Diabetes Symptoms, Control and Management

Dr Jeremy Sims explains Type 2 Diabetes symptoms and causes, and provides advice on Diabetes control and management.

Dr Jeremy Sims MB BS MSc MRCGP FRIPH FRSH PGDipHI DipN&H MRNT CCCReg

Previously known as non-insulin dependent diabetes or maturity onset diabetes, Type 2 diabetes is essentially a disorder of middle age onwards. However, with the increase in childhood obesity in recent years there have been increasing reports of this form of diabetes in much younger age groups. Therein lies a clue to the origin of this disorder. Because Type 2 diabetes is closely linked to obesity. As the rates of obesity have soared over the last twenty years or so, so in tandem has the incidence of Type 2 diabetes.

The underlying factor leading to Type 2 diabetes is a failure of the pancreas to produce sufficient insulin – the blood glucose controlling hormone. This may be for one or both of two reasons. The first that there are insufficient insulin-producing cells in the pancreas to meet demands. The second that there is resistance by the body’s target cells to the insulin which is produced, thus requiring increasing amounts to ensure effect. Either way the ultimate poverty of effect of insulin is related to over weight or obesity.

One of the main actions of insulin is to help regulate blood sugar (or to be precise, blood glucose) levels. It achieves this in part by promoting uptake of sugar by cells e.g. muscle cells. Insufficient action of insulin leads to a reduction in sugar uptake and therefore causes an abnormal rise in blood sugar. The result: the symptoms of diabetes.

There are a number of symptoms associated with type 2 diabetes, the most common are:

• Excessive thirst
• Passing of excessive amounts of urine
• Fatigue
• Frequent skin infections e.g. boils
• Itchiness

Typically your doctor will make a diagnosis of diabetes based upon your symptoms and the results of a simple blood test. The latter will assess your blood sugar levels. A blood sample is typically taken after your have fasted overnight.

Type 2 diabetes often runs in families but even so there are ways you can prevent its onset.

• Keep to a healthy weight
• Eat a healthy diet
• Ensure adequate levels of daily exercise

Treatment depends very much upon how well controlled your blood sugar levels are. Initially diabetes management and control may involve dietary changes alone. Your doctor usually refers you to a local dietician to advise you about diet.

If on review diet alone has been unsuccessful then your doctor may consider medication for diabetes control. Typically, this is either metformin or gliclazide tablets.

Tablets for diabetes control act in different ways:

• They help the pancreas to produce more insulin
  Or
• Help your body to use insulin more effectively
  Or
• Slow down the rate at which glucose is absorbed by the bowel after eating a meal

For some sufferers of Type 2 diabetes treatment with dietary changes and tablets is not entirely effective for diabetes management, and they may then need insulin injections.

If you suffer from Type 2 diabetes your doctor and other health personnel will be available to help you. But there are things you can do to help yourself control diabetes, and these can be very effective in their own right.

• If you are over weight – try to lose some weight: Evidence shows that a 10% reduction in body weight can lead to on average a 50% reduction in fasting blood sugar levels.
   
• Exercise Regularly: with regard to diabetes, regular physical activity aids weight management; improves insulin sensitivity and therefore blood glucose control; aids blood fats control; and improves your overall sense of well-being.
   
• Eat healthily: maintain and adhere to a healthy diabetic diet.
   
• Keep a regular eye on your blood sugar levels