Understanding diabetes

Dr Ravi Govender MBChB, General Practitioner, Intercare Wilgeheuwel

Living with diabetes does not only have an impact on your quality of life, but also on those around you.

Diabetes mellitus is a chronic condition characterized by hyperglycaemia due to a deficiency of insulin secretion by the pancreas. A lack of insulin affects carbohydrate, protein, fat, as well as water and electrolyte metabolism.

I am diabetic myself, which allows me to better understand the concerns of those patients, friends and family who are diabetic as well.

Diabetes is classified into 2 types:

Type 1: Previously known as insulin dependent diabetes mellitus (IDDM). It is affecting approximately 5-10% of the population who has diabetes. It is an autoimmune condition in which the body turns on itself and destroys the beta-cells of the pancreas that produce insulin which lowers blood glucose levels. It occurs mainly in younger people and children.

Type 2: Previously known as non-insulin dependent diabetes mellitus (NIDDM). It is affecting 90-95% of the population who has diabetes. With type 2 diabetes, your body either resists the effects of insulin or doesn't produce enough insulin to maintain a normal glucose level. There's no cure for type 2 diabetes but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar levels, you may also need diabetes medications or insulin therapy.

Gestational diabetes occurs in some pregnant women.

Signs and symptoms

  • Loose dry skin
  • Furred tongue and cracked lips
  • Tachycardia
  • Hypotension
  • Reduced intraocular pressure
  • Breathing may be deep and sighing due to acidosis. The breath is usually fetid and the sickly sweet smell of acetone may be apparent
  • Mental apathy, confusion or coma may also be present
  • Weight loss
  • Dizziness
  • Frequent urination
  • Excessive thirst
  • Tiredness
  • Blurred vision
  • Neuropathies: loss of sensation in feet, pins and needles, diminished impalpable pulses in feet
  • Hypertension and atherosclerosis


Causes of Diabetes

  • The exact cause of type 1 diabetes is unknown. What is known is that the immune system attacks and destroys your insulin-producing cells in the pancreas. This results in little or no insulin in your body, causing a build-up of sugar in your bloodstream. Type 1 is caused by a combination of genetic susceptibility and environmental factors. These factors remain unclear.
  • In pre-diabetes and type 2 diabetes, your cells become resistant to the action of insulin and your pancreas is unable to produce enough insulin to overcome resistance. Sugar builds up in the bloodstream instead of moving into the cells where it is required for energy. It is uncertain as to why this occurs. Obesity is strongly linked to the development of type 2diabetes, but not everybody with type 2 is overweight.

Modern medicine, better medical facilities and doctors that care, would impact on better outcomes. Hopefully I would be one of them.

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