Diabetes

Diabetes is a global health issue as it affects people from all works of life and in a variety of countries ranging from the developed to developing countries.  Recent figures from World Health Organisation, estimates that as many as about half a billion people currently live with diabetes around the world with thousands yet to be diagnosed. 

What is Diabetes?

Diabetes is a medical condition described as excess glucose (sugar) circulating around your body. This high levels lead to damages which are referred to as the complications of diabetes. The World Health Organisation brings to light that there are about 422million people worldwide living with diabetes and this number continues to be on the increase.  There are 2 main known types different types of diabetes and different causes of diabetes types; however 90% of the people living with diabetes globally are diagnosed with type 2 diabetes.  Other types of diabetes include type 1 diabetes, Maturity Onset Diabetes of the Young (MODY), Latent Autoimmune Disease of Adulthood (LADA), Gestational diabetes, Neonatal diabetes, secondary causes of diabetes (e.g. pancreatic diabetes (type 3c diabetes), steroid induced diabetes, drug induced diabetes). 

Please watch this video from Diabetes UK for further explanation.

Symptoms of Diabetes

The main symptoms of type of diabetes include: 

  • Increased thirst and urination
  • Fatigue (When you are very tired) 
  • Recurring genital thrush 
  • Numbness or tingling in feet or hands 
  • Sores that are slow to heal or do not heal 
  • Unexplained weight loss (you lose weight without trying) – More weight loss in type 1
  • Blurred vision 
  • Dry skin or blushing skin
An individual may sometimes not show symptoms. A lack of symptoms does not excuse the occurrence of diabetes within the body. There are some other symptoms which can be considered life threatening. This is often referred to as diabetic Ketoacidosis (DKA). These symptoms include 
  • Fruity smelling breath 
  • Dry skin or blushing skin 
  • Nausea or vomiting 
  • Abdominal (stomach) pain 
  • Difficulty in breathing 
  • Confusion or difficulty concentrating 
If you have any of these life threatening symptoms, you need to seek urgent medical attention. 

Complications of Diabetes

If diabetes is left untreated or with suboptimal glycaemic (sugar) management, it can lead to processes referred to as glucose toxicity (excess sugar in circulation harming the body) and lipotoxicity (excess fat in circulation harming the body).  Some examples of diabetes complications include:

  • Cardiovascular disease examples include strokes, heart attacks, narrowing of the arteries (atherosclerosis) etc.
  • Nerve damage (neuropathy)– A raised glucose levels can cause injuries to the walls of small blood vessels called capillaries which are a source of nourishment to the nerves particular the legs. This can lead to numbness, burning, pain, tingling, slow healing wounds and a possible amputation. 
    • In men, erectile dysfunction can occur due to nerve damage to the genitals. 
  • Increase risk of Kidney damage (nephropathy) leading to diabetes:  the kidneys play an important role in filtering (removing) waste from the bloods. When blood sugars are raised, this process of filtration can be damaged leading to kidney failure.  
  • Increase risk of damage to the eyes (diabetic retinopathy):  leading to poor eyesight or blindness. The blood vessels of the retina can be damaged which can potentially lead to blindness. Other causes of eye damage from diabetes include glaucoma. 
  • Increased risk of dental disease:  Raised blood glucose can increase the occurrence of dry mouth and gum disease
  • Increased risk of low mood (depression) often forgotten and not mentioned but dealing with diabetes can be cumbersome. Improper management of mental health can lead to complications with diabetic management. 
  • Increased risk of vascular dementia (vascular dementia) 
  • Increased risk of harm to mother and child during pregnancy (e.g. still birth).

Diabetes Eye care and support

Provision of information and support to prevent and manage diabetes eye complications with support from optometrist and ophthalmologist.

Diabetes foot risk assessment, management, and support

Provision of information and support to prevent and manage diabetic foot problems and referral to podiatrist if needed.

Cardiovascular risk assessment, management and support

Use of varying assessment tools to estimate a patient’s risk of developing cardiovascular disease (CVD) and offering support to reduce the risk

Blood pressure management and support

Includes diagnosis, review, optimisation of medications, and treatment of resistant hypertension with input from cardiology when required.

Diabetes diet and lifestyle support

Discuss diet and lifestyle changes to encourage better glycaemic control with input from diabetic dietitian

Diabetes dental care and support

Discuss problems with teeth and gums and refer to dentist if and when required.

Glycaemic(sugar) management and support

Management and treatment of hyperglycaemia (raised sugar) from a holistic point of view and accompanying complications; and management of hypoglycaemia where relevant.

Diabetes foot risk assessment, management, and support

Provision of information and support to prevent and manage diabetic foot problems and referral to podiatrist if needed.

Chronic kidney risk assessment, management and support

Assessment and diagnosis of CKD through blood test results Identify underlying causes and risk factors for disease progression. Follow on care and treatment of people with or at risk of developing chronic kidney disease with support of nephrologist if and when needed.

Pre-diabetes risk management and support

Identification through a blood test and support to prevent progression to diabetes with input from diabetic dietitian.

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