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DIABETES CARE DIABETES CARE DIABETES

Diabetes at a glance

Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood.
Insulin produced by the pancreas lowers blood glucose.
Absence or insufficient production of insulin causes diabetes.
The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent).
Symptoms of diabetes include increased urine output, thirst and hunger as well as fatigue.
Diabetes is diagnosed by blood sugar (glucose) testing.

The major complications of diabetes are both acute and chronic.

Acutely: dangerously elevated blood sugar, abnormally low blood sugar due to diabetes medications may occur.
Chronically: disease of the blood vessels (both small and large) which can damage the eye, kidneys, nerves, and heart may occur

Diabetes treatment depends on the type and severity of the diabetes. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, insulin medications are considered.

Risk factors

Although researchers don't fully understand why some people get type 2 diabetes and others don't, it's clear that certain factors increase your risk. These factors include:

Weight. Being overweight is one of the main risk factors for type 2 diabetes. The more fatty tissue you have, the more resistant your cells become to your own insulin. Still, it's not just a matter of how much you weigh. It also depends on where the weight is distributed. If you have extra weight in the upper part of your body — particularly around your abdomen — you're especially at risk. The good news is that many people with type 2 diabetes who are overweight can improve their glucose levels simply by losing weight.
Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose, makes your cells more sensitive to insulin, increases blood flow and improves circulation in even the smallest blood vessels. Exercise also helps build muscle mass. That's important because most of the glucose in your blood is absorbed into your muscles. When you have less muscle tissue, more sugar stays in your blood.
Family history. The risk of type 2 diabetes increases if you have a parent or sibling with the disease. In fact, researchers have confirmed that a variant in a particular gene increases the risk of developing type 2 diabetes. In a July 2006 study, the risk of developing diabetes was about 80 percent higher for participants who inherited two copies of the newly identified gene variant than for participants who didn't carry the variant.
Age. The risk of type 2 diabetes increases as you get older, especially after age 45. Often, that's because people tend to exercise less, lose muscle mass and gain weight as they age. But diabetes is also increasing dramatically among children, adolescents and younger adults.
Race. For reasons that aren't entirely clear, people of some races are more likely to develop diabetes. More than 6 percent of the general population has diagnosed diabetes, according to the American Diabetes Association. But that rate doubles for blacks and Hispanics and more than doubles for American Indians. Among the Pima Indians of Arizona, half of all adults have type 2 diabetes — one of the highest rates of diabetes in the world.
Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes is greater. If you gave birth to a baby weighing more than 9 pounds, you're also at risk of type 2 diabetes.
Depression. Depression seems to increase the risk of type 2 diabetes, possibly because people with depression often gain weight and are inactive.

Signs and symptoms of diabetes

Type 2 diabetes develops slowly. Many people have type 2 diabetes for several years before the condition is diagnosed, often through routine screening tests.

Typically, the earliest red flags are increased thirst and frequent urination. That's because excess glucose circulating in your body draws water from your tissues, making you feel dehydrated. To quench your thirst, you may drink more water and other beverages — which leads to more frequent urination.

Other signs and symptoms of type 2 diabetes include:

Flu-like symptoms. Sugar is an important fuel. When it doesn't reach your cells, you may feel tired and weak.
Weight fluctuations. Because your body is trying to compensate for lost fluids and sugar, you may eat more than usual and gain weight — which causes your cells to become more resistant to the action of insulin. But the opposite also can occur. You may eat more than normal but still lose weight because your muscle tissues don't get enough glucose to generate growth and energy.
Blurred vision. High levels of blood sugar pull fluid from your tissues, including the lenses of your eyes. This affects your ability to focus. Once your diabetes is treated and your blood sugar levels drop, your vision should improve. Over a period of years, however, diabetes can also cause new blood vessels to form in your retina — the back part of your eye — as well as damage old vessels. For most people this causes only mild vision problems. But for others, the effects can be much more serious. In some cases, diabetes can lead to blindness.
Slow-healing sores or frequent infections. Diabetes affects your body's ability to heal and fight infection. Bladder and vaginal infections can be a particular problem for women.
Nerve damage (neuropathy). Excess sugar in your blood can damage the small blood vessels to your nerves. You may notice tingling and loss of sensation in your hands and feet, as well as burning pain in your arms, hands, legs and feet.
Red, swollen, tender gums. Diabetes increases the risk of infection in your gums and in the bones that hold your teeth in place. Your gums may pull away from your teeth, your teeth may become loose, or you may develop sores or pockets of pus in your gums — especially if you have a gum infection before diabetes develops.

Signs and symptoms of acute attack

Faint and dizzy
May be confused
Pale skin with profuse sweating
Rapid pulse
Breathing shallow
odourless with low blood glucose
fruity, acetone breathe with high blood glucose
Limbs may tremble
Altered levels of consciousness

Treatment for hyperglycemia and hyperglycemia without knowledge of blood glucose levels

Rest the casualty, reassure them and obtain a medical history
Prepare a sugar based drink and introduce the drink
If casualty is unconscious place sugar granules under tongue and wait 15 seconds for them to dissolve. Repeat this process until the casualty regains consciousness.
Encourage casualty to drink sugary liquid

Diabetics with prescribed insulin

High blood glucose levels should be treated as prescribed by the casualty's doctor. Self medication of insulin is required. The casualty should administer the insulin. First aiders are not qualified to administer any form of medication.