There are currently over 3.2 million people with diabetes in the UK, or 6 per cent of the adult population, and 85–90 per cent of these sufferers have type 2.
Diabetes mellitus is a disorder where the body doesn’t produce enough insulin, or doesn’t react properly to the insulin it produces, causing a build-up of glucose in the blood. Type 2 diabetes often smoulders on for a long time before it is recognised and diagnosed – it is believed that there are hundreds of thousands of undiagnosed cases in the UK.
This book gives the basic information needed to understand what type 2 diabetes is, how to recognise it, and, most essentially, how to manage it, including details on:
• The symptoms of type 2 diabetes
• Risk factors for type 2 diabetes and how to reduce those risks
• The various medicinal treatments and support available
• Changes to daily routines, diet, exercise and attitude that can improve life with type 2 diabetes.
There are currently over 3.2 million people with diabetes in the UK, or 6 per cent of the adult population, and 85–90 per cent of these sufferers have type 2.
Diabetes mellitus is a disorder where the body doesn’t produce enough insulin, or doesn’t react properly to the insulin it produces, causing a build-up of glucose in the blood. Type 2 diabetes often smoulders on for a long time before it is recognised and diagnosed – it is believed that there are hundreds of thousands of undiagnosed cases in the UK.
This book gives the basic information needed to understand what type 2 diabetes is, how to recognise it, and, most essentially, how to manage it, including details on:
• The symptoms of type 2 diabetes
• Risk factors for type 2 diabetes and how to reduce those risks
• The various medicinal treatments and support available
• Changes to daily routines, diet, exercise and attitude that can improve life with type 2 diabetes.
Your Guide to Understanding and Dealing with Type 2 Diabetes: What You Need to Know
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Overview
There are currently over 3.2 million people with diabetes in the UK, or 6 per cent of the adult population, and 85–90 per cent of these sufferers have type 2.
Diabetes mellitus is a disorder where the body doesn’t produce enough insulin, or doesn’t react properly to the insulin it produces, causing a build-up of glucose in the blood. Type 2 diabetes often smoulders on for a long time before it is recognised and diagnosed – it is believed that there are hundreds of thousands of undiagnosed cases in the UK.
This book gives the basic information needed to understand what type 2 diabetes is, how to recognise it, and, most essentially, how to manage it, including details on:
• The symptoms of type 2 diabetes
• Risk factors for type 2 diabetes and how to reduce those risks
• The various medicinal treatments and support available
• Changes to daily routines, diet, exercise and attitude that can improve life with type 2 diabetes.
Product Details
| ISBN-13: | 9781783725809 |
|---|---|
| Publisher: | Summersdale |
| Publication date: | 06/11/2015 |
| Series: | Personal Health Guides |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 224 |
| File size: | 2 MB |
About the Author
Read an Excerpt
Your Guide to Understanding and Dealing with Type 2 Diabetes
What You Need to Know
By Keith Souter
Summersdale Publishers Ltd
Copyright © 2015 Keith SouterAll rights reserved.
ISBN: 978-1-78372-580-9
CHAPTER 1
An overview of diabetes
Diabetes mellitus is a lifelong disorder of carbohydrate metabolism that occurs when the pancreas does not produce enough insulin or when the tissues do not respond to the body's own insulin.
The characteristic feature of diabetes in an undiagnosed or untreated form is excess thirst and increased tendency to pass urine. This is the result of raised blood-glucose levels. Over time this can lead to serious damage to various body systems.
Common symptoms of diabetes
• Increased thirst
• Increased frequency of urination, especially at night
• Excessive tiredness
• Weight loss and loss of muscle bulk
• Itching around the genitals or frequent episodes of thrush
• Wounds or cuts are slow to heal
• Blurred vision, as a result of the lens of the eyes becoming dry
Types of diabetes
There are two main types of diabetes, which make up the vast majority of cases. They share the name diabetes mellitus, but each type has its own features, causes and indicated treatments.
Both types affect the blood-glucose levels and both produce complications unless they are adequately treated. These complications can significantly impair health and even lead to early death.
Type 1 diabetes
This is characterised by lack of insulin production. It used to be called juvenile onset diabetes or insulin dependent diabetes. This was because it tended to occur in children and young adults. It requires treatment with insulin.
It is an autoimmune condition in which the immune system attacks the insulin-producing cells in the pancreas. There is therefore a deficiency of insulin and the individual will have to take insulin injections for the rest of his or her life. It is not possible at this stage in time to prevent Type 1 diabetes from developing. Type 1 diabetes accounts for about ten per cent of all diabetes cases worldwide.
