Diabetes

Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Diabetes type 1

The autoimmune reaction of the body to the pancreatic beta cells in the islets of Langerhans and the resulting destruction of these beta cells, cause an immediate insuline deficiency, resulting in type 1 diabetes.

Diabetes mellitus type 1 is a degenerative disease, which is traditionally treated using insuline injections. These injections replace the missing hormone, but the complications can be far-reaching. Hyperglycemia is a common contributor to a number of complications like

Heart and vascular diseases

Eye and kidney complaints

Poor vascularisation

Damage to nerve cells (neuropathy)

Diabetic feet

High susceptibility for infections

Erectile penile dysfunction

Diabetes type 2

Type 2 diabetes used to be known as maturity onset, or non-insulin dependent diabetes. Although type 2 diabetes typically affects individuals over the age of 40, today it occurs at an increasingly younger age, especially in people who have a family history of diabetes.

Diabetes mellitus type 2 is by far the most common form, affecting 85 - 90% of all people with diabetes. Experts estimate that nearly one-third of people who have type 2 diabetes don't even know it. If the condition is left uncontrolled, the consequences (like with diabetes type 1) can be life threatening.

Hypoglycemia

Part of living with diabetes is learning to cope with some of the problems that go along with having the disease. Hypoglycemia or low blood glucose (sugar) is one of those problems. Hypoglycemia happens from time to time to everyone who has diabetes.

Hypoglycemia, sometimes called an insulin reaction, can happen even during those times when you're doing all you can to manage your diabetes. So, although many times you can't prevent it from happening, hypoglycemia (low blood glucose) can be treated before it gets worse. For this reason, it's important to know what hypoglycemia is, what symptoms of hypoglycemia are, and how to treat hypoglycemia.

What are the symptoms of hypoglycemia?

The symptoms of hypoglycemia include:

Shakiness

Dizziness

Sweating

Hunger

Headache

Pale skin color

Sudden moodiness or behavior changes, such as crying for no apparent reason

Clumsy or jerky movements

Seizure

Difficulty paying attention, or confusion

Tingling sensations around the mouth

How do you know when your blood glucose is low?

Part of managing diabetes is checking blood glucose often. Ask your doctor how often you should check and what your blood glucose levels should be. The results from checking your blood will tell you when your blood glucose is low and that you need to treat it.

You should check your blood glucose level according to the schedule you work out with your doctor. More importantly though, you should check your blood whenever you feel low blood glucose coming on. After you check and see that your blood glucose level is low, you should treat hypoglycemia quickly.

If you feel a reaction coming on but cannot check, it's best to treat the reaction rather than wait. Remember this simple rule: When in doubt, treat. How do you treat hypoglycemia?

The quickest way to raise your blood glucose and treat hypoglycemia is with some form of sugar, such as 3 glucose tablets (you can buy these at the drug store), 1/2 cup of fruit juice, or 5-6 pieces of hard candy.

Ask your health care professional or dietitian to list foods that you can use to treat low blood glucose. And then, be sure you always have at least one type of sugar with you.

Once you've checked your blood glucose and treated your hypoglycemia, wait 15 or 20 minutes and check your blood again. If your blood glucose is still low and your symptoms of hypoglycemia don't go away, repeat the treatment. After you feel better, be sure to eat your regular meals and snacks as planned to keep your blood glucose level up. It's important to treat hypoglycemia quickly because hypoglycemia can get worse and you could pass out. If you pass out, you will need IMMEDIATE treatment, such as an injection of glucagon or emergency treatment in a hospital.

Glucagon raises blood glucose. It is injected like insulin. Ask your doctor to prescribe it for you and tell you how to use it. You need to tell people around you (such as family members and co-workers) how and when to inject glucagon should you ever need it. If glucagon is not available, you should be taken to our hospital number for treatment for low blood glucose. If you need immediate medical assistance or an ambulance, someone should call the emergency number ( 511 25 11) for help.

If you pass out from hypoglycemia, people should:

NOT inject insulin.

NOT give you food or fluids.

NOT put their hands in your mouth.

Inject glucagon.

Call for emergency help.

How do you prevent low blood glucose?

Good diabetes control is the best way we know to prevent hypoglycemia. The trick is to learn to recognize the symptoms of hypoglycemia. This way, you can treat hypoglycemia before it gets worse.

Hypoglycemia Unawareness

Some people have no symptoms of hypoglycemia. They may lose consciousness without ever knowing their blood glucose levels were dropping. This problem is called hypoglycemia unawareness.

Hypoglycemia unawareness tends to happen to people who have had diabetes for many years. Hypoglycemia unawareness does not happen to everyone. It is more likely in people who have neuropathy (nerve damage), people on tight glucose control, and people who take certain heart or high blood pressure medicines.

As the years go by, many people continue to have symptoms of hypoglycemia, but the symptoms change. In this case, someone may not recognize a reaction because it feels different.

These changes are good reason to check your blood glucose often, and to alert your friends and family to your symptoms of hypoglycemia. Treat low or dropping sugar levels even if you feel fine. And tell your team if your blood glucose ever drops below 50 mg/dl without any symptoms.