Diabetes in a nutshell

Diabetes mellitus is when the sugar levels in your blood are too high - "mellitus" means honeyed or sweet in Latin, and diabetes means passing through. This occurs when either you’re not producing enough of a hormone called insulin, or your insulin is not working properly. Insulin is made by your body and it helps move glucose (sugar) from the bloodstream into the cells of your body so it can be used as energy.

In the US, almost 29 million people have been diagnosed with diabetes and about 8 million more are living with type 2 diabetes but remain undiagnosed. Over 96 million people have pre-diabetes, and if things remain unchanged it’s predicted that almost 15% of adults will have diabetes in the US by 2030.

About 90% of people with diabetes have type 2 diabetes and about 8% have type 1, with the remainder being rarer types of diabetes. If you have diabetes of any type, you’re twice as likely to be admitted to the hospital compared to someone without diabetes.

I think I might have diabetes, what symptoms should I look out for?

The typical symptoms of diabetes are feeling very thirsty and needing to urinate more than normal, with having to get up a lot in the night to go pee as a common complaint in people with undiagnosed diabetes. Other symptoms can include losing weight, feeling particularly tired, changes to your vision or sensations in your hands and feet, cuts or wounds taking longer to heal than normal or getting more infections than usual such as thrush. If you have any symptoms that could be diabetes you should see your doctor, who will send you for a blood test.

The three most common types of diabetes are type 1, type 2 and gestational diabetes. In Type 1 diabetes your body's immune system attacks the pancreas where insulin is made so your body is unable to make insulin. It can start at any age but it usually starts when you’re young, in childhood or in the teens. Type 1 diabetes is more likely than the other types to cause weight loss. Symptoms progress quickly and you may become quite unwell. It can be life-threatening if not treated, and this requires insulin treatment for life.

Type 2 diabetes usually causes very mild symptoms to start with and these then worsen slowly over months to years. It typically occurs in older people or people who are overweight or obese. In type 2 diabetes your pancreas gland doesn’t produce enough insulin, or the insulin that it makes isn’t effective at helping move the sugar from the blood into your body's cells. It can be treated with diet changes and weight loss if mild, or tablets, although if it doesn’t respond to these you may also require insulin or other medication injections.

Gestational diabetes is the type of diabetes that can develop in pregnancy. It doesn’t usually cause symptoms but it's one of the things that’s checked at your antenatal appointments. A close eye will be kept on you and your growing baby during pregnancy, and treatment is sometimes started to protect you both from complications. The diabetes usually improves some weeks after giving birth, but you’re at a higher risk of it coming back for future pregnancies and of developing type 2 diabetes in the future.

There’s no cure for diabetes at present but there are ways to manage it so that it is controlled the best it can be in order for it to have as little impact on your life as possible. You will have regular checks with your doctor, medication may be introduced, depending on the type of diabetes and the severity. You will need to make lifelong lifestyle changes – regular exercise and weight loss, if appropriate, and follow a healthy diet. Some people with type 2 diabetes who lose a lot of weight find their blood sugar becomes well controlled again and so can sometimes manage to stop their medication as a result, but usually find they need to restart it again if they put the weight back on.

Type 1 diabetes needs careful management with insulin – your specialist diabetes team will teach you to match insulin doses to what you’re eating and when you’re exercising, and they’ll teach you how to make the best food choices. This is immediately life-threatening if left untreated.

It’s important to keep both type 1 and type 2 diabetes under control to avoid health problems further down the line. Diabetes carries a risk to blood vessels, especially those to the heart, brain and kidneys. Left poorly treated, you increase your risk of heart attacks, strokes and kidney disease. It can also affect your eyesight, and this will be checked every year. It’s similar to looking after your blood pressure if this runs high – it carries the same risks to your blood vessels. Much of the healthcare costs for diabetes are spent on treating the complications that have developed as a result of diabetes being poorly controlled.