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Diabetes is a very common condition affecting over 3 million people in the UK. The illness often goes unnoticed in its initial stages.

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What is diabetes?

Diabetes is a condition which affects your blood sugar levels. If you suffer from diabetes, your blood sugar levels are permanently too high, which can cause a range of symptoms and can lead to serious complications in the long term. It is estimated that half a million people in Britain suffer from diabetes without having been diagnosed. If you think you might be one of them, you should consider getting tested. The earlier a diabetes patient is diagnosed, the better - the condition needs to be monitored and controlled in order to prevent it from worsening and causing serious harm.

Who is at risk of developing diabetes?

There are two different types of diabetes. Type 1 diabetes is a hereditary autoimmune condition, which is usually diagnosed during the teenage years. It occurs, when your body is unable to produce insulin, which is needed to process glucose. As a result, the blood level of glucose remains too high. Treatment of this type of diabetes involves insulin injections and a balanced diet in order to keep the blood sugar level under control.
Type 2 diabetes is significantly more common than type 1 and usually affects patients over 40.

Type 2 diabetes occurs, when the pancreas produces too little insulin or when your body is unable to use the insulin it produces in an effective way. Both cases lead to an increased blood sugar level, which can cause damage to your inner organs if left untreated. Risk factors include being overweight, having impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT) and having a family history of diabetes. You also have an increased risk for developing diabetes if you are from South Asian, African, African-Caribbean and Middle Eastern descent.

Can diabetes be prevented?

Maintaining a healthy weight and eating a balanced diet helps reduce your risk of type 2 diabetes, as does regular exercise. Type 1 can not be prevented, as it is hereditary.

What are the symptoms?

Both type 1 and type 2 can lead to the patient feeling tired, thirsty and needing to urinate frequently, especially at night. Weight loss and loss of muscle bulk can also be indicators of diabetes. The condition often goes unnoticed in its initial stages, as its symptoms are missed or misinterpreted. If your blood sugar level gets very high, you will experience symptoms of hyperglycemia. These include extreme thirst and a dry mouth, drowsiness and blurred vision.

How is diabetes diagnosed?

There are a number of tests which can help establish whether a patient is diabetic or not. These include a random blood glucose test, fasting blood glucose test and the HbA1c test. If you are suffering from diabetes symptoms or have an increased risk of suffering from this condition, you should get tested. You can take a HbA1c blood test through our online doctor service. If your HbA1c blood test result indicates that you are diabetic, your GP will conduct follow-up tests to confirm your diagnosis and establish which treatment is most suitable for you.

Are there any possible complications?

If left untreated, diabetes can cause serious damage to your health, affecting various parts of the body. Complications include cardiovascular disease, damage to the retina of your eyes, nerve damage and kidney disease. It can also lead to life-threatening emergencies such as diabetic ketoacidiosis and hyperosmolar hyperglycaemic state (very high blood sugar). There are numerous other health problems associated with diabetes, such as polycystic ovary syndrome, thyroid disease, muscular problems and dental health issues.

How is diabetes treated?

How your diabetes is treated depends on which type you suffer from and how well controlled your blood sugar levels are. While patients with type 1 require regular insulin injections, diabetics suffering from type 2 can be treated with a range of medicines. The first step towards controlling glucose levels consists of managing your diet and eating healthily.

In many cases, type 2 diabetes can be controlled without medication, if the patient follows an appropriate diet. If you have been diagnosed with type 2 diabetes and require medical treatment, your doctor will aim to treat you with tablets. If your condition can not be controlled with oral medication, you may require insulin injections on a regular basis.

Which types of medicine are used to control type 2 diabetes?

The following types of medication can be used to control type 2 diabetes:

Metformin
Brand names: Glucophage, Riomet, Fortamet, Glumetza, Obimet Dianben Diabex Diaformin


Sulphonylureas
Brand names: Amaryl, Minodiab, Daonil, Euglucon, Diamicron

Glitazones (also known as Thiazolidinediones)
Brand name: Actos

Gliptins
Brand name: Januvia

GLP-1 Agonists
Brand names: Byetta, Victoza

Acarbo / Acarbose
Brand names: Glucobay

Nateglinide and Repaglinide
Brand names: Starlix, Prandin, Novonorm

Can diabetes be cured?

There is currently no cure for diabetes. Once you have been diagnosed, the condition needs to be monitored and controlled on a permanent basis. Diabetes has the tendency to worsen over time, which is why it is vital to diagnose and treat it as early as possible.

How should I adjust my diet?

If you have been diagnosed with diabetes, your doctor will recommend that you eat healthily as part of your treatment. This is an important step in controlling your blood sugar levels. You should aim to have regular meals, spaced out over the day. Including starchy foods rich in carbohydrates will help keep your glucose levels balanced, you should opt for carbs which are absorbed slowly, such as pasta, rice, oats or wholemeal bread.

It is also important to keep your intake of saturated fats low. It is a good idea to try and include beans, lentils and other pulses in your diet as they have little impact on your blood sugar levels and can help to reduce blood fats. As with a normal diet, you ought to eat at least 5 portions of fruit and veg every day and aim to eat fish twice every week.

Be cautious with alcohol - drinking alcohol on an empty stomach can lead to hypoglycemia in patients taking diabetes medication. It is also important to limit your salt intake to no more than 6g per day to prevent an increase in blood pressure.

Most importantly, you should limit your intake of sugar, as it increases the glucose levels in your blood. Watch out for sugar in ready meals and fizzy drinks.

Your doctor will be able to assist you in devising a personal meal plan to manage your diabetes.

Which side effects can occur?

When undergoing medical treatment for diabetes, you may experience side effects. Which side effects are likely depends on the medication or combination of medications your doctor has prescribed. Always read your patient leaflet and ask a doctor if you are experiencing any side effects.

Always consult a doctor if you experience:

Seizures, jaundice, unusual tiredness or drowsiness, dizziness, severe muscle pain, difficulty breathing, irregular heartbeat, stomach pain and nausea, blue or cold skin, dark urine, swelling of the face, lips, tongue or throat, severe blistering, peeling or red skin rash

What is hypoglycaemia?

Most types of medication used to treat diabetes can cause hypoglycaemia (low blood sugar). Hypoglycaemia can lead to fainting and coma. You should eat regular meals and monitor your blood sugar levels closely to prevent this potential emergency situation. Your doctor will give you guidance on how to avoid and if necessary treat this side effect when prescribing your medication. Symptoms of hypoglycaemia include weakness and trembling, dizziness and light-headedness as well as headache, irritability and lack of concentration.

Drug Comparison Table

Your GP will assess your condition and choose the best treatment for you. Diabetes treatment can consist of a combination of medicines and always relies on a healthy diet in addition to any medication taken. The following table gives an overview over different types of medication used to treat diabetes. For a complete list of warnings and side effects please read your patient leaflet or ask your doctor.

 

Type of Medication

How does it work?

Who is it for?

Common side effects

Contraindications

Metformin

Metformin reduces the amount of sugar produced in the liver, increases the sensitivity of muscle cells to insulin and delays the absorption of sugar into the bloodstream.

Patients with type 2 diabetes

Feeling sick or being sick, diarrhoea, unusual taste, lack of appetite

Decreased kidney function, decreased liver function, dehydration, reduced blood flow to vital organs, respiratory failure, heart failure, alcohol abuse

Sulphonylureas

Sulphonylureas help the pancreas produce more insulin and allow the cells to use insulin more effectively.

Patients with type 2 diabetes

Low blood glucose

Hypersensitivity to sulfonylurea, pregnancy

Glitazones

Reverse the insulin resistance, thus lowering blood sugar.

Patients with type 2 diabetes

Sore throat, infections of nose and sinus, urinary tract infection, muscle pain, dizziness, headache, bloatedness

Macular edema, heart failure, water retention, bloody urine, injury or broken bones, cancer of the bladder, abnormal liver function tests, low blood pressure

Gliptins

Gliptins block the enzyme DPP-4, which destroys a hormone called incretin; as a result, the body can produce more insulin

Patients with type 2 diabetes

Aches and pains, cough, difficulty breathing and loss of voice, ear congestion, fever, nose and throat infections, sneezing

Serious reaction to sitagliptin

GLP-1 Agonists

GLP-1 Agonists increase insulin production while inhibiting glucagon release when glucose levels are increased. They also slow down the rate at which your stomach digests food.

Patients with type 2 diabetes

Nausea, reduced appetite (which can result in weight loss)

Kidney failure, pancreatitis

Acarbo

Acarbo inhibits enzymes needed to digest carbohydrates, so that less glucose is produced; as a result, blood glucose levels decrease.

Patients with type 2 diabetes

Flatulence, diarrhoea

Hypersensitivity to ingredients, cirrhosis, inflammatory bowel syndrome, colonic ulcer, malabsorption syndromes, kidney problems, diabetic ketoacidosis

Nateglinide and Repaglinide

Nateglinide and Repaglinide act on the cells in the pancreas, causing them to produce more insulin.

Patients with type 2 diabetes

Headache, nasal congestion and runny nose, joint and back pain, flu-like symptoms and cough, constipation

Hypersensitivity to any of the ingredients

Insulin injections

Insulin injections are used to replace the lacking insulin which is normally produced by your body; Insulin processes blood sugar and decreases glucose levels

Suitable for patients with type 1 or type 2 diabetes

Side effects are rare and are usually caused by allergic reactions such as swelling and itching around the injection site. A more serious allergic reaction can involve nausea and vomiting

Eating disorders and liver problems, malabsorption syndromes, kidney problems, over - or underactive thyroid gland, low blood sugar, potassium deficiency

If you have a question about this service, please email info@dred.com with the question, and one of our doctors will get back to you within 24 hours.

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