What is Type 2 Diabetes? Our healthcare experts shed some light on this topic

Type 2 Diabetes Mellitus is an increasingly common condition which causes the levels of glucose (sugar) to be too high in the blood. It is becoming increasingly common in the population and can often go undetected for years causing unseen damage inside the body. For many people it can largely be prevented by simple lifestyle measures.

What causes diabetes and what are some of the risk factors for developing it?

Diabetes can be caused by many factors but primarily caused by stress to the body by: being overweight, and/or not having an active lifestyle or a healthy diet. There is also evidence suggesting stress and depression can also contribute. South East Asian people are known to have a higher risk of developing diabetes. Women who have had Diabetes in pregnancy are also at higher risk of developing Type 2 Diabetes Mellitus after pregnancy.

How does diabetes develop?

Insulin is a hormone which is produced by an organ called ‘the pancreas’. The pancreas releases Insulin when there are high levels of glucose (sugar) in the blood. This causes glucose to be removed from the blood and moved into the liver, muscles and other cells that require and store glucose. This is how our body regulates blood glucose levels. If a person is at risk of diabetes and ‘over uses’ or ‘abuses’ this blood glucose regulation system, the body becomes ‘tired’ and eventually we develop ‘insulin resistance’. This is when the body becomes less sensitive to insulin and leads to very high blood glucose levels.

How is diabetes diagnosed?

Type 2 Diabetes Mellitus (diabetes) is usually diagnosed using a blood test called ‘HbA1c’. This test will tell us what a person’s average blood glucose levels have been over the last 12 weeks as it measures the amount of glucose binding to the red blood cells. A single random blood glucose level, which is taken by some patients at home, will give the blood glucose for the present moment, but is not very useful for diagnosing or checking diabetes control - unless you have been advised by your doctor to monitor at home (it is important to do so if you are taking certain medications or insulin).

What are some of the complications caused by diabetes?

Uncontrolled, high blood glucose levels can cause many complications including: - Cardiovascular disease (heart attacks, strokes and peripheral vascular disease) - Diabetic nephropathy (damage to kidneys that can lead to kidney failure) - Diabetic neuropathy (damage to nerves – this can happen anywhere in the body and there can be many symptoms such as nerve pain, reduced sensation of touch and temperature, indigestion problems) - Diabetic retinopathy (damage to eyes that can lead to blindness)

How do we manage diabetes once we are diagnosed with it?

If you have been diagnosed with Type 2 Diabetes Mellitus, it is important that you:

1. Make healthy dietary changes – if you are not sure what to change, you can speak to your diabetes nurse, GP or pharmacist to discuss this.

2. Increase exercise and general activity levels.

3. Attend any diabetes education sessions you are referred for – the more you understand about it the better you can manage it.

4. Ensure you attend regular checks with your GP surgery to check diabetes control and monitoring for any risk of complications. These checks include: blood tests for HbA1c, kidney function and cholesterol; a urine test for protein leakage from the kidney; a foot check to ensure nerves are not damaged; blood pressure check to manage stroke, heart attack and kidney damage risk.

5. Ensure you attend any retinopathy (eye screening) when you are sent appointments – this may be done by your opticians or the eye hospital and is done once yearly to check for any damage to the back of your eye caused by high blood glucose and high blood pressure.

6. Take any prescribed medication as recommended – if you are having any issues with taking medication, please discuss these with your GP, diabetes nurse or pharmacist so that they can help manage your diabetes appropriately and not prescribe unnecessary medicines or order unnecessary tests.

7. Attend any hospital appointments you may be referred to . Type 2 Diabetes Mellitus is managed using a ‘stepwise approach’ using national guidelines. To reduce the risk of complications, healthcare professionals will aim for ‘treatment targets’ for patients based on their age, medical history, risk of complications and medications as well as what a patient is able to manage. The main targets include HbA1c levels, blood pressure readings and cholesterol levels. This is why it is important to attend for all of the regular checks listed, so that the best way to manage the diabetes can be considered. This may involve using diet and exercise alone, or with medications.

Often, patients are started on tablets. When a combination of different tablets has not been successful, it may be suggested that a patient is started on injections such as insulin or other diabetes medicines that are also injected.

Some patients can ‘reverse’ their diabetes using dietary and lifestyle changes – we call this ‘remission’. You will still need to have yearly Diabetes checks even if your blood glucose is now in normal range.

If you have been identified as having ‘pre-diabetes’, you must follow dietary and exercise advice you are given for the long-term to help reduce the risk of developing Type 2 Diabetes Mellitus.

If you would like to discuss diabetes further with a member of the Nishkam Healthcare Trust clinical team, please contact us via the form on the homepage.