What is diabetes?

When you are diagnosed with type 1 diabetes, you know you have a condition that will be with you for life. That’s why it’s so important to learn to live with diabetes.

Drug treatment for type 1 diabetes is all about insulin. Insulin is a hormone made by the pancreas that plays an important role in your body. Without insulin, your body is unable to make proper use of the food you eat, so the glucose from your food remains in the bloodstream. This causes the level of glucose in your blood to rise, especially after eating.

Having high blood glucose (or high blood sugar, as it is also known) carries with it a number of health problems and risks, which is why diabetes needs to be treated and managed.

What causes diabetes?

Type 1 diabetes develops when the body's immune system starts to destroy the insulin-making cells in the pancreas. The immune system is our natural defence system against foreign substances such as viruses and bacteria.

No one knows exactly why this happens. We do know that members of some families are more likely to get type 1 diabetes than others. We also know that there is likely to be some external influence at play. But how these different factors interact and lead to diabetes is something we don’t know yet.

What happened before you developed diabetes?

When your pancreas was working normally and produced the necessary insulin, your body automatically kept your blood sugar exactly at the right level throughout the day and night.

The amount of sugar in the blood must not get too high or too low. Two hormones - insulin and glucagon - are produced in the pancreas to ensure blood sugar levels are well controlled through the day.

Blood sugar and food

Blood sugar rises after eating. Before you had diabetes, insulin would be released into your blood after each meal you ate, to remove the sugar from your blood stream and transport it to different cells in your body.

Insulin acts like a key. It opens doors in the walls of different types of cells, enabling sugar from your blood to get into the cell to provide energy. By removing sugar from the blood and taking it to body cells, insulin also lowers blood sugar to its normal level again. When this mechanism works properly, blood sugar levels stay low, usually lower than 7 mmol/l in the morning.

When you have diabetes

When you have diabetes, you are not producing enough insulin ‘keys’ to open the doors into your body’s cells. The effects of this start to show in how you feel and how your body acts. So when sugar can't get into your muscle and other cells to produce energy, you feel tired. Also, as the sugar cannot get into the cells to be used, it builds up in the bloodstream. When you were first diagnosed with diabetes, sugar may have been building up in the blood for some time, and you may have found that your blood sugar level was very high.

Sugar in the urine

Without enough insulin, the amount of sugar in your bloodstream rises to very high levels. When that happens, some of the sugar finds its way through the kidneys into your urine. The sugar that spills into the urine carries a lot of water along with it, which makes you very thirsty, so you find yourself drinking a lot and needing to urinate frequently.

The high quantity of lost sugar in the urine could also play a role in weight loss, usually seen before the diagnosis of type 1 diabetes.

Ketones in the urine

Without enough insulin, your body cannot use the sugar in your blood, so the body will instead try to burn fat for fuel. When the liver burns fat too quickly, it produces poisonous waste products called ketones. Ketones are dangerous because they make the blood acidic. When ketones reach your kidneys, some flow out in the urine together with sugar.

Ketoacidosis

If you are producing ketones and are not treated with insulin, you will develop a serious condition called ketoacidosis. Ketoacidosis makes people feel very unwell; they develop stomach pains and experience nausea and vomiting. Their cheeks become flushed and they may even lose consciousness. This can lead to diabetic coma. Ketoacidosis requires immediate treatment with insulin and fluid.

Now that you have diabetes

To keep your blood sugar under control, now that you have diabetes, you have to do what your body once did automatically. The goal of diabetes treatment is to mimic the insulin pattern you had before you developed diabetes and to keep your blood sugar level as near normal as possible.

Diabetes treatment

You will have to have insulin injections every day - either twice a day or more frequently. Healthy eating is important. Make sure you eat regular meals and don't forget to exercise regularly too. You will also need to familiarise yourself with the different aspects of your diabetes, including how to test your blood sugar and what to do if your blood sugar is too high or too low. It may feel as if there is a lot to take in, and that a lot of changes need to be made. But don’t be disheartened - managing your diabetes will soon become a straightforward part of your daily life.

Long term complications

As well as the day-to-day implications of diabetes, you also need to know about the possible long-term effects. Having diabetes means you are at risk of developing a number of different health complications including:

  • Eye problems
  • Kidney problems
  • Damage to nerves and feet.
You also have an increased susceptibility to heart disease and high blood pressure over the long term. You can help prevent these complications by keeping your blood sugar as close as possible to the level found in people without diabetes.

What is diabetes? A summary

  • It’s caused by a lack of insulin in the body
  • It’s a condition that’s for life
  • Insulin allows sugar to be transported to the body’s cells
  • Lack of insulin leads to build-up of sugar in the blood
  • Untreated diabetes can make you feel tired, thirsty and urinate more frequently
  • Untreated diabetes can lead to a serious condition called ketoacidosis
  • Unintentional weight loss could also be a sign of type 1 diabetes
  • Treatment for diabetes means insulin injections to keep blood sugar levels close to normal
  • Keeping blood sugar levels low helps prevent long term health complications.

 

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Last updated: May 2007