Diabetes
Diabetes is a lifelong condition that causes a person's blood sugar level to
become too high.
The two main types of diabetes are:


type 1 diabetes
type 2 diabetes
The difference between the two types of diabetes is explained below.
In the UK, diabetes affects approximately 2.9 million people. There are also thought to
be around 850,000 people with undiagnosed diabetes.
Symptoms of diabetes
The main symptoms of diabetes are:




feeling very thirsty
urinating frequently, particularly at night
feeling very tired
weight loss and loss of muscle bulk
Type 1 diabetes can develop quickly, over weeks or even days.
Many people have type 2 diabetes for years without realising because early
symptoms tend to be general.
What causes diabetes?
The amount of sugar in the blood is usually controlled by a hormone called insulin,
which is produced by the pancreas (a gland behind the stomach).
When food is digested and enters your bloodstream, insulin moves glucose out of the
blood and into cells, where it is broken down to produce energy.
However, if you have diabetes, your body is unable to break down glucose into energy.
This is because there is either not enough insulin to move the glucose, or the insulin
produced does not work properly.
AQA B3.3 Controlling internal conditions – Joe Ewen, Rebecca Timms and Rebecca Bartlett (Cheney
School)
Type 1 diabetes
In type 1 diabetes, the body's immune system attacks and destroys the cells that
produce insulin. As no insulin is produced, your glucose levels increase, which
can seriously damage the body's organs.
Type 1 diabetes is often known as insulin-dependent diabetes. It is also
sometimes known as juvenile diabetes or early-onset diabetes because it usually
develops before the age of 40, often during teenage years.
Type 1 diabetes is less common than type 2 diabetes. About 10% of all people with
diabetes have type 1 diabetes.
If you are diagnosed with type 1 diabetes, you will need insulin injections for the rest of
your life. You will also need to pay special attention to certain aspects of your lifestyle
and health to ensure your blood glucose levels stay balanced – for example, by eating a
healthy diet and carrying out regular blood tests.
Causes of type 1 diabetes
Type 1 diabetes occurs because your body is unable to produce insulin. Insulin usually
moves glucose out of your blood and into your cells, where it is converted to energy.
However, in type 1 diabetes, there is no insulin to move glucose out of your
bloodstream and into your cells.
Without insulin, the body breaks down its own fat and muscle (leading to weight loss). In
type 1 diabetes this can lead to a serious short- term condition where the bloodstream
becomes acidic along with dangerous dehydration (diabetic ketoacidosis).
Type 1 diabetes is an autoimmune condition, where your immune system (the body's
natural defence against infection and illness) mistakes the cells in your pancreas as
harmful and attacks them.
Read more information about the causes of type 1 diabetes.
Treating type 1 diabetes
It is important that diabetes is diagnosed as early as possible so that treatment can be
started.
Diabetes cannot be cured, but treatment aims to keep your blood glucose levels as
normal as possible, and control your symptoms to prevent health problems developing
later.
If you are diagnosed with diabetes, you will be referred to a diabetes care team for
specialist treatment. Your care team will be able to explain your condition to you in
detail and help you understand your treatment. They will also closely monitor your
condition.
AQA B3.3 Controlling internal conditions – Joe Ewen, Rebecca Timms and Rebecca Bartlett (Cheney
School)
As your body cannot produce any insulin, you will need to have regular insulin treatment
to keep your glucose levels normal. You will need to learn how to match the insulin you
inject to the food you eat, taking into account your blood glucose level and how much
exercise you do. This skill needs to be practised and learnt gradually. Many centres now
provide courses to teach these skills.
Insulin comes in several different forms, each of which works slightly differently. For
example, some last up to a whole day (long-acting), some last up to eight hours (shortacting) and some work quickly but do not last very long (rapid-acting). Your treatment
may include a combination of these different insulin preparations.
Read more information about diagnosing diabetes and treating type 1 diabetes.
Complications
Left untreated, diabetes can cause many different health problems. Large amounts of
glucose can damage blood vessels, nerves and organs.
