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This month
Diabetes for Dummies
UK Edition
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Now with over 20 UK editions -
written by UK authors for UK readers.
Each month in our great new series of
Dummies Articles, we highlight a particular Dummies book which is
relevant to over 50s readers including extracts and tips from the
books themselves.
If you want to buy any of the books
you can immediately click on the images to link to Amazon and buy
them online.
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Controlling Your Glucose for Diabetes
(an extract from Diabetes for Dummies.
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In order to understand the symptoms of diabetes, you need to know a
little about the way the body normally handles glucose and what happens
when things go wrong. The following sections explain the fine line that
your body treads between control and lack of control of its glucose
levels.
Hormones at the helm
A hormone is a chemical substance made in one part of the body that
travels (usually through the bloodstream) to a distant part of the body
where it performs its work. A hormone called insulin finely controls the
level of glucose in your blood. Insulin acts like a key to open the
inside of a cell, such as muscle or fat, so that your glucose can enter.
If your glucose can't enter the cell, it can provide no energy to the
body from that cell.
Because of the important role it plays, insulin
is essential for growth. In addition to providing the key to entry of
glucose into the cell, scientists consider insulin the "builder hormone"
because it does the following:
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- It enables fat and muscle to form.
- It allows storage of glucose in a form called glycogen for use when
fuel is not coming in.
- It blocks breakdown of protein.
Without insulin, you couldn't survive for long. With the fine-tuning
that insulin gives, the body manages to keep the level of glucose in
your body pretty steady at about 3.3 to 6.4 mmol/l all the time.
Symptoms and signposts
Your glucose starts to rise in your blood when your body doesn't
produce enough insulin or when it's not working effectively. Once
your glucose rises above 10.0 mmol/l, glucose begins to seep into
your urine and make it sweet (as the ancient Greeks and Romans
noticed). Up to that point, your kidney — the filter for your blood
— is able to extract glucose before it enters your urine. Losing
glucose into the urine leads to many of the short-term complications
of diabetes.
The following list identifies the most common early symptoms of
diabetes and how they occur. One or more of the following symptoms
may be present when diabetes is diagnosed:
- Frequent urination and thirst: The glucose in your urine draws more
water out of your blood, so more urine forms. More urine in your
bladder makes you feel the need to urinate more frequently during
the day and to get up at night to empty the bladder, which keeps
filling up. As the amount of water in your blood declines, you feel
thirsty and drink much more frequently.
- Fatigue: Because glucose can't enter cells that depend on insulin as
a key for glucose (the most important exception is the brain, which
does not need insulin), glucose can't be used as a fuel to move
muscles or to facilitate the many other chemical reactions that have
to take place to produce energy. Before you're diagnosed with
diabetes, you will often feel tired, and you're likely to feel much
stronger once treatment allows glucose to enter cells again.
- Weight loss: Weight loss is common among some people with diabetes
because they lack insulin, which is the builder hormone. When
insulin is lacking for any reason, the body begins to break down.
You lose muscle tissue. Some of the muscle converts into glucose
even though it cannot get into cells. It passes out of your body in
the urine. Fat tissue breaks down into small fat particles that can
provide an alternate source of energy. As your body breaks down and
you lose glucose in the urine, you often experience weight loss.
However, most people with diabetes are heavy rather than skinny.
Weight loss is much more likely to be a symptom of type 1 rather
than type 2 diabetes.
- Persistent vaginal infection among women: As your blood glucose
rises, all the fluids in your body contain higher levels of glucose,
including the sweat and body secretions such as semen in men and
vaginal secretions in women. Many bugs, such as bacteria and fungi,
thrive in the high glucose environment. Women may begin to complain
of itching or burning, an abnormal discharge from the vagina, and
sometimes an odour.
 In the U.K., all patients who register with a new GP will be offered
a new patient registration check, which should include a dipstick
test of your urine for glucose and protein. The idea is to pick up
diabetes early in people who don't have any symptoms. Unfortunately,
the level of blood sugar at which your body lets glucose "overflow"
into your urine varies from person to person, and at different times
of your life. As you get older, for instance, you can usually have
much higher levels of blood glucose without getting sugar in your
urine. That makes the urine screening test for diabetes notoriously
inaccurate. If you (or someone you know) think you might have
diabetes but your urine is negative for sugar on testing, make sure
you ask to have a fasting blood test. |
Dummies Articles in this series
Other Dummies Books
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Discovering ways to treat Diabetes
A condition that must have been diabetes mellitus appears in the
writings of China and India more than 2,000 years ago. The
description is the same one that the Greeks and Romans reported —
urine that tasted sweet. Scholars from India and China were the
first to describe frequent urination. But it wasn't until 1776 that
researchers discovered the cause of the sweetness — glucose. And it
wasn't until the nineteenth century that doctors developed a new
chemical test. Later discoveries showed that the pancreas produced a
crucial substance, called insulin, which controlled the glucose in
the blood. Since that time, insulin has been extracted and purified
— and it's still a real life saver today. Oral drugs have been
available for the past 40 years and stand alongside injected insulin
in the fight to reduce blood glucose.
Once insulin was discovered, diabetes specialists, led by Elliot
Joslin and others, recommended three basic treatments for diabetes
that are as valuable today as they were when first suggested in
1921:
The discovery of insulin has not solved the problem of diabetes,
although it saves the lives of thousands. Before the use of insulin
became widespread, the only treatment had been starvation; as people
treated in this way aged, they were found to have unexpected
complications in the eyes, the kidneys and the nervous system. And
insulin did not address the problem of the much larger group of
people with diabetes now known as type 2. Their problem was not lack
of insulin but resistance to its actions. Fortunately, doctors now
have the tools to bring the disease under control.
The next major discovery was the group of drugs called
sulphonylureas, the first drugs that could be taken by mouth to
lower the blood glucose. But the only way to know the level of the
blood glucose was still by testing the urine, which was entirely
inadequate for good diabetic control.
Around 1980, the first portable meters for blood glucose testing
became available. This made it possible, for the first time, to
relate treatment to a measurable outcome. This has led, in turn, to
discovery of other great drugs for diabetes like rosiglitazone,
pioglitazone, acarbose, repaglinide nateglinide and others. |
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