Diabetes

Dr Angela Murphy continues.

The International Diabetes Federation estimate 1 in 11 people globally have diabetes. Over 90% will have Type 2 diabetes – this occurs because of both resistance to insulin action and decreasing secretion of insulin over the years. Type 2 diabetes is commonly associated with obesity and although still considered a disease of adults, it is being diagnosed more frequently in younger patients. Type 1 diabetes is due to autoimmune destruction of the insulin secreting cells of the pancreas and usually presents in people before the age of 40 years.

Diabetes is diagnosed if:
a fasting blood glucose level is ≥ 7.0mmol/L, or
a two-hour post glucose challenge is ≥ 11.1mmol/L, or
a HbA1c value is >6.5%.

The consequence of high blood sugar levels is damage to blood vessels all over the body. Macrovascular disease occurs in the large blood vessels of the heart, brain and legs resulting in such conditions as a heart attack or stroke. Microvascular disease occurs in the small blood vessels of the eyes, nerves, and kidneys. If high blood sugar levels are present with high blood cholesterol and high blood pressure, this increases the severity of these complications. It is thus, imperative that these risk factors are well treated too.

Treatment is always founded on a healthy lifestyle and so nutrition, exercise, and mental well being must be addressed. Thereafter, the correct medication must be decided on and doctor and patient must discuss the choices.

Monitoring of blood glucose is important to assess if the chosen management plan is working. Home glucose monitoring can be done with a glucometer or with continuous glucose sensors. The HbA1c level is measured at visits to the health care provider, and this provides an average of blood glucose over the previous three months.

Managing diabetes is a daily challenge.

The diabetes team accompanies the person living with diabetes and offers clinical advice, lifestyle guidance and overall support.