Diabetes

1. Diabetes
Theresa Lowry-Lehnen
RGN, BSc (Hon’s) Specialist Nurse Practitioner, PGCC, Dip Counselling,
Dip Adv Psychotherapy, BSc (Hon’s) Clinical Science, PGCE (QTS), H. Dip. Ed, MEd,
MHS Accredited Emotional Intelligence assessor (Psychology), PhD Psychology

2. Video- Diabetes made simple.
 https://www.youtube.com/watch?v=MGL6km1NB
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3. Video on Diabetes
 https://www.youtube.com/watch?v=sTgB
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4. Diabetes Mellitus
 Diabetes comes from the Greek word ‘to pass
through’
 Diabetes is a long-term condition caused by too
much glucose, a type of sugar, in the blood.
 There are two main types of diabetes, which are
explained below:
 type 1 diabetes – Insulin Dependent
 type 2 diabetes – Non-insulin Dependent

5. What are the symptoms?
 feeling very thirsty
 going to the toilet a lot (urine), especially at night
 extreme tiredness / fatigue
 weight loss and muscle wasting (loss of muscle bulk) mainly
type 1 Diabetes. Type 2 is associated with obesity.
 Blurred vision.
 Recurrent skin infections.
 Vaginal infections or infections of the foreskin in
uncircumcised men.
 Slow healing of wounds / sores.
 Symptoms of type 1 diabetes can develop quickly, over
weeks or even days
 Many people have type 2 diabetes for years without
knowing it because type 2 diabetes may be associated with
no symptoms

9. How does diabetes occur?
 Diabetes is a metabolic condition in which the
body does not properly regulate glucose in the
blood.
 When we eat carbohydrates, the body breaks
them down into sugars, including glucose.
 Glucose is transported by the bloodstream to the
cells, where it is used for energy.
 The hormone insulin, secreted by the pancreas, is
responsible for moving glucose from the blood into
the cells.
 People with diabetes either do not make insulin, or
their body does not properly respond to insulin,

10. Type 1 Diabetes
 Type 1 diabetes develops as a result of an autoimmune
attack on the pancreas that causes it to stop producing
the hormone insulin. Without insulin, blood glucose is not
regulated and type 1 diabetes develops.
 The exact cause is unknown, but the illness tends to run
in families. Among people with a genetic predisposition
for type 1 diabetes, an environmental trigger appears to
stimulate the immune system attack on the pancreas.
Certain viral infections in the first year of life are
associated with an increased risk for type 1 diabetes.
 Far less common than type 2 diabetes – 5-10% of all
people with diabetes
 Need to take insulin injections for life

12. Type 2 Diabetes
 Type 2 diabetes accounts for 90 to 95 percent of
all diabetes cases. Type 2 diabetes typically begins
with insulin resistance, a condition in which the
pancreas produces insulin but the body cells do
not respond to it properly.
 As the disease progresses, the pancreas may
eventually lose its ability to produce insulin.
 Type 2 diabetes also involves a strong genetic
component combined with other risk factors,
including obesity and a sedentary lifestyle.
 Obesity-related diabetes is sometimes referred to
as maturity-onset diabetes because it is more
common in older people.

14. Diabetes in pregnancy
(Gestational Diabetes)
 Gestational diabetes is a form of glucose intolerance that
develops during pregnancy. Although the cause is unknown,
it occurs more often in obese women and women with a
family history of diabetes.
 It affects approximately12% of pregnant women.
 Gestational diabetes can increase the risk of health problems
in an unborn baby, so it is important to keep the levels of
glucose in the blood under control.
 Women who develop gestational diabetes are more likely to
develop type 2 diabetes later in life.

