What is diabetes
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DIABETES
Overview
This disease is no respecter of people who otherwise live 'healthy' active lives. It can strike any adult at any time and without too much notice. For these reasons it is important to be aware of the risks and symptoms and, if in any doubt, take a test or consult a medical professional. The consequences of a missed diagnosis are life changing.
What is Diabetes?
Diabetes mellitus occurs when there is too much glucose in the blood.
Two Types
Type 1. This develops because the cells in the pancreas that produce insulin - the hormone that controls the use of sugars by the cells - have been destroyed. It is considered to be an auto-immune disease, where the immune system of the body, the system that essentially deals with bacterial or viral infections, mistakenly targets the insulin producing cells and destroys them. When this happens, insulin output is severely reduced or eliminated.
Type 2. Historically this version is clearly associated with family history, getting older - those over 40 - is associated with obesity, and with a strong ethnic prevalence. People of Asian and black ethnicity have a five fold increase in the prevalence of this disease, particularly when this is combined with other key risk factors. Type 2 diabetes is however a largely avoidable condition.
Are more people getting Diabetes?
Cases of Type 2 diabetes are ten times more prevalent than Type 1 and have increased very significantly in recent years and are now at 1.8 million. Moreover, there are medical estimates that for every three or four people that are known about with this disease there is one person who has the disease but has yet to be diagnosed. From such figures estimates suggest that a further one million people are affected without knowing it.
A typical English town with a population of 120,000 will have approximately 7% of its inhabitants with this disease. Undiagnosed diabetes has a destructive effect on the blood vessels, leading to a host of unwanted events including loss of limbs, vision and nervous control.
In an era where the emerging emphasis is on personal responsibility for health and disease prevention there is no better place to start than to establish your status with regard to Type 2 diabetes.
This disease, alternatively named 'maturity onset' diabetes, is appearing beyond the boundaries of its historical title and appearing well down the age range and is now affecting overweight teenagers. With much of the adult UK population being overweight - and this being a root cause of this disease - it is easy to see how the prevalence is likely to increase as the population ages.
Do you measure up?
Being obese refers to being heavier than an 'ideal' weight for your height. This occurs when you are simply carrying an excessive amount of body fat. Standing on the bathroom scales can be misleading in measuring this since it measures the overall body weight and not the difference between muscle and body fat.
Body fat is measured by doctors and insurance companies - whose actuaries have an interest in how long an insured is likely to live - from the 'Body Mass Index' (BMI). BMI is determined by dividing the body weight (in Kg) by the height in metres squared (Kg/m2). Obesity is a Body Mass Index (BMI) of 30 and above.
The waist : hip girth ratio is an alternative to the traditional BMI. It is easier for individuals to use and is claimed by some to be more accurate in predicting disease risk from obesity. The average recommended waist : hip ratio for men is 0.9 and for women is 0.85. When dividing the waist size by the hip size (in either inches or cms) the following results are a guide to the best and worst ratios. To be accurate in measuring the waist; place a tape measure around the waist at its widest circumference while breathing out and with the abdomen relaxed - then measure the widest part of the hips.
Male ratio Female ratio
Very good 0.85 0.75
Good 0.85-0.90 0.75-0.80
Average 0.90-0.95 0.80-0.85
High Risk 0.95-1.00 0.85-0.90
Very high risk 1.00+ 0.90+
The National Obesity Forum has established that females with a waist girth of greater than 35'' and males with a girth of greater than 40'' have a greatly increased risk of Type 2 diabetes and heart disease. Thicker waists may double or quadruple these risks compared with thinner waistlines.
What are the Signs and Symptoms of Diabetes?
The signs and symptoms may not be clearly obvious, non-existent and may even be disregarded as a passing phase in the process of ageing.
Confusingly, symptoms can either appear quickly or develop slowly and include:
- Blurred vision
- Cuts or sores with delayed healing
- Genital itching or recurrent yeast infections (Thrush)
- Weight loss
- Increased thirst / dry mouth
- Urinating frequently (mostly at night)
- Leg pain
- Tiredness / fatigue
Warning signs (Note: The more risk factors there are, the greater the risk.)
Age and ethnicity
If you are over 40 years the risk rises with increased age. Afro-Caribbean, Asians or people of other minority ethnic origin have an increased risk based on the lower age limit of 25 plus years.
Family and personal history
If close relatives (father, mother, brothers or sisters) have diabetes this puts the individual at risk.
If there has been a diagnosis of any condition affecting the circulation, including blood pressure, heart attack or stroke this may be considered to be an increased risk.
Weight
An important study of distribution of disease statistics (epidemiology) showed a clear association where 80% of people with Type 2 diabetes were overweight. Being overweight with a second risk factor, eg being physically inactive, is a high risk combination. Calculate your own BMI or the waist : hip girth ratio and assess your risk from this item; alternatively the GP or practice nurse can readily provide the BMI.
Waist
Women with a waist measurement of 31.5in (80cm) or greater indicates an increased risk.
Men (white or Afro-Caribbean) with a waist measurement of 37in (94cm) or greater
indicates an increased risk. For Asian men the measurement is 35in (90cm) or greater.
Other factors
Pregnancy can develop a temporary type of diabetes - gestational diabetes. Such a history, or giving birth to a large baby, can increase the risk of a woman developing diabetes in the future.
Women with Polycystic Ovary Syndrome - a condition that affects the ovaries and the production of eggs - and who are overweight are at an increased risk.
People who have raised blood sugar levels (known as impaired glucose tolerance or impaired fasting glycaemia) should be routinely tested to prevent diabetes emerging.
Conditions such as raised triglycerides (a type of fat circulating in the blood) and major mental health conditions can also increase the risk.
Diabetes mellitus should not be confused with diabetes insipidus, which is caused by a deficiency of the hormone controlling urine excretion; Anti-Diuretic Hormone (ADH).
How do I know if I have Diabetes?
If in doubt - get checked.
Today there are many simple and inexpensive ways to check yourself for diabetes either by testing yourself, or by contacting your GP.
If in doubt, do not hesitate.
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