Our body needs fuel for daily energy and this comes from the food we eat. The more energy we expend the more calories we require. We rely on a balance of nutrients from a variety of foods but for our basic unit of fuel energy we rely on glucose. We get it either from ingesting pure sugar or by eating carbohydrate and absorbing the digested glucose or by converting other foodstuffs into glucose. Diabetes is a medical disorder resulting from an abnormality of blood glucose control. It presents with high blood glucose levels measured by a blood test and with common symptoms such as passing urine frequently and being thirsty .

A certain level of glucose in the blood is always necessary so that the body can continue to tick over. If maintenance of this appropriate level of blood sugar fails the body’s engine will eventually conk out due a lack of proper fuel supply. Diabetes is the disease resulting from a defunct control mechanism where the blood glucose levels rise dangerously high. This means two things. First, the energy normally obtained from sugar is stuck in the blood circulation and therefore starving the cells of the body which results in fatigue as a symptom. Second, the build up of high sugar in the blood causes a dangerous imbalance of bodily fluid resulting in severe dehydration diabetic ketoacidosiswith consequent body failure The maintenance of blood glucose is controlled by insulin produced in the pancreas. Diabetes is the result of some problem with either insulin production or insulin action.

Normally blood glucose levels are tightly regulated by insulin and this mechanism goes wrong in diabetes. Insulin is a chemical messenger and is secreted into the blood by the pancreas when the blood sugar rises. The pancreas is very sensitive to blood sugar rises and although insulin is secreted into the blood continuously in small amounts it is delivered in much larger quantities after we eat food. Insulin helps drive the sugar from the blood into the cells of the body for use as fuel. Diabetes happens when either too little insulin is produced from the pancreas or the insulin fails to encourage the blood sugar to enter the cells of the body. If this is the case then the sugar will build up in the blood. This is exactly what happens when somebody develops diabetes.

The basic defects causing diabetes are therefore those affecting insulin supply from the pancreas and those reducing the action of insulin at its target sites. The net result will mean that glucose cannot be transferred from the blood to the tissues. The level of glucose in the blood builds up to abnormally high levels. This results in an upset in metabolism where there is reduced fuel for energy production in the tissues but where the high glucose in the blood circulation has a potential to damage the arteries in the longer term.

Insulin is therefore the critical factor in helping the body transfer the fuel provided by the food we eat into the cells of the body. Scientists have described a variety of different defects, both of insulin delivery and of insulin action, and because of this different types of diabetes have been described and different treatments are available. The net result of these problems is however, similar because they all result in high blood glucose levels with typical symptoms. This is why there is an impression of only one disorder called diabetes.

The most common types are known as diabetes, Type 1 and Type 2, but there is also Gestational diabetes occurring in pregnancy, diabetes secondary to specific pancreatic inflammation as occurs in pancreatitis, diabetes resulting from a drug side effect such as occurs with steroid based medication and there are an increasing number of genetic mutations associated with diabetes which are not found in Type 1 or Type 2 diabetes.

After assessing the typical symptoms and confirming the diagnosis with a blood test, one of the next logical steps would be to establish the specific diabetes type so that the most appropriate treatment can be initiated. For Type 1 diabetes it is usually appropriate for insulin treatment to be started immediately, for Type 2 diabetes there is a range of different treatments on offer.

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