Diabetes Types, Symptoms, Causes, and Medicines
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high.
There are two main types of diabetes:
- type 1 diabetes – where the body's immune system attacks and destroys the cells that produce insulin
- type 2 diabetes – where the body does not produce enough insulin, or the body's cells do not react to insulin
Type 2 diabetes is far more common than type 1.
During pregnancy, some women have such high levels of blood glucose that their body is unable to produce enough insulin to absorb it all. This is known as gestational diabetes.
In type 1 diabetes your pancreas no longer makes insulin, so you have to inject it to control your blood glucose levels. Insulin is a hormone made in your pancreas. It helps your body use glucose (sugar) for energy.
There are different types of insulin, taken at different times:
- Insulin taken once or twice a day. This is called long-acting, background or basal insulin. It gives your body the insulin it needs whether you eat or not. Basal insulin should keep your blood glucose stable overnight and between meals.
- Insulin taken with food or drink. This is called fast-acting, mealtime or bolus insulin. It helps reduce the rise in blood glucose caused by eating or drinking. You usually take it before a meal, snack or drink with carbohydrates in it.
Most people need medicine to control their type 2 diabetes. This helps keep your blood sugar level as normal as possible to prevent health problems of diabetes. You may have to take it for the rest of your life, although your diabetes medicine or dose may need to change over time. Adjusting your diet and being active is usually also necessary to keep your blood sugar level down.
Medicines for type 2 diabetes:
There are many types of medicine for type 2 diabetes. It can take time to find a diabates medicine and dose that's right for you.
You'll usually be offered a diabetes medicine called metformin first. You may need to take extra diabetes medicines, or a different diabetes medicine such as insulin, if:
- Diabetes treatment is not keeping your blood sugar levels within a healthy range
- You have heart problems or need to lose weight
Your general practitioner or diabetes doctor will recommend the diabetes medicines most suitable for you. Your diabetes medicine might not make you feel any different, but this does not mean it's not working. It's important to keep taking it to help prevent future health problems.
Metformin is the most common medicine for type 2 diabetes. It can help keep your blood sugar at a healthy level. It comes as tablets you take with or after meals. Common side effects of metformin include feeling or being sick and diarrhea. If this happens to you, your diabetes doctor may suggest trying a different type called slow-release metformin.
Other diabetes medicines
If metformin does not work well enough on its own, you cannot take it or you have other health problems, you may need to take other diabetes medicines alongside or instead of metformin. These include:
- Other tablets that help lower your blood sugar, such as gliclazide, glimepiride, linagliptin or pioglitazone
- Tablets that lower your blood sugar and help your heart pump blood around your body, such as dapagliflozin or empagliflozin
- Injections that lower your blood sugar and help you lose weight, such as exenatide or liraglutide
You'll need insulin if other diabetes medicines no longer work well enough to keep your blood sugar within a healthy range. Sometimes you may need insulin for a short time, such as if you're pregnant, if you're ill, or to bring your blood sugar level down when you're first diagnosed. You inject insulin using an insulin pen. This is a device that helps you inject safely and take the right dose. Using an insulin pen does not usually hurt. The needles are very small, as you only inject a small amount just under your skin. Your diabetes doctor will show you where to inject and how to use your pen. Your general practitioner or diabetes specialist will recommend the type of insulin treatment that's best for you.
Your diabetes medicine may cause side effects, but most people do not get any. The side effects you may get depend on which diabetes medicines you're taking. Do not stop taking your diabetes medicine if you get side effects. Talk to your diabetes doctor, who may suggest trying a different diabetes medicine for your diabetes.
Low blood sugar (hypos): Some diabetes medicines can cause low blood sugar, known as hypoglycemia or hypos. If you take medicine that can cause hypos, your diabetes doctor might recommend that you check your blood sugar regularly. You'll be given a testing kit and shown how to do a finger-prick test. If you take insulin at least twice a day and have frequent or severe hypos, you might also be offered a continuous glucose monitor or flash monitor. This is a small sensor you wear on your skin that lets you check your blood sugar level at any time.
Travelling with diabetes medicines
If you're going on holiday:
- Pack extra diabetes medicine – speak to your diabetes doctor about how much to take
- Carry your diabetes medicine in your hand luggage just in case checked-in bags go missing or get damaged
- If you're flying with a diabetes medicine you inject, get a letter from your general practitioner or diabetes doctor that says you need it to treat diabetes
Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased. It's very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.
Visit your general practitioner as soon as possible if you experience the main symptoms of diabetes, which include:
- Feeling very thirsty
- Peeing more frequently than usual, particularly at night
- Feeling very tired
- Weight loss and loss of muscle bulk
- Itching around the penis or vagina, or frequent episodes of thrush
- Cuts or wounds that heal slowly
- Blurred vision
Type 1 diabetes can develop quickly over weeks or even days.
Many people have type 2 diabetes for years without realizing because the early symptoms tend to be general.
The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce energy. However, if you have diabetes, your body is unable to break down glucose into energy. This is because there's either not enough insulin to move the glucose, or the insulin produced does not work properly. There are no lifestyle changes you can make to lower your risk of type 1 diabetes. But you can help manage type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight.
If you're diagnosed with diabetes, you'll need to eat healthily, take regular exercise and carry out regular blood tests to ensure your blood glucose levels stay balanced. You can use the BMI healthy weight calculator to check whether you're a healthy weight. People diagnosed with type 1 diabetes also require regular insulin injections for the rest of their life. As type 2 diabetes is a progressive condition, medicine may eventually be required, usually in the form of tablets.
Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year. If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it's not treated. Screening, which involves a 30-minute check to examine the back of the eyes, is a way of detecting the condition early so it can be treated more effectively.
Diabetic eye screening is a test to check for eye problems caused by diabetes. Eye problems caused by diabetes are called diabetic retinopathy. This can lead to sight loss if it's not found early. The eye screening test can find problems before they affect your sight. Pictures are taken of the back of your eyes to check for any changes. If you have diabetes and you're aged 12 or over, you'll get a letter asking you to have your eyes checked at least once a year.
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