Type 2 diabetes
This is characterised by ineffective response to the body's own insulin.
It used to be called maturity onset diabetes, or insulin independent diabetes. This was because it tended to occur in adults who are overweight. The treatment usually involves dietary control and possibly oral hypoglycaemic drugs to lower the blood-glucose.
It is perfectly possible to prevent Type 2 diabetes. Type 2 diabetes accounts for about 90 per cent of all diabetes cases worldwide.
Gestational diabetes
This is diabetes that starts during pregnancy and goes away at the end of the pregnancy. It is usually discovered in the middle trimester of pregnancy.
Why we use the terms Type 1 and Type 2
The main reason why the older names are no longer used is simply because we are seeing increasing incidence of the following diabetes variants around the world. We see Type 1 developing in adults and we see Type 2 developing in children. In some countries, Type 2 accounts for almost half of newly diagnosed diabetes in children and adults.
Complications of diabetes
There are several possible complications from diabetes that may be divided into groups.
• Metabolic – problems with sugar levels, either from the condition or its treatment. The condition also affects protein and fat metabolism.
• Vascular – these can be subdivided into:
1. Macro-vascular – disease of large blood vessels, for example: coronary arteries (angina and heart attacks), peripheral arteries (intermittent claudication) and cerebral arteries (strokes).
2. Micro-vascular – disease of small blood vessels, for example: diabetic retinopathy (blood vessels in the retinae of the eyes), nephropathy (blood vessels in the kidneys) and neuropathy (blood vessels to the small tissues and the nerves).
• Immune impairment – making diabetics more susceptible to infections
• Cataracts and other eye problems
• Erectile dysfunction and loss of libido
• Foot and joint problems
• Skin problems
Diabetes is a leading cause of blindness, amputation and kidney failure.
Women who are already diabetic before they conceive a child are five times more likely to have babies with congenital heart disease than women without diabetes.
Babies born to women who develop gestational diabetes do not have the same risk because the condition tends to occur in the middle trimester after the baby's heart and organs have developed.
Life expectancy
Diabetes is a serious condition that can lead to early death if it is not carefully managed.
According to Diabetes UK, the life expectancy on average is reduced by:
• more than 20 years for people with Type 1 diabetes.
• up to ten years for people with Type 2 diabetes.
With good control of the diabetes, however, there is normal life expectancy.
Pre-diabetes
This is a very important condition. It is when the blood-glucose level is higher than normal, but not high enough to be diagnosed as diabetes. It is a state that increases the risk of diabetes.
It is estimated that there are around seven million people in the UK with pre-diabetes. The good news is that with alteration of lifestyle consisting of a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use Type 2 diabetes can be avoided.
Some risk factors for diabetes
There are a number of factors that increase the risk of diabetes.
Genetic tendency
The likelihood of developing Type 2 diabetes is also influenced by genetics and environmental factors. Research has shown that if:
• either parent has Type 2 diabetes, the risk of inheritance of Type 2 diabetes is 15 per cent.
• both parents have Type 2 diabetes, the risk of inheritance of Type 2 diabetes is 75 per cent.
Ethnicity
A lot of attention has been paid to changes in lifestyle, as many countries have adopted Western diets, with drastic increase in diabetes and increased incidence of heart disease and stroke. This has been particularly apparent in certain ethnic groups, such as some Native Americans and indigenous Australians.
The risk of diabetes is increased for some ethnic groups and reduced for others. Type 2 diabetes is six times more prevalent in people of South Asian ancestry and three times more likely to occur in people of African and Afro- Caribbean ancestry.
Obesity and diabetes
There seems to be a clear link between obesity and diabetes. It has been observed that as the incidence of obesity rises, so too does the incidence of diabetes.
In Japan, the incidence of diabetes is relatively low. However, among Japanese people who emigrated to the USA and adopted a Western lifestyle and diet, the incidence of both obesity and diabetes rose. Interestingly, in sumo wrestlers in Japan, who have to maintain body bulk in order to compete in this traditional sport, diabetes rates are significantly above normal.
Diabetes around the world
Diabetes mellitus is an important condition for both the individual and for society. It is important to the individual because it can affect his or her overall health. It predisposes people to other conditions and has many potential complications. If it is poorly controlled it can lead to early death.
The number of people suffering from diabetes is increasing every year. This seems to be the result of social changes in dietary habits with overconsumption of energy-rich foods, rising levels of obesity and more sedentary lifestyles.
