1. Dr Kiran Sodha Patient Participation Group October 2014
Diabetes
Dr Kiran Sodha
Patient Participation Group
October 2014

2. Summary Explanation of diabetes
Why we worry about diabetes and it’s long term effects on the body
Risks of developing diabetes
Management and treatment of diabetes
Conclusion & Questions

3. What is diabetes? We all need sugar (glucose) in our blood to survive
Our body fuel is sugar
For bodily functions including brain and muscle
We need a constant supply of glucose, but it must be the right level
levels between 4 - 6mmol/l
If too high, or too low we get symptoms
In diabetes, blood sugar levels rise too high

4. What happens in diabetes?
Without diabetes:
Food eaten and digested in stomach – broken down into glucose – blood sugar levels rise
Insulin made by the pancreas acts as a transporter. Moves the sugar from the blood into body cells for use now or at a later stage – which then lowers the blood sugar.
In diabetes:
The pancreas is impaired so insulin does not work as well or it is not produced at all
Blood sugar levels in the body rise which make us feel unwell

5. Diabetes Type 1 Type 2 Pancreas completely stops functioning
Normally happens in younger people
Autoimmune most likely cause – the body mistakenly attacking the cells that make insulin
Genetic component
Type 2
Insulin may not be as effective or insulin production is reduced
Usually later in life over age of 40
More common if overweight
1 in 20 aged over 65, 1 in 5 over 85
5 times more common in South Asian & afro-caribbean populations
Increased risk if other family members have diabetes

6. ‘My blood sugar is high. What’s the fuss?’
High sugar levels in the blood make us feel unwell
Feeling thirsty all the time
Passing large amounts of urine
Tiredness, weight loss
Blurred vision
Recurrent infections
Severe: dehydration, drowsiness, life-threatening
Some might not have any symptoms (type 2)

7. Longer term complications
Increased risk of angina, heart attacks, stroke, poor circulation
Kidney damage which can lead to kidney failure
Eye problems affecting vision
Nerve damage
Foot problems due to poor circulation and nerve damage
Impotence due to poor circulation and nerve damage

8. Diagnosing & monitoring diabetes control
Diabetes diagnosis
Random blood sugar >11 mmol/l
Fasting blood sugar >7 mmol/l
Glucose tolerance test >11 mmol/l
HbA1c >6.5 (limited use)
Pre-diabetes
fasting blood sugar >6.1 - <7
Glucose tolerance test >7.8 - <11.1
Nearly 1 in 5 of 40-65years in UK have ‘pre-diabetes’

9. Managing & Treating diabetes
What are the aims of treatment?
To keep your blood glucose level as near normal as possible
Lifestyle – diet, weight & exercise
Medication – tablets or insulin (injections)
Manage risk factors
Keep blood pressure down
Stop smoking
Keep cholesterol down
Prevent & manage complications
Regular checks of blood sugar, HbA1c, cholesterol & blood pressure
Eye checks, Foot checks
Kidney tests, urine tests

10. Lifestyle Diet Weight loss Reduce fat, reduce salt, reduce sugar
Increase fibre intake, fruit & vegetables
Weight loss
May help to reduce glucose
Increased overall wellbeing, mood & fitness
Physical activity, reduce risk of cardiovascular complications as well

12. Exercise Minimise sedentary/sitting periods 2 and half hours a week =
30 minutes of exercise per day over 5 days or
75 minutes of vigorous activity
Eg – Brisk walking, cycling, running, football, swimming, carrying or moving goods including groceries
Minimise sedentary/sitting periods
Reduce time in front of TV

13. Medications Metformin Gliclazide Gliptins Insulin
Increases the effectiveness of insulin the body has
Gliclazide
Increased release of insulin from the pancreas
Gliptins
Increase hormones that lead to increased release of insulin
Insulin
Many different types – short acting / long acting – to suit different lifestyles
Can be given directly by injection if tablets are not effective
Use in type 1 diabetes

14. Hypoglycaemia (low blood sugar)
May occur with certain medications and insulin
Symptoms
weakness, faintness, hunger
Confusion, strange behaviour
Sweating, cold, clammy
Pins & needles in lips/tongue
Treatment
Sweets, sugary drinks, glucose drinks
Check blood sugar and follow up with further food to prevent hypoglycaemia occurring again

15. Summary Any questions? What diabetes is Why we treat How we diagnose
Management – lifestyle, medications and routine checks
Managing hypoglycaemia
Any questions?

16. http://www. patient. co. uk/health/low-fat-diet-sheet http://www. nhs