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Dealing with diabetes

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Dealing with diabetes

Nearly three million people in the UK have diabetes and a further one million may have undiagnosed Type 2 diabetes.

Dr Sarah Jarvis has the lowdown on this long-term condition and the role that blood sugar levels play.

Diabetes, or diabetes mellitus, is a health condition that’s caused by having too much glucose – a type of sugar – in your blood. There are two main forms of the condition, known as Type 1 and Type 2 diabetes.

What is diabetes?

The main symptoms of diabetes are:

  • Extreme thirst
  • Frequent urination, especially at night
  • Extreme tiredness
  • Unexplained weight loss
  • Regular thrush
  • Blurred vision

With Type 1 diabetes, symptoms may develop rapidly, suddenly coming on in days or weeks. Type 2 diabetes develops more slowly, with symptoms being quite general, and many people may have it for years without it being diagnosed. 

Type 1 and Type 2 diabetes

“Both Type 1 and Type 2 diabetes are diagnosed on the basis of your blood sugar being too high,” explains Dr Sarah Jarvis; “Type 1 diabetes tends to start earlier in life (usually in childhood or teenage years) and has to be treated with insulin injections from the outset.”

Type 1 diabetes is less common than Type 2. Whereas Type 1 occurs when the body produces no insulin at all, Type 2 occurs when the body doesn’t produce enough insulin or when the cells in the body don’t react to insulin (known as insulin resistance).
The hormone insulin is important, as it helps control the amount of sugar in the blood. Produced by the pancreas, it works by moving glucose out of the blood and into cells, where it’s broken down into energy.

Type 2 diabetes is more closely linked to being overweight. It more often runs in families, tends to come on in adulthood and can often be treated with diet, weight control and tablets, at least in the early stages.

“There is no mild form of diabetes, and regular treatment and follow-up are crucial for both,” emphasises Dr Jarvis; “both Type 1 and Type 2 diabetes can cause serious complications if not properly controlled.” 

What should blood sugar levels be?

Type 1 diabetics and Type 2 diabetics being treated with insulin need to measure their blood sugar levels regularly during the day and before meals to ensure they remain stable.

Blood sugar is measured by millimols per litre (mmol/l). According to UK charity ‘Diabetes UK’, blood sugar levels for Type 2 adult diabetics should be:

  • 4 to 7 mmol/l before meals
  • Less than 8.5 mmol/l two hours after meals.

For Type 1 diabetics, ranges are:

  • 4 to 7 mmol/l before meals
  • Less than 9 mmol/l two hours after meals

Blood sugar levels are tested for diabetes, normally after eight hours of fasting, using the following levels:

  • Normal – 70 to 100mg/dl (5.6mmol/l)
  • Pre-diabetes or impaired glucose tolerance -101 to 126mg/dl (5.6 to 7mmol/l)
  • Diabetes – more than126mg/dl (7mmol/l) 

Why are blood sugar levels important?

If blood sugar falls too low, hypoglycaemia can occur. A blood sugar level below 3.9 – and definitely below 3mmol/l – is classified as a ‘hypo’ (see below).

Some medicines for diabetes – insulin injections and tablets called sulphonylureas and glinides – can drop blood sugar too much, causing a hypo. This can also be triggered if a meal is missed or delayed, after exercising or if alcohol is drunk on an empty stomach.

If blood sugar levels rise too high, hyperglycaemia (hyper) may occur. With very high levels, a person can become dehydrated and even comatose, and hospital treatment is required. 

Recognising a hypo

“A hypo makes you feel very unwell and may cause dangerous complications including brain damage and heart attack in severe cases,” explains Dr Jarvis.

 If you’re diabetic, signs of hypoglycaemia include:

  • Feeling irritable
  • Dizziness
  • Palpitations
  • Lack of concentration
  • Feeling hungry and trembly
  • Headache
  • Tiredness
  • Blurred or double vision,

In a more severe hypo, people become more confused and uncoordinated, may look pale, tremble and sweat, and later may become drowsy or even unconscious.

As the ability to concentrate and focus is affected, sufferers may appear drunk. 

What to do if someone is having a hypo

If someone is still alert enough to swallow safely, giving them rapidly absorbed sugar will often be enough to bring their blood sugar back to normal. Try:

  • Sugar cubes
  • Glucose tablets
  • A sugary soft drink
  • Milk
  • Orange juice

If you’re not sure if someone is having a hypo or hyper attack, it’s safe to give sugar, even though it won’t make much difference to a hyper.

If they’re semi-conscious, you should never give them anything by mouth. Instead, call an ambulance immediately.
If you want to understand more about diabetes, then you can send a question to our panel of experts. 

Find out more

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