What is diabetes?

Diabetes mellitus is one of the most common chronic conditions in the world and occurs when the body fails to process glucose correctly. Many South Africans have diabetes, but a large number remain undiagnosed. 

Type 1 diabetes is a progressive autoimmune disease that is usually diagnosed in children and young adults, whereas type 2 diabetes is mostly caused by unhealthy lifestyle and usually starts in adulthood. Some women can also develop signs of diabetes while they are pregnant – this is called gestational diabetes. 

It is possible to live a healthy life with diabetes, if you learn to recognise the symptoms of diabetes at an early stage, receive proper medical care, and make healthy lifestyle changes.

The role of insulin

Insulin is produced by the beta cells of the pancreas; it is secreted in response to an increased concentration of glucose in the blood, and is vital in controlling blood glucose levels. A person with diabetes cannot control their blood glucose and they become hyperglycaemic – meaning that they have abnormally high levels of glucose in the blood. 

Type  1 diabetes

Type 1 diabetes is a disorder of sugar/carbohydrate metabolism in which the pancreas is no longer able to produce any insulin. This is due to destruction of the insulin-producing beta cells of the pancreas by an autoimmune process.

Type 1 diabetes commonly develops before the age of 40, with a peak incidence around 14. Those with a strong family history of diabetes are at risk of developing the disease.

The long-term complications of type 1 diabetes can be well controlled by using a “tight-control” regime in which blood glucose is measured several times each day and the insulin dose adjusted accordingly.

Type 2 diabetes

Type 2 diabetes is the most common variety of diabetes. It is a disorder of carbohydrate metabolism in which the body effectively becomes resistant to the hormone insulin.

Type 2 diabetes is strongly associated with obesity, a sedentary lifestyle, and abnormal lipid levels.

Initially, the person with this disorder has impaired tolerance to glucose, commonly known as insulin resistance. This develops into high blood glucose levels after eating and eventually high blood glucose levels even when fasting.

Some people with type 2 diabetes remain relatively sensitive to insulin, while others have little or no insulin sensitivity. This difference affects treatment of the disease. In general, those type 2 diabetics who are not obese retain some sensitivity to insulin.

Gestational diabetes

Gestational diabetes occurs during pregnancy and is a condition where the body cannot produce enough insulin. This happens because of extra weight and changing hormones.

Gestational diabetes can lead to serious complications, and both mother and child also have an increased risk to develop diabetes at a later stage in their lives.
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