Diabetes throws a significant load on the heath resources of all countries and, since so many people who are diagnosed with it are of working age, it can have a huge impact on a country's economy.
Most deaths are likely to take place in countries with limited resources where there are not facilities for renal dialysis or complex surgery. Indeed, insulin is not available in many of the poorest countries. This accounts for the high mortality rates in those countries.
About 80 per cent of all people with diabetes live in the poorest countries. By comparison, around 80 per cent of the money spent on diabetes care occurs in the richest countries.
UK situation
The UK has a population of 63 million, the third largest in the European Union. According to the charity Diabetes UK, there are around 850,000 people in the UK who have undiagnosed diabetes.
Cost
Diabetes UK estimates that around ten per cent of the NHS annual budget is used to fund treatment of diabetes, equating to about £9 billion per year.
Diabetes can affect anyone
Having diabetes should not stop you from enjoying life and being successful in your chosen field.
• Elvis Presley – the king of rock 'n' roll had diabetes.
• Queen Hatshepsut – a pharaoh of ancient Egypt who apparently had diabetes.
• Johnny Cash – the singer, had diabetes.
• George Lucas – the producer of Star Wars has Type 2 diabetes.
• Gary Hall – the Olympic swimmer has Type 1 diabetes.
• Sir Steve Redgrave – multiple Olympic Gold rower has Type 1 diabetes.
• Halle Berry – a movie star who has diabetes (originally diagnosed Type 1, but re-diagnosed Type 2).
CHAPTER 2'The honey-sweet siphon' – the history of diabetes
Medical writers have been aware of this condition for at least 4,000 years. Its nature and its cause, however, remained a mystery for centuries.
The fact that writers in different cultures observed and advised about this condition makes it clear that diabetes has affected people around the world throughout history. As we will see in this chapter, it is not a condition restricted to the modern world. Having said that, contemporary lifestyles may be making diabetes more common than it was in the past.
Ancient Egypt – first observations
In 1862, Edwin Smith, a young amateur Egyptologist and adventurer, purchased two papyri in Luxor. It is unclear from whom he bought them, but it is said that they had been found between the legs of a mummy in the El-Asasif area of the Theban necropolis on the other side of the Nile from Luxor.
Both these papyri dated to about 1,534 BCE, but were thought to be copies of far older texts. One became known as the Edwin Smith papyrus and is the oldest known surgical text in the world. The other was eventually purchased by German Egyptologist Georg Ebers in 1872. This papyrus is a medical text outlining the state of Egyptian knowledge about medicine and the treatment of over 700 afflictions.
The Ebers papyrus is thought to have been written by a physician called Hesy-Ra, who mentions several types of urinary problem, some of which almost certainly refer to urinary infections like cystitis, where the main symptom is frequent micturition, or passage of urine. He makes a distinction between the frequent passage of urine with pain (which would have been from urinary infections) and the frequent passage of a lot of urine without pain, which we call polyuria. The latter is almost certainly a description of diabetes. The treatment advised by Hesy-Ra included a liquid extract of bones together with grain, grit, wheat, green lead and earth. Unfortunately, it is unlikely that the treatment would have had any beneficial effect.
Ancient India – the two different types of diabetes
The Indian surgeon and physician Sushruta (600–501 BCE) wrote a textbook called Sushruta-samhita, which means Sushruta's compendium. In it he details 650 drugs used by doctors of his time. In addition, he detailed many operations using 42 surgical techniques and over 120 surgical instruments. He gave instructions on how to surgically repair the nose (cutting off the nose being the penalty for adultery and other transgressions) and also how to do a lithotomy, the operation to remove urinary stones. He is recognised as the father of plastic surgery.
He describes the symptoms of diabetes, which he called madhumeh, to describe the sweetness and stickiness of the patient's urine. Madu is used in several Indo-Aryan languages to mean honey or sweet.
Another Indian physician called Charaka, who is thought to have flourished sometime between the second century BCE and the second century CE, refined Sushruta's observations. He wrote the Charakasamhita, meaning Charaka's compendium, and in it differentiates between two types of diabetics. One group, who were thin and young and another group who were older and fatter. He also noted that the older group lived longer. This was the first attempt to divide diabetics into two groups, basically Type 1 and Type 2.
Remarkably, Charaka suggested a test: if the urine of such a patient was poured near an anthill it would attract ants!
