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Diabetes - Causes, symptoms & treatments

Diabetes can cause damage to your blood vessels. This increases your risk of developing heart and circulatory diseases. 

What is diabetes?

Diabetes is a condition that causes high levels of glucose (a type of sugar) in your blood. This is because of a problem with a hormone called insulin your pancreas produces. Insulin moves glucose from your bloodstream and into the cells of your body for energy. If your body doesn't make enough insulin or can't use the insulin it makes, glucose stays in the bloodstream and can’t move across into your cells to give them energy to work properly. 

What are the types of diabetes?

Type 1 diabetes happens when your body cannot make insulin. This type most commonly affects children and young adults, and is a result of your body’s immune system attacking the cells that produce insulin in the pancreas. 1 in 10 people with diabetes are Type 1.

Type 2 diabetes happens when your pancreas isn’t making enough insulin or your body can no longer use the insulin it makes. 

Type 2 diabetes is much more common than Type 1 and tends to develop gradually as people get older – usually after the age of 40. But more and more people every year are being diagnosed at a much younger age.

It's closely linked with: 

  • being overweight, especially if you carry weight around your middle
  • being physically inactive
  • a family history of Type 2 diabetes.

Some ethnic groups have a much higher rate of diabetes - particularly people of South Asian and African Caribbean origin.

This webpage focuses on Type 2 diabetes.

How does Type 2 diabetes affect your heart?

After we eat, we begin to digest foods and break carbohydrates down into glucose. In people who don't have diabetes, insulin is released by their pancreas when they eat. It acts as a signal for cells around their body to absorb the glucose and use it as fuel for energy.

If you have Type 2 diabetes, your body doesn't make enough insulin or can't use the insulin it makes, and the cells don't absorb enough glucose. This causes high levels of glucose in your bloodstream.

High levels of glucose in your blood can damage the walls of your arteries, and make them more likely to develop fatty deposits (atheroma).

If atheroma builds up in your coronary arteries (the arteries that supply oxygen-rich blood to your heart), this is coronary heart disease and can lead to a heart attack. If this happens in the arteries that carry blood to your brain it can lead to a stroke.

People with diabetes are twice as likely to have a stroke 

What are the signs and symptoms of Type 2 diabetes?

It's not always easy to tell if you have diabetes. Many people with Type 2 diabetes have no symptoms and don't know they have it, or symptoms can develop slowly or start out of the blue - it varies from person to person.

You may have diabetes if you are:

  • often very thirsty
  • peeing more than usual, particularly at night
  • often very tired
  • losing weight unexpectedly
  • having blurred vision
  • having genital itching or regular episodes of thrush
  • noticing that your cuts or wounds heal slowly.

Don't ignore symptoms. Your doctor can diagnose you, help you manage your condition and stop things getting worse.

How is Type 2 diabetes diagnosed?

If you have any of the symptoms listed above, contact your GP. They may arrange a blood test to check your blood glucose level and they may also test your urine. 

Finger-prick blood glucose levels can be taken, or there is a blood test called an HbA1c (Haemoglobin A1c) that is used to test what your average blood glucose has been over a few months. It can be more helpful for doctors as it gives them a long term view of what your blood glucose level is, whereas a finger-prick blood glucose can only test what your blood sugar is at that very moment.

How can I reduce my risk of developing Type 2 diabetes?

You can greatly reduce your risk of developing Type 2 diabetes by keeping a healthy weight and sticking to a healthy lifestyle.

Here are some steps you can take to reduce your risk:

The great news is that doing these things will not only reduce your risk of developing Type 2 diabetes, but also make you less likely to develop other heart and circulatory diseases such as coronary heart disease and stroke - as well as being great for your general mental and physical wellbeing.

How can I manage my Type 2 diabetes?

If you have diabetes, it's very important to make sure that you control your blood glucose levels, blood pressure and cholesterol levels to help reduce your risk of heart and circulatory diseases like coronary heart disease, heart attack and stroke. You can do this by managing your weight and sticking to a healthy lifestyle.

Get tips on lifestyle changes

Mark explains how he manages his diabetes:

 

Your doctor will regularly check your HbA1c (haemoglobin A1c) levels and you will review them together to see how stable your glucose level has been over a period of time. These levels will help your doctor work out whether your lifestyle changes and medication are working, or if they need to make a change to your treatment plan. If your treatment plan has changed you may have an HbA1c test after 3 months, and once you are stable on a treatment plan your HbA1c levels need to be checked every 6 months.

Medications and treatments for Type 2 diabetes

You can manage diabetes very successfully with lifestyle changes and medicines. The first line of treatment if you're overweight is to try and lose some weight, become more physically active, and have a healthy diet - including cutting down on sugary and fatty foods and drinks.

If this doesn't help to control your glucose levels, your doctor may prescribe medication such as Metformin and Sitagliptin. Type 2 diabetes can progress over the years and so treatment may change over time. Many people with Type 2 diabetes eventually need to have insulin injections to control their diabetes. 

Type 2 diabetes puts you at higher risk of having a heart attack or stroke, so your doctor may prescribe a cholesterol-lowering medicine such as statins to help protect your heart. Your doctor may also recommend that you take a fibrate medicine to help control your triglyceride levels.

If you have diabetes, you should have a review each year with your GP or diabetes nurse to make sure that you're not developing any of the complications of diabetes, including coronary heart disease.

What is diabetic ketoacidosis?

Diabetic ketoacidosis occurs in people with diabetes when the body begins to run out of insulin and starts to break down fat for energy instead of glucose. 

While diabetic ketoacidosis usually occurs in people with Type 1 diabetes, it can occasionally happen to people with Type 2 diabetes. When this happens, harmful substances known as ketones build up in the body as a result of fat breakdown. This can be life-threatening if you don't seek medical attention straight away. 

Symptoms of diabetic ketoacidosis include:

  • needing to pee more than usual
  • being sick
  • pain in the stomach
  • feeling very thirsty
  • confusion
  • breath that smells fruity (people say it smells like pear drops sweets)
  • feeling very tired
  • fainting
  • deep or fast breathing

You can buy home testing kits for diabetic ketoacidosis, which will test your blood or urine for ketones. It's important to call 999 or go to A&E if you are diabetic and worried about the above symptoms.

For more information on diabetic ketoacidosis, visit the NHS website.

Help and support

If you have diabetes, it's important to know you're not alone. Find support from healthcare professionals and the people around you.

Call our Heart Helpline at 0300 330 3311 to speak to one of our Cardiac Nurses. They can give you information and support about heart and circulatory diseases, and their risk factors.

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