Diabetes Series by Dr. Donal O'Gorman, PhD
1. What is Diabetes?
Diabetes is a condition associated with an increase in the amount of glucose circulating in the blood stream. The glucose in our blood comes from the breakdown of food we eat, often referred to as carbohydrate (eg potato, sugar, cereals, bread, etc) and can also be made by the liver. It is often thought that diabetes is related to an increase in sugar from the diet, but this is not the case.
Most people have a fasting blood glucose concentration of 5mmol/l. When we eat carbohydrate foods, the blood glucose may increase to 8-10 mmol/l after about 30-minutes and return to 5 mmol/l by 90-minutes. A person with diabetes will have a fasting glucose level greater than or equal to 7 mmol/l. When they eat, the blood glucose levels rise a lot higher and take a lot longer to return to the original value.
Could I get diabetes?
It is possible for any of us to develop diabetes and we should all be aware that our genes may lead us to develop the condition or the lifestyle we adopt may increase the risk. There are a number of risk factors that predispose people to diabetes. It should be noted that just because you may have one or more risk factors, does not mean that you will develop diabetes but it should increase your awareness. Here are some of the recognised risk factors:
1. Family history
At least one person in the family who already has diabetes increases the risk for others. Often people with diabetes will be able to detect a two or three generation family history of the condition.
2. Obesity
Weight gain, especially around the waist, is associated with a greater risk of developing diabetes.
3. Age
As we get older there is a greater risk for developing diabetes. Those greater than 45 years of age should be especially more aware of the condition.
4. High blood pressure
Diabetes is associated with a number of other conditions, including blood pressure.
5. High blood lipids
If cholesterol levels are outside the normal range, or circulating fat in the form of triglycerides is high, the risk of diabetes also increases.
6. Diabetes during pregnancy
A small percentage of women develop diabetes during pregnancy, which can return to normal following the birth of the baby. There is however a greater risk of developing diabetes later in life
7. Birth weight
Having a very low or very high birth weight is associated with increased risk for the development of diabetes later in life.
How would I know if I had diabetes?
The majority of people with diabetes may have the condition for a number of years before it is detected. This is with the exception of people with Type 1 diabetes, who present in a very ill condition at hospital (the different classifications of diabetes will be discussed in a future article). There are a number of symptoms that we should be aware of including:
1. Increased thirst
If you are constantly thirsty and craving fluids, especially if you notice this right throughout the day and night. A person may have a dry mouth and drink litres of fluid each day. This is called polydipsia.
2. Increased frequency of passing urine
Despite being thirsty you are constantly going to the bathroom to urinate. Again this happens with alarming frequency and will involve going to the bathroom a number of times during the night. This is called polyuria.
3. Weight loss
If you have noticed a decrease in body weight, without changing your lifestyle that may have led to those changes.
4. Blurred vision
You may experience blurred vision periodically, this is a result of the high blood glucose concentrations.
What should I do if I think I have diabetes?
The first thing would be to go to your GP and explain your symptoms. They may decide to ask you to provide a urine or blood sample. In this sample they will check for blood glucose. If the glucose values are above the normal range, they may repeat the test before confirming that you have the condition. If you do not have diabetes but do have a number of risk factors, you may be asked to have your blood glucose checked more frequently.
Topics to be covered in future articles:
1. Prevalence of diabetes
2. Classification of diabetes
3. Impaired glucose tolerance
4. The importance of insulin
5. The metabolic syndrome
6. Management of diabetes
7. Can we prevent diabetes?
8. Is physical activity beneficial for diabetes?
9. What should I do before starting to exercise?
10. Physical activity recommendations
11. Resistance vs. Endurance training
12. Type 1 diabetes and exercise
13. Diabetes and the elite sports performer
14. Diabetes in children and adolescents
15. Gestational diabetes
16. Diabetes and cardiovascular disease
17. Other diabetes complications
18. Diabetic foot