The 14th November 2020 marks the 29th World Diabetes Day. Since its conception in 1991, World Diabetes Day has been the principal worldwide campaign that raises awareness of the disease diabetes mellitus (DM). This year’s theme focuses on ‘The nurse and diabetes’, and how pivotal a role nurses play in supporting those living with this condition. Do you understand diabetes? Are you familiar with its effects on the human body? If the answer is no, this blog is for you.

Here’s a few startling facts about DM… In 2019, nearly 465 million adults had a DM diagnosis worldwide. This figure is predicted to increase to nearly 580 million by the year 2030. In the same year, the disease took the life of 4.2 million people with healthcare costs totaling more than $760 billion. This equates to approximately 10% of the total global spend on all healthcare, which is a huge figure! It also puts into perspective just how big a problem DM is across the planet.

What is diabetes mellitus?

Diabetes is a chronic, metabolic disease. The word ‘metabolic’ derives from ‘metabolism’, which refers to the body’s ability to breakdown food into energy. With DM, the problem lies with the body’s ability to breakdown sugar (in the form of glucose) into energy for the body to use. When we eat food, the body breaks it down into smaller pieces. Some of these smaller pieces are in the form of glucose, our body’s main energy source. Once in the blood, it travels around the body, being dispensed to all cells, so all of our bodily processes can be carried out and function correctly. The body uses a hormone called insulin to help in the process of converting glucose into energy, ready for use by our cells. Insulin is produced by the pancreas, an organ that is part of our digestive system. In DM, the pancreas either doesn’t produce insulin at all, or it does not produce enough good quality insulin, meaning there is nowhere for the glucose to go but stay in the blood. As a result, the glucose levels rise, which then leads to symptoms of DM.

Types of DM

There are three main types of diabetes:

  • Type 1 (DM1): An autoimmune form of the condition, meaning the body’s immune system attacks and destroys the cells of the pancreas that are responsible for producing insulin. People with DM1 must rely on a synthetic form of insulin, usually injected by the person several times a day, in order to control blood sugar at safe levels. Sometimes an insulin pump is fitted which negates the need to inject.
  • Type 2 (DM2): The most common form of the disease. With DM2, the pancreas either does not produce enough insulin, does not produce effective insulin, or the cells of the body do not react to insulin correctly. In the early stages, this form of the disease can be effectively managed by exercising regularly, eating healthily and making necessary lifestyle changes. Over time, the disease progresses, and people may require medication in the form of tablets, and eventually insulin injections, like with DM1.
  • Gestational: A form of DM that develops during pregnancy and usually resolves once the baby is born. Women who are overweight, 40+ years of age, and have a family history of DM2 are more at risk of developing this condition.

This blog will mainly focus on the differences between DM1 and DM2. We will discuss gestational diabetes in more detail in a future blog.

Effects of DM on the body

The short and long-term effects of DM1 and DM2 are the same. The short-term effects of DM1 tend to come on quickly and may be fatal if not controlled promptly. Some of the shared and more immediate symptoms of DM1 and DM2 include:

  • Excessive thirst and hunger
  • Increased urination
  • Tiredness and fatigue
  • Skin infections and slowly healing skin wounds
  • Visual disturbance, including blurred vision
  • Mood swings
  • Headaches
  • Weight changes (DM1 is usually associated with unexplained weight loss, whereas DM2 is usually associated with progressive weight gain)

If DM is not managed well, long-term complications of the disease relate to problems with the cardiovascular, kidney, nerve and visual systems of the body. This leaves a person susceptible to developing:

  • Heart attacks and