Ancient Greece – diabetes
Aretaeus of Cappadocia first used the word 'diabetes' in the second century CE to indicate this condition. The word was derived from dia meaning 'through' and betes meaning 'passing', likening the passing through of urine to a siphon action. He also described the characteristic of the disease, which causes 'a melting down of the flesh and limbs into the urine.' He thought that it was a disorder of kidney function.
Claudius Galenus of Pergamum (circa 130–200 CE) was a famous second-century Greek physician practising in the Roman Empire. He described the excessive passage of urine, which he called diarrhoea urinosa, and the extreme thirst as dipsakos.
Ancient China and Japan
The sweetness of the urine of diabetics was noted by the Chinese physician Chen Chuan in the seventh century CE. At about the same time the Japanese physician Li Hsuan noted that the sweet urine of these patients would attract dogs. He also noted that diabetic patients were more likely to develop infections, including boils and sores and a respiratory disorder that was like tuberculosis.
Both Chen Chuan and Li Hsuan recommended that it should be treated by abstinence from sex and from wine and the avoidance of salty food, which would make the thirst worse. This is perfectly logical, of course, but focusing on the avoidance of sugar and sweets would have been more effective.
Arabic medicine
In the tenth century CE, the great Persian polymath known as Avicenna (980–1037 CE) pushed the frontiers of medicine on several fronts.
An astute clinician, he wrote that diabetes was associated with two specific complications. Firstly, there was a 'fall down' of sexual function. Secondly, people with this condition were prone to develop gangrene of their extremities. As we shall see later in this book, these are definite complications.
He also improved the method of giving medication by coating his pills in silver or gold leaf. In an age of alchemy, precious metals were thought to enhance the effectiveness of medicines. This also reduced the bitter taste of many medicines.
For diabetes, he advocated a mixture of herbs including lupin, fenugreek and zedoary (white turmeric) seeds. These do, in fact, have mild hypoglycaemic effects (they lower blood-sugar) so they would have had some positive consequence.
The Renaissance – discoveries about the cause and the first effective treatment
This period of time saw an explosion in science, philosophy, art and literature.
Doctors like William Harvey (1578–1657) studied anatomy and started to give an explanation for the way that the body worked. He was a physician and anatomist who fought in the English Civil War and who was court physician to three kings of England. After graduating from Cambridge University, he went to study medicine and anatomy at the University of Padua in Italy. In 1616 he announced his discovery of the circulation of the blood, and in 1628 he published his work Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (An Anatomical Exercise on the Motion of the Heart and Blood in Animals). It was the most significant piece of medical research ever written and laid the foundation for the scientific study of medicine.
Dr Thomas Willis (1621–1675) was another anatomist who, like Harvey, was deeply interested in the body's blood supply. He published several books in the 1660s, the most significant being a work about the brain. In it he described the circle of blood vessels at the base of the brain, which were formed from major arteries travelling up the front of the neck to join with ones from the back of the neck to produce an arterial circle which gave off branches to supply blood to the various areas of the brain. This is called the Circle of Willis.
Dr Willis was also intrigued by diabetes. He referred to it as 'the pissing evil', but went on to state that diabetic urine was 'wonderfully sweet as if it were imbued with honey or sugar' since tasting patients' urine was an art that most physicians practiced in his day. He added the Latin word mellitus, meaning 'honey-sweet'. Hence, the name diabetes mellitus literally means the honey-sweet syphon, which effectively describes the symptoms of excessive urination of sweet urine.
(Continues...)
Excerpted from Your Guide to Understanding and Dealing with Type 2 Diabetes by Keith Souter. Copyright © 2015 Keith Souter. Excerpted by permission of Summersdale Publishers Ltd.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Contents
Cover,Title Page,
Copyright,
Dedication,
Acknowledgements,
Introduction,
PART ONE – UNDERSTANDING TYPE 2 DIABETES,
Chapter 1: An overview of diabetes,
Chapter 2: 'The honey-sweet siphon' – the history of diabetes,
Chapter 3: Metabolism and what goes wrong in diabetes,
Chapter 4: The symptoms of diabetes and how they come about,
Chapter 5: The reasons why complications occur,
PART TWO – DEALING WITH TYPE 2 DIABETES,
Chapter 6: How diabetes is diagnosed and managed,
Chapter 7: The complications of diabetes,
Chapter 8: Lifestyle changes to treat Type 2 diabetes,
Chapter 9: Drugs for Type 2 diabetes,
Chapter 10: Using the Life Cycle with Type 2 diabetes,
Glossary,
Directory of useful addresses,
References,