Download Diabetes

Diabetes
Dr Kiran Sodha
Patient Participation Group
October 2014
Summary
• Explanation of diabetes
• Why we worry about diabetes and it’s long
term effects on the body
• Risks of developing diabetes
• Management and treatment of diabetes
• Conclusion & Questions
What is diabetes?
• We all need sugar (glucose) in our blood to
survive
• Our body fuel is sugar
– For bodily functions including brain and muscle
• We need a constant supply of glucose, but it must
be the right level
– levels between 4 - 6mmol/l
• If too high, or too low we get symptoms
• In diabetes, blood sugar levels rise too high
What happens in diabetes?
• Without diabetes:
– Food eaten and digested in stomach – broken down into
glucose – blood sugar levels rise
– Insulin made by the pancreas acts as a transporter. Moves
the sugar from the blood into body cells for use now or at
a later stage – which then lowers the blood sugar.
• In diabetes:
– The pancreas is impaired so insulin does not work as well
or it is not produced at all
– Blood sugar levels in the body rise which make us feel
unwell
Diabetes
• Type 1
– Pancreas completely stops functioning
– Normally happens in younger people
– Autoimmune most likely cause – the body mistakenly attacking
the cells that make insulin
– Genetic component
• Type 2
–
–
–
–
–
Insulin may not be as effective or insulin production is reduced
Usually later in life over age of 40
More common if overweight
1 in 20 aged over 65, 1 in 5 over 85
5 times more common in South Asian & afro-caribbean
populations
– Increased risk if other family members have diabetes
‘My blood sugar is high. What’s the fuss?’
High sugar levels in the blood make us feel unwell
– Feeling thirsty all the time
– Passing large amounts of urine
– Tiredness, weight loss
– Blurred vision
– Recurrent infections
– Severe: dehydration, drowsiness, life-threatening
– Some might not have any symptoms (type 2)
Longer term complications
– Increased risk of angina, heart attacks, stroke,
poor circulation
– Kidney damage which can lead to kidney failure
– Eye problems affecting vision
– Nerve damage
– Foot problems due to poor circulation and nerve
damage
– Impotence due to poor circulation and nerve
damage
Diagnosing & monitoring
diabetes control
• Diabetes diagnosis
–
–
–
–
Random blood sugar
Fasting blood sugar
Glucose tolerance test
HbA1c
>11 mmol/l
>7 mmol/l
>11 mmol/l
>6.5 (limited use)
• Pre-diabetes
– fasting blood sugar
– Glucose tolerance test
>6.1 - <7
>7.8 - <11.1
Nearly 1 in 5 of 40-65years in UK have ‘pre-diabetes’
Managing & Treating diabetes
• What are the aims of treatment?
1.
To keep your blood glucose level as near normal as possible
–
–
2.
Manage risk factors
–
–
–
3.
Lifestyle – diet, weight & exercise
Medication – tablets or insulin (injections)
Keep blood pressure down
Stop smoking
Keep cholesterol down
Prevent & manage complications
–
–
–
Regular checks of blood sugar, HbA1c, cholesterol & blood
pressure
Eye checks, Foot checks
Kidney tests, urine tests
Lifestyle
• Diet
– Reduce fat, reduce salt, reduce sugar
– Increase fibre intake, fruit & vegetables
• Weight loss
– May help to reduce glucose
– Increased overall wellbeing, mood & fitness
– Physical activity, reduce risk of cardiovascular
complications as well
Exercise
• 2 and half hours a week =
• 30 minutes of exercise per day over 5 days
or
• 75 minutes of vigorous activity
– Eg – Brisk walking, cycling, running, football, swimming,
carrying or moving goods including groceries
Minimise sedentary/sitting periods
– Reduce time in front of TV
Medications
• Metformin
– Increases the effectiveness of insulin the body has
• Gliclazide
– Increased release of insulin from the pancreas
• Gliptins
– Increase hormones that lead to increased release of insulin
• Insulin
– Many different types – short acting / long acting – to suit
different lifestyles
– Can be given directly by injection if tablets are not
effective
– Use in type 1 diabetes
Hypoglycaemia (low blood sugar)
• May occur with certain medications and insulin
• Symptoms
–
–
–
–
weakness, faintness, hunger
Confusion, strange behaviour
Sweating, cold, clammy
Pins & needles in lips/tongue
• Treatment
– Sweets, sugary drinks, glucose drinks
– Check blood sugar and follow up with further food to prevent
hypoglycaemia occurring again
Summary
What diabetes is
Why we treat
How we diagnose
Management – lifestyle, medications and routine checks
Managing hypoglycaemia
Any questions?
http://www.patient.co.uk/health/low-fat-dietsheet
http://www.nhs.uk/Livewell/Goodfood/Docume
nts/Eatwellplate.pdf