What causes diabetes?

When food is digested and enters the bloodstream, a hormone called insulin is released by the pancreas which moves glucose out of the blood and into cells where it is broken down to produce energy. Diabetes is caused when the pancreas doesn’t produce enough insulin, any insulin at all, or the insulin it does produce doesn’t work properly. The glucose produced builds up in the bloodstream causing high blood sugar levels. The causes of Type I diabetes differ from Type 2, though the exact mechanisms for the development of both diseases are not known.

Type I, also known as Insulin-dependent, early onset or juvenile diabetes The body’s immune system attacks and destroys the cells that produce insulin. The body is therefore unable to break down glucose into energy and blood sugar levels rise. Type 1 usually develops before the age of 40, often during teenage years. Type 1 is thought to be caused by a combination of genetic predisposition and an environmental trigger, which causes the immune systems to target and kill off its own insulin-producing cells. This trigger could be a virus. People with Type 1 will require insulin injections for the rest of their life and will need to pay particular attention to aspects of lifestyle and health to ensure that blood sugar levels are well-
controlled.

Type 2, or Insulin-resistant diabetes The body can still produce some insulin but not enough, or the body becomes resistant to insulin. There is a genetic link in Type 2 as well, but there are several risk factors which increase the likelihood of developing the condition including being overweight or obese, over 40, of Afro-Carribbean or South Asian origin, inactive, smoking and having high blood pressure or heart disease. Women with polycystic ovary syndrome or those who developed diabetes during pregnancy are also more at risk. People with Type 2 may be able to control symptoms with diet, exercise and regular blood glucose monitoring. However as Type 2 is a progressive condition, medication may eventually be needed, usually in the form of tablets.

Symptoms of diabetes, Types 1 and 2, include feeling thirsty, frequent urination, especially during the night, extreme tiredness, unexplained weight loss, genital itching or thrush, slow healing cuts, blurred vision.

With Type 1, the symptoms are usually obvious and develop quickly. In Type 2, the condition develops slowly over several years and therefore the signs may not be so obvious. In both cases, symptoms are quickly relieved once treatment starts and blood sugar levels are under control.

Diabetic Ketoacidosis Around one in 4 people who are diagnosed with Type 1 diabetes are suffering with a potentially life-threatening condition called diabetic ketoacidosis. The symptoms of this condition are serious loss of appetite, nausea and vomiting, temperature, stomach pains and a fruity, chemical smell on the breath (similar to pear drops).

Risks High blood sugar levels are very damaging for the body. When diabetes is not managed well, diabetes is associated with serious complications including heart disease, stroke, blindness, kidney disease, nerve damage and amputations. However, blood sugar levels can usually be controlled managed in both Type 1 and Type 2 with a combination of diet, exercise and medication. Regular medical check-ups are essential to catch any problems early.

Hypoglycaemia Diabetics on insulin treatment can develop abnormally low blood sugar levels. Symptoms include pale, sweaty skin, confusion, slurring, headaches, double vision and in extreme cases, unconsciousness. Rapid administration of glucose is needed to return blood sugar levels to a normal level.

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Did you know?

* There are two types of diabetes, with slightly different causes and treatments: Type 1 and Type 2. Type 1 is the least common and accounts for around 10% of all cases in the UK. It is unpreventable, usually develops suddenly and occurs before the age of 40. In contrast, many people have Type 2 for years without realising it. Being overweight, inactive and smoking increase the likelihood of developing Type 2.

* In the UK, diabetes affects around 2.9m people. In addition there are thought to be around 850,000 people with undiagnosed diabetes.

• The NHS spends around 10% of its budget on diabetes and the prevalence of the condition is predicted to rise to 4m by 2025. An estimated £14bn is spent each year treating diabetes and its complications, with the cost of treating complications representing the much higher cost.

• The rate of people affected by Type 1 diabetes is rising by 4% annually in the UK and we do not know why.

• There is no cure for diabetes but it can be managed effectively with medication, diet and exercise.