education: Diabetes education is an important first step. All people with diabetes need to be informed about their condition.

Physical activity: Regular physical activity helps your body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.

Nutrition: What, when and how much you eat all play an important role in regulating blood glucose levels.

Weight management: Maintaining a healthy weight is especially important in the management of type 2 diabetes.

Medication: Type 1 diabetes is always treated with insulin. Type 2 diabetes is managed through physical activity and meal planning and may require medications and/or insulin to assist your body in controlling blood glucose more effectively.

Lifestyle management: Learning to reduce stress levels in day-to-day life can help people with diabetes better manage their disease.

Blood pressure: High blood pressure can lead to eye disease, heart disease, stroke and kidney disease, so people with diabetes should try to maintain a blood pressure level at or below 130/80. To do this, you may need to change your eating and physical activity habits and/or take medication.