Even a mildly raised glucose level that does not cause any symptoms can have
damaging effects in the long term.
Read more about the complications of type 1 diabetes.
Living with diabetes
If you have type 1 diabetes, you will need to look after your health very carefully. Caring
for your health will also make treating your diabetes easier and minimise your risk of
developing complications.
Eating a healthy, balanced diet and exercising regularly will lower your blood glucose
level. And stopping smoking (if you smoke) will reduce your risk of developing a
cardiovascular disease.
Type 2 diabetes
Type 2 diabetes is where the body does not produce enough insulin, or the body's cells
do not react to insulin. This is known as insulin resistance.
Type 2 diabetes is far more common than type 1 diabetes. In the UK, around 90% of all
adults with diabetes have type 2 diabetes.
If you are diagnosed with type 2 diabetes, you may be able to control your symptoms
simply by eating a healthy diet and monitoring your blood glucose level. However, as
type 2 diabetes is a progressive condition, you may eventually need medication, usually
in the form of tablets.
Type 2 diabetes is often associated with obesity. Obesity-related diabetes is sometimes
referred to as maturity-onset diabetes because it is more common in older people.
AQA B3.3 Controlling internal conditions – Joe Ewen, Rebecca Timms and Rebecca Bartlett (Cheney
School)
Causes of type 2 diabetes
Insulin is a hormone produced by part of the pancreas, a large gland located behind the
stomach.
Insulin controls the amount of glucose (sugar) in your blood. It moves glucose from
the blood into your cells, where it is converted into energy.
In type 2 diabetes, not enough insulin is produced to maintain a normal blood glucose
level (insulin deficiency), or your body is unable to use the insulin that is
produced effectively (insulin resistance).
Read more about the causes of type 2 diabetes.
Treating type 2 diabetes
It is important diabetes is diagnosed as early as possible. Diabetes cannot be cured, but
treatment aims to keep your blood glucose levels as normal as possible to control your
symptoms and minimise health problems developing later.
If you are diagnosed with diabetes, you may be referred to a diabetes care team for
specialist treatment, or your GP surgery may provide first line diabetes care.
In some cases of type 2 diabetes, it may be possible to control your symptoms by
altering your lifestyle, such as eating a healthy diet (see below).
However, as type 2 diabetes is a progressive condition, you may eventually need
medication to keep your blood glucose at normal levels. To start with this will usually
take the form of tablets, but later on it may include injected therapies, such as insulin.
Read more about treating type 2 diabetes.
Complications
Left untreated, diabetes can cause many health problems. Large amounts of glucose
can damage blood vessels, nerves and organs.
Even a mildly raised glucose level that doesn't cause any symptoms can have
damaging effects in the long term.
Read more about different complications of type 2 diabetes.
Living with diabetes
If you have type 2 diabetes, you will be advised to look after your health carefully.
Caring for your health will also make treating your diabetes easier and minimise your
risk of developing complications.
AQA B3.3 Controlling internal conditions – Joe Ewen, Rebecca Timms and Rebecca Bartlett (Cheney
School)
It helps to eat a healthy, balanced diet, stop smoking (if you smoke), drink alcohol in
moderation and take plenty of regular exercise.
Gestational diabetes (in pregnancy)
During pregnancy, some women have such high levels of blood glucose their body is
unable to produce enough insulin to absorb it all. This is known as gestational diabetes
and affects around 5% of pregnant women.
Pregnancy can also make existing type 1 diabetes worse. Gestational diabetes can
increase the risk of health problems developing in an unborn baby, so it is important to
keep your blood glucose levels under control.
In most cases, gestational diabetes develops during the second trimester of pregnancy
(weeks 14-26) and disappears after the baby is born. However, women who
have gestational diabetes are at increased risk (30%) of developing type 2 diabetes
later in life (compared to a 10% risk for the general population).
www.nhs.uk
AQA B3.3 Controlling internal conditions – Joe Ewen, Rebecca Timms and Rebecca Bartlett (Cheney
School)