Diabetes

Diabetes mellitus, more commonly known as diabetes, is a chronic condition that affects how the body uses energy from food. After we eat, food is broken down into sugar, or glucose, and is released into the bloodstream. This increases blood sugar levels, signalling the pancreas to release insulin, a hormone that allows blood sugar into the body’s cells to be used as energy.

In diabetes, the body either does not make enough insulin (as in the case of type 1 diabetes) or cannot use insulin effectively (as in the case of type 2 diabetes). Without insulin, blood sugar stays in the bloodstream, increasing blood sugar levels. This can lead to serious health complications.

Type 1 and type 2 diabetes are both a result of the body not being able to store and use glucose properly.

Type 1 diabetes

Type 1 diabetes is usually diagnosed in children and teenagers, but can occur in adults as well. It is an autoimmune disease characterised by the body's inability to produce insulin. Insulin's main role is to allow glucose, our body's main energy source, to enter our cells. Without enough insulin, glucose builds up in the bloodstream, leading to high blood sugar levels. People who have type 1 diabetes must inject themselves with insulin to manage their blood sugar levels.

Type 2 diabetes

Type 2 diabetes typically occurs with increased age, but can sometimes show up in younger people. In type 2 diabetes, cells become resistant to insulin and cannot use it effectively - this is known as insulin resistance. The pancreas may also not produce enough insulin to manage blood sugar levels. Unlike type 1 diabetes, this type is related to lifestyle factors as well as genetics. Treatments are usually aimed at slowing the progression through a healthy lifestyle and careful monitoring of blood sugar levels. If blood sugar levels cannot be effectively managed through diet and exercise alone, medication may be prescribed to manage the condition.

Although the development and treatment for both conditions differ, the complications of untreated high blood sugar levels over the long term, such as cardiovascular disease, eye problems, and kidney failure, are the same.

The symptoms of type 1 and type 2 diabetes are usually the same, but differ in how quickly they appear.

Symptoms of both include:

• increased thirst
• frequent urination, especially at night
• unintended weight loss
• feeling fatigued
• recurring thrush
• blurry vision
• slower healing cuts and wounds

In type 1 diabetes, these are normally intense and develop quickly over a short period of time, such as over a few weeks. Type 2 diabetes symptoms typically come on more gradually, meaning that the condition can often go unnoticed for several years.

The causes and risk factors for developing type 2 diabetes include:

• sedentary lifestyle
• being overweight
• having prediabetes
• being over the age of 40, or over 25 if you are of African-Caribbean, Black African, or South Asian descent
• having a close family member, such as a parent, brother, or sister with type 2 diabetes
• having had gestational diabetes (diabetes during pregnancy)
• having non-alcoholic fatty liver disease
• having high blood pressure
• having polycystic ovary syndrome

Although some risk factors, such as family history, cannot be modified, it is possible to prevent or delay type 2 diabetes through lifestyle changes like eating healthier and maintaining adequate physical activity levels.

Because all cells need glucose to function, type 2 diabetes affects many major organs. This includes your heart, blood vessels, nerves, eyes and kidneys. Diabetes also shares many risk factors with other serious chronic diseases, meaning that there are many coexisting conditions that may arise.

Complications include:

• cardiovascular problems such as heart disease, stroke, high blood pressure and the narrowing of blood vessels (atherosclerosis)
• nerve damage - over time, high blood sugar can damage nerves, causing pain and numbness that may begin at the extremities called diabetic neuropathy - this type of nerve damage can also cause erectile dysfunction
• kidney disease due to damage to the tiny blood vessels in the kidneys - over time, this can cause the kidneys to fail, which may require dialysis or a kidney transplant
• eye damage - diabetes can damage blood vessels in the eyes, which can lead to eye diseases like cataracts, glaucoma, and blindness, known as diabetic retinopathy
• skin infections - high blood sugar can dry out the skin, leaving those with diabetes more susceptible to cuts and and infections
• slow wound healing, which can lead to to serious infections that can cause further complications, such as damage that may need amputation

Diet and exercise

The first line of treatment is usually through improvements in diet and increased exercise. A healthy diet and adequate exercise can increase insulin sensitivity, improve cholesterol and blood pressure levels (both are risk factors for diabetes), and help you maintain a healthy weight. Diet and exercise can even put your diabetes into remission - meaning that your blood sugar levels are below the parameters used for a diabetes diagnosis.

Tablets and medication

If diet and exercise alone are not effective in managing your blood sugar levels, you may be prescribed medication.

The most common type of medication is Metformin. Metformin decreases the amount of glucose released into the bloodstream and makes your body more responsive to insulin. Other medications include: alpha-glucosidase inhibitors, dopamine agonists, DPP-4 inhibitors, GLP-1 receptor agonists, meglitinides, SGLT-2 inhibitors, sulfonylureas, and thiazolidinediones.

Weight loss surgery

Weight loss surgery may be recommended for those with diabetes who also have a BMI over 35 and have been unsuccessful in losing weight despite trying other weight loss methods.

While family history and genetics play a role in the development of type 2 diabetes, you take steps to reduce your risk by:

• following a healthy diet, choosing nutrient-dense foods like vegetables and fruit and keeping in mind portion sizes - one study has shown a 50% reduction in diabetes risk among those who consume more fruits and vegetables
• exercising regularly - the NHS recommends getting at least 150 minutes of moderate intensity physical activity or 75 minutes of vigorous intensity activity a week
• maintaining a healthy weight - losing 5 to 7 percent of your body weight may help prevent or delay diabetes
• quitting smoking if you currently smoke - smokers have a 30-40% increased risk of developing diabetes
• lowering your alcohol intake - excessive alcohol consumption can increase your risk of developing the condition

There is no specific diet you have to follow, but general recommendations include:

• following a regular eating schedule - do not skip meals
• being aware of portion sizes
• eating foods high in fibre, such as fruits, leafy vegetables and whole grains
• eating fewer amounts of sodium, sweets, and refined grains

You may also benefit from seeing a registered dietitian, who will be able to help you monitor your carbohydrate intake, plan well-balanced meals and keep healthy habits.

If you have been diagnosed with diabetes, you can purchase Metformin online from euroClinix. To ensure that this treatment is suitable for you, you will need to complete a simple online consultation. Once approved by our doctors, they will issue a prescription and our UK pharmacy will dispense and deliver it straight to your door with free next-day delivery.