Diabetes - Medtick
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Diabetes

What is it?

There are two main types of diabetes:

  • Type 1 diabetes
  • Type 2 diabetes

Other types of diabetes are:

DIABETES TYPE 1

(Diabetes type 1 mellitus, Insulin-dependent diabetes, juvenile diabetes)

What is it?

  • A condition resulting from beta-cell destruction in the pancreas, leading to a severe impairment of insulin secretion and eventual absolute insulin deficiency causing is too much glucose (sugar) in the blood as it does not move to the body organs easily because a lack of insulin.
  • It is less common than diabetes type 2 and occurs in patients under 40 years and young persons.
  • Insulin in required to move glucose from the blood to the cells. It is in the cell when glucose is broken to make energy.
    In diabetes type 1 condition, the body produces no insulin and symptoms can be very sudden.
  • It is important to diagnose diabetes and control it since it can increase the chance of heart conditions, kidney disorders, blindness, nerve disorders, poor circulation causing skin infections, erectile dysfunction and nerve disorders.

Diagnosis of diabetes includes any of the following:

A fasting plasma glucose level ≥ 126 mg/dL (7 mmol/L); fasting is defined as no caloric intake for at least 8 hours

  • A 2-hour plasma glucose level ≥ 200 mg/dL (11.1 mmol/L) or during a 75-g oral glucose tolerance test
  • An A1c level ≥ 6.5% (≥ 48 mmol/mol)
  • A random plasma glucose level ≥ 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms of hyperglycemia (ie, polyuria, polydipsia, polyphagia, weight loss) or hyperglycemic crisis
  • Measuring concentrations of insulin or C-peptide (a fragment of proinsulin that serves as a marker for insulin secretion) is rarely necessary to diagnose diabetes type 2 or differentiate diabetes 2 from Diabetes type 1. Insulin levels generally are high early in the course of diabetes type 2 and gradually wane over time. A fasting C-peptide level > 1 ng/dL in a patient who has had diabetes for more than 1-2 years is suggestive of diabetes type 2  (ie, residual beta-cell function).

American Diabetes Association (ADA)

Poor sugar control

  • ‘Please see your medical doctor even if display some symptoms as as symptoms can vary from individual to individual’
  • Please beware of hypoglycaemia (poorly controlled diabetes) when having low sugar levels, poor controlled diet and poor control and use  of diabetic medication

Glucose testing

Cause

  • Unknown cause

Others:

Syndromes

Vitamins, herbals and minerals

Condition can becomes worse when:

  • Not enough insulin medication
  • Being unwell
  • Eating too much (one should have regular size meals at same time each day).

DIABETES TYPE 2

What is it?

This type of diabetes is when one has too much glucose (sugar) in blood.

  • This is the most common form and is usually diagnosed to patients over 40 years. However it can occur in persons younger due to being overweight and obese.
    Insulin is needed to move glucose into cells of the body; cells break down glucose and use it for energy.
  • In diabetes type-2 the body does not produce enough insulin or does not use insulin correctly even though adequate amounts are produced when having condition.
  • This condition develops more slowly than diabetes type 1.
  • One may experience very mild symptoms (initially) and patients do not notice the condition since it is not having a major impact on their lives.
  • It is important to diagnose diabetes and control it (since it is a progressive disease) and can increase the chance of heart conditions, kidney disorders, blindness, nerve disorders, poor circulation causing skin infections, erectile dysfunction and nerve disorders.
  • A patient’s diabetes result after doing a glucose test of HbA 1c 53mmol/l (HbA 1c(%) 7.0mmol/l) or greater could indicate diabetes.

Glucose Testing

Testing should be considered in overweight or obese adults who have one or more of the following risk factors:

  • First-degree relative with diabetes
  • High-risk race/ethnicity (i.e. Black, Latinx, Native American, Asian American, Pacific Islander)
  • History of cardiovascular disease
  • Hypertension (high blood pressure) (≥ 140/90 mm Hg or on therapy for hypertension)
  • High-density lipoprotein cholesterol level < 35 mg/dL (0.90 mmol/L) and/or a triglyceride level > 250 mg/dL (2.82 mmol/L)
  • Polycystic ovary syndrome
  • Physical inactivity
  • Other clinical conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans)
  • Testing should begin at age 45 years.
  • Testing for prediabetes and/or diabetes type 2 in asymptomatic patients should be considered in adults of any age who are overweight or obese and who have one or more additional risk factors for diabetes.
  • Among Asian, a BMI ≥ 23 kg/m2 is the threshold for  all other persons, a BMI ≥ 25, kg/m2 is the threshold.

American Diabetes Association (ADA)

Diagnosis of diabetes includes any of the following:

A fasting plasma glucose level ≥ 126 mg/dL (7 mmol/L); fasting is defined as no caloric intake for at least 8 hours

  • A 2-hour plasma glucose level ≥ 200 mg/dL (11.1 mmol/L) or during a 75-g oral glucose tolerance test
  • An HBA1c level ≥ 6.5% (≥ 48 mmol/mol) on two separate occasions (usually taken two to four weeks apart).
  • A random plasma glucose level ≥ 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms of hyperglycemia (ie, polyuria, polydipsia, polyphagia, weight loss) or hyperglycemic crisis
  • Measuring concentrations of insulin or C-peptide (a fragment of proinsulin that serves as a marker for insulin secretion) is rarely necessary to diagnose diabetes type 2 or differentiate diabetes 2 from Diabetes type 1. Insulin levels generally are high early in the course of diabetes type 2 and gradually wane over time. A fasting C-peptide level > 1 ng/dL in a patient who has had diabetes for more than 1-2 years is suggestive of diabetes type 2  (ie, residual beta-cell function).

American Diabetes Association (ADA)

National Institute for Health and Care Excellence-recommended treatment targets for people with type 2 diabetes mellitus

  • HbA1c ≤58.0mmol/mol (7.5%);
  • Blood pressure <140/80mmHg;
  • Total cholesterol <5mmol/L and HDL<4mmol/L.

National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. NICE guideline [NG28]. 2019. Available at:
https://www.nice.org.uk/guidance/NG28
(accessed September 2019)

Poor sugar control

  • ‘Please see your medical doctor even if display some symptoms as as symptoms can vary from individual to individual’
  • Please beware of hypoglycaemia (poorly controlled diabetes) when having low sugar levels, poor controlled diet and poor control and use  of diabetic medication

Glucose testing

Scoring system used to estimate cardiovascular disease risk among patients in Europe with type 2 diabetes and elevated BP

Cause

Good sugar control (diet and exercise measures) is essential in gestational diabetes.

It reduces the chance of:

Syndromes

Medication

www.arrx.org

Vitamins, herbals and minerals

Condition can becomes worse when:

  • Not taking enough insulin or medication
  • Being unwell
  • Eating too much (one should have regular size meals at same time each day)
Good diet control and exercise measures is important

Symptoms

DIABETES TYPE 1

(Symptoms develop very quickly)

  • Increase thirst, heavy sweating and need to urinate frequently?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • Constant hiccups?
  • Weight loss?
  • Loss of bulk on muscle?
  • Re-occurring thrush (yeast killing cells become weak and fungal cells grow) symptoms?
  • Itching around vagina or penis?
  • Blurred vision (dry eyes)
  • Smell of pear drops or nail varnish in breath?
  • Cold feet and hands numb and painful?
  • High blood glucose levels?

Male only:

DIABETES TYPE 2

(Symptoms develop slowly over a period of time, some patients only develop a few symptoms)

  • Increase thirst, heavy sweating and need to urinate frequently?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • Constant hiccups?
  • Weight loss?
  • Loss of bulk on muscle?
  • Re-occurring thrush (yeast killing cells become weak and fungal cells grow) symptoms?
  • Itching around vagina or penis?
  • Blurred vision (dry eyes)
  • Fruity-smelling breath (pearl drops sweet smell) and/or ‘nail varnish’ smell in breath?
  • Cold feet and hands numb and painful?
  • High blood glucose levels?

Male only:

Nail changes:

Complications /Information to beware of/General tips:

Do not wait, phone for ambulance if have or develop:

See a Medical Doctor urgently if:

  • Loss of appetite
  • Stomach pain
  • High fever
  • Nausea and vomiting
  • Fruit smell (like pear drops or nail varnish) from breath

If type-1 or type-2 left untreated it can leas to:

Others:

Diet

Eye Test and Driving Authority

General tips

Hot baths and massage

  • Some diabetics cannot tell if their skin feels hot or cold sensations (peripheral neuropathy) and may burn their skin leading to skin infection and/or a serious muscle breakdown called rhabdomyolysis.
  • Hot baths can increase blood flow and may reduce blood glucose levels in one’s blood due to an increase in insulin levels produced by ones body.
  • Massages are fine if one has no poor circulation, it is not fine if one has poorly controlled or advanced  diabetes and/or is prone to muscle breakdown this can lead  to numbness, heart problems and/or kidney failure  as well as a  serious muscle breakdown called rhabdomyolysis.
  • Avoid massaging areas when one has insulin injected as the pressure in the area may influence the way their body absorbs the shot and their alter their intake.
  • Excessive heat can can cause your heart to beat faster which may be of concern if one has an underlying heart issue/cardiovascular issue.

Foot care Patient Advice (especially diabetics or with poor foot circulation)

  • Look at feet each day. If you are not able to check if someone else can, particularly if you have reduced sensation in feet.
  • If you get a cut, bruises, redness, blister bleeding; please see your medical doctor, in the meantime cover it up with a clean dry dressing.
  • If you have dry skin, use a moisturising cream or oil but do not use between toes (one may have athletes foot or be at risk).
  • Cut your nails along curvature with toe nail clippers, not straight across. Do not damage your skin.
  • Wash feet regularly everyday in warm soapy (anti-bacterial soap) and/or salty (antiseptic) water especially between toes and ‘pat dry’ thoroughly.
  • Try to avoid foot burns:
    • Check bath temperature with hand before you put your feet in.
    • Keep your feet away from hot objects e.g. hot water bottles, electric blankets, close to fire, hearers
    • Avoid slip on shoes
    • Avoid top flat shoes, pointy shoes (have broad front with room for toes, sandals and flip flops that cause rubbing).
    • Always feel inside shoes for stones or rough edges before you put them on.
    • Always wear comfortable low heel shoes/trainers, (heels too low can strain the foot arch, cause sore and cracked heels)
    • Make sure they fit well (comfortable fastening, liner and buckles to prevent rubbing otherwise can get blisters). Take into account any corns, bunions, awkward shape. (If have no choice, consider specially fitted shoes to take account of bunions, corns deformities)
    • When buying new shoes, wear your usual socks.
    • Gradually break in new shoes.
  • Always wear comfortable socks (not too tight) with footwear. Socks protect you from a rubbing shoe.
  • Do not walk bare foot anywhere. One may damage their feet.
  • Rotate ones ankles move feet up and down and do regular feet exercise to improve suppleness and blood circulation.

This condition may show similar symptoms to other types of diabetes and/or other conditions:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Diabetes in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

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