Transcript Diabetes
Diabetes Dr Kiran Sodha Patient Participation Group October 2014 Summary • Explanation of diabetes • Why we worry about diabetes and it’s long term effects on the body • Risks of developing diabetes • Management and treatment of diabetes • Conclusion & Questions What is diabetes? • We all need sugar (glucose) in our blood to survive • Our body fuel is sugar – For bodily functions including brain and muscle • We need a constant supply of glucose, but it must be the right level – levels between 4 - 6mmol/l • If too high, or too low we get symptoms • In diabetes, blood sugar levels rise too high What happens in diabetes? • Without diabetes: – Food eaten and digested in stomach – broken down into glucose – blood sugar levels rise – Insulin made by the pancreas acts as a transporter. Moves the sugar from the blood into body cells for use now or at a later stage – which then lowers the blood sugar. • In diabetes: – The pancreas is impaired so insulin does not work as well or it is not produced at all – Blood sugar levels in the body rise which make us feel unwell Diabetes • Type 1 – Pancreas completely stops functioning – Normally happens in younger people – Autoimmune most likely cause – the body mistakenly attacking the cells that make insulin – Genetic component • Type 2 – – – – – Insulin may not be as effective or insulin production is reduced Usually later in life over age of 40 More common if overweight 1 in 20 aged over 65, 1 in 5 over 85 5 times more common in South Asian & afro-caribbean populations – Increased risk if other family members have diabetes ‘My blood sugar is high. What’s the fuss?’ High sugar levels in the blood make us feel unwell – Feeling thirsty all the time – Passing large amounts of urine – Tiredness, weight loss – Blurred vision – Recurrent infections – Severe: dehydration, drowsiness, life-threatening – Some might not have any symptoms (type 2) Longer term complications – Increased risk of angina, heart attacks, stroke, poor circulation – Kidney damage which can lead to kidney failure – Eye problems affecting vision – Nerve damage – Foot problems due to poor circulation and nerve damage – Impotence due to poor circulation and nerve damage Diagnosing & monitoring diabetes control • Diabetes diagnosis – – – – Random blood sugar Fasting blood sugar Glucose tolerance test HbA1c >11 mmol/l >7 mmol/l >11 mmol/l >6.5 (limited use) • Pre-diabetes – fasting blood sugar – Glucose tolerance test >6.1 - <7 >7.8 - <11.1 Nearly 1 in 5 of 40-65years in UK have ‘pre-diabetes’ Managing & Treating diabetes • What are the aims of treatment? 1. To keep your blood glucose level as near normal as possible – – 2. Manage risk factors – – – 3. Lifestyle – diet, weight & exercise Medication – tablets or insulin (injections) Keep blood pressure down Stop smoking Keep cholesterol down Prevent & manage complications – – – Regular checks of blood sugar, HbA1c, cholesterol & blood pressure Eye checks, Foot checks Kidney tests, urine tests Lifestyle • Diet – Reduce fat, reduce salt, reduce sugar – Increase fibre intake, fruit & vegetables • Weight loss – May help to reduce glucose – Increased overall wellbeing, mood & fitness – Physical activity, reduce risk of cardiovascular complications as well Exercise • 2 and half hours a week = • 30 minutes of exercise per day over 5 days or • 75 minutes of vigorous activity – Eg – Brisk walking, cycling, running, football, swimming, carrying or moving goods including groceries Minimise sedentary/sitting periods – Reduce time in front of TV Medications • Metformin – Increases the effectiveness of insulin the body has • Gliclazide – Increased release of insulin from the pancreas • Gliptins – Increase hormones that lead to increased release of insulin • Insulin – Many different types – short acting / long acting – to suit different lifestyles – Can be given directly by injection if tablets are not effective – Use in type 1 diabetes Hypoglycaemia (low blood sugar) • May occur with certain medications and insulin • Symptoms – – – – weakness, faintness, hunger Confusion, strange behaviour Sweating, cold, clammy Pins & needles in lips/tongue • Treatment – Sweets, sugary drinks, glucose drinks – Check blood sugar and follow up with further food to prevent hypoglycaemia occurring again Summary What diabetes is Why we treat How we diagnose Management – lifestyle, medications and routine checks Managing hypoglycaemia Any questions? http://www.patient.co.uk/health/low-fat-dietsheet http://www.nhs.uk/Livewell/Goodfood/Docume nts/Eatwellplate.pdf