15.  Normal and diabetic blood sugar ranges
 Normal blood glucose level in humans is about 4
mm (4 mmol/L or 72 mg/dL)
 When operating normally the body restores blood
sugar levels to a range of 4.4 to 6.1 mmol/L (82 to
110 mg/dL)
 Shortly after a meal the blood glucose level may
rise temporarily up to 7.8 mmol/L (140 mg/dL)
 For people with diabetes, blood sugar level targets
are as follows:
 Before meals: 4 to 7 mmol/L for people with type 1
or type 2
 After meals: under 9 mmol/L for people with type 1
and 8.5mmol/L for people with type 2

19. Hypoglycaemia
 Hypoglycaemia is the term for a low level of sugar
(glucose) in the blood (less than 4 mmols/l) and if
untreated can lead to coma/ unconsciousness.
 The immediate treatment for a hypo is to have
some food or drink that contains sugar such as a
glass of lucozade, fruit juice or 4 to 5 dextrose or
boiled sweets
 After having something sugary, there may be a
need to have a longer-acting carbohydrate food,
such as a few biscuits or a sandwich
 Monitor blood sugars regularly.

20. Hyperglycaemia
 Hyperglycaemia occurs when there is a higher than
normal level of glucose (sugar) in the blood
 Steps need to be taken to lower blood glucose
levels, such as increasing the dose of insulin
 Diet and exercise can also be used to adjust blood
glucose levels
 Left untreated, hyperglycaemia can develop into
diabetic ketoacidosis which is a serious condition
that can lead to coma
 Diabetic ketoacidosis will need to be treated in
hospital.

21. How is diabetes diagnosed?
 Diabetes is diagnosed by examining glucose levels
in blood samples using one or more of the following
tests:
 Random glucose test — a glucose level above
11.1mmol/L taken at a random time on two
occasions is a diagnosis of diabetes.
 Fasting glucose test — a glucose level above
7.8mmol/L measured without anything to eat and
on two different days is a diagnosis of diabetes.
 Glucose tolerance test — a blood glucose test is
taken two hours after a glucose drink is given to the
patient. A level above 11.1mmol/L is a diagnosis of
diabetes, while a level below 7.8 is normal.

22. Type 1 Diabetes: Do’s
 Blood glucose testing kit used regularly — to
measure the blood glucose levels and control the
insulin dose.
 Learn how to give insulin injections — needed for
life.
 If a smoker-stop.
 Follow the diet advised by the doctor and eat at
regular times.
 Exercise regularly and eat more or decrease the
insulin to prevent low blood sugar levels.

23. Type 1 Diabetes: Do’s
 Carry some form of sugar (and a protein snack)so
that a low blood sugar can be treated quickly.
 Visit the doctor regularly so that blood glucose
levels can be checked and eyes, urinalysis and
feet examined for signs of diabetic symptoms.
 Tell the doctor if you feel ill or if you have been
diagnosed with another disease.
 Carry identification (such as a card or bracelet)
that says you have diabetes, in case of an
emergency.

24. Type 2 Diabetes: Do’s
 If overweight, lose weight — losing as little as a few
pounds can reduce the need to take medication.
 Follow the diet advised by the doctor.
 If a smoker-quit.
 Learn how to use the home glucose testing kit
(either blood or urine) and use it regularly —to
measure glucose levels.
 If need for insulin, learn how to give insulin
injections.

25. Type 2 Diabetes: Do’s
 Visit the doctor regularly so that the blood
pressure, blood glucose levels and amount of
lipids (fat) in the blood can be checked, and your
eyes, urinalysis and feet examined.
 Tell the doctor if you feel ill or if you have been
diagnosed with another disease.
 Carry identification (such as a card or bracelet)
that says you have diabetes, in case of an
emergency.

26. Blood glucose monitor

27. Exercise and Diabetes
Weight loss
Lower blood sugar levels
Lower blood pressure
Stronger muscles and joints
Better self image
Self confidence
Better shape

28. What is the outlook?
 Type 1 diabetes:
 Type 1 diabetes is a lifelong condition, but, if treated
effectively, will reduce the risk of developing late-
stage diabetic complications.
 Type 2 diabetes:
 Type 2 diabetes is also a lifelong condition, but it can
usually be controlled with a combination of diet and
medication, although as the disease progresses,
insulin injections may be required to minimise the risk
of further complications.