What is Diabetes?
Diabetes mellitus is a metabolic disorder associated with higher than normal blood sugar levels. For people with diabetes, the body either produces insufficient insulin, no insulin at all or the body fails to respond to the insulin that is produced. However, insulin is an important hormone as it reduces blood sugar levels.
Even today, the exact causes for diabetes remain unknown. However, we do know that a combination of factors are involved. Modern lifestyles, for instance, play a significant role: a lack of exercise combined with excessive eating and potentially also environmental factors. Type 2 diabetes also has a strong hereditary component.
Diabetes symptoms
Characteristic symptoms are tiredness, weakness, generally feeling unwell, increased thirst and drinking, frequent urination, itching sensation, urinary tract infections, loss of weight, impaired vision and mood swings.
In spite of this, diabetes is often only discovered by chance. This is because high blood sugar frequently causes few or no symptoms over a long period – especially with type 2 diabetes. In the past, it was frequently referred to as "adult-onset diabetes", and is the most common form of diabetes. In this guide, we will also look at type 1 diabetes, gestational diabetes and some rarer forms of diabetes.
Type 1 Diabetes
Type 1 diabetes tends to occur before the age of 40, often in childhood, and is not usually associated with obesity.Type 1 diabetes is an autoimmune disease, whereby the immune system attacks and destroys healthy cells in the body by mistake. In the case of type 1 diabetes, it is the beta cells of the pancreas which are attacked. These beta cells are responsible for producing insulin and distributing it into the bloodstream.
When around four fifths of the beta cells have been destroyed, the body's own insulin is no longer able to control the blood sugar. The result is hyperglycaemia, which means that the blood sugar is excessively high. Eventually, the destruction of the beta cells results in absolute insulin deficiency. Research has not yet been able to determine what causes this disruption to the autoimmune system. It is thought that hereditary factors, viral infection and environmental factors play an important role.
Type 1 diabetes affects between 8 to 10 % of all people with diabetes.
Type 2 Diabetes
Type 2 diabetes typically only occurs after the age of 40, but can also occur at a younger age. Due to the fact that obesity is a major risk factor in developing the disease, and given that obesity in childhood is on the increase, growing numbers of children and young people are being diagnosed with the condition.
In type 2 diabetes, the beta cells do still produce insulin, but it is no longer used effectively by the other cells in the body: their sensitivity to insulin is reduced. Fat and muscle cells in particular become "insulin resistant". Initially, the body can compensate for this by increasing its production of insulin. However, as the disease progresses, the continuing activity of the insulin-producing cells in the pancreas results in the gradual failure of insulin production. Over the long term, type 2 diabetes also leads to absolute insulin deficiency. Hereditary factors play a significant role for type 2 diabetes. Having a parent with type 2 diabetes significantly increases the risk of developing type 2 diabetes.
In addition to an impaired sugar metabolism, type 2 diabetics often suffer from additional medical conditions, such as high blood pressure (hypertension), obesity or morbid obesity (adiposity), disruptions to the lipometabolism and vascular disease. In combination, high blood pressure, high blood sugar, high cholesterol, and obesity are grouped together under the term metabolic syndrome. Sometimes referred to as “The Deadly Quartet”, metabolic syndrome is regarded as a significant risk factor in developing coronary heart disease.
Type 2 diabetes affects around 90 % of all people with diabetes.
Gestational Diabetes
Gestational diabetes is high blood glucose that is first discovered during pregnancy. This is primarily caused by hormones that elevate blood glucose; at the same time, the mother's pancreas does not produce enough insulin to reduce the blood glucose. The high blood sugar can endanger the child, since the glucose will be passed to the foetus through the umbilical cord – the foetus then has to produce large amounts of its own insulin in order to normalise the blood glucose. This can result in excessive growth in the unborn child, along with delivery complications and injury hazards, underdeveloped lungs and liver, as well as post-delivery complications, a lack of oxygen and an increased risk of obesity and diabetes throughout their entire life.
Gestational diabetes affects approximately four in one hundred pregnant women, primarily obese women or those with a family history of diabetes. However, all of the complications can be avoided with early diagnosis and treatment!
The following put you at increased risk of developing gestational diabetes:
- Obesity
- Parents or siblings with diabetes
- Previous delivery of a baby weighing more than 4,500 g at birth
- Previous miscarriages
- Gestational diabetes in a previous pregnancy
Rare Types of Diabetes
MODY diabetes
MODY stands for “Maturity Onset Diabetes of the Young” and describes adult diabetes symptoms that occur in children and juveniles. This type of diabetes tends to begin during childhood or adolescence. Insulin therapy is not required with this type of diabetes, or at least not during its early stages. MODY encompasses several forms of diabetes that are caused by a mutation (or change) in a single gene. MODY diabetes affects around 2 to 5% of all diabetics.
LADA diabetes
LADA stands for “latent autoimmune diabetes in adults”. Like type 1 diabetes, LADA is an autoimmune disease whereby antibodies are found in the blood which are identical to those seen in type 1 diabetes (elevated levels of pancreatic autoantibodies and/or insulin antibodies). LADA can develop in adults of any age, but is often first diagnosed in people in their twenties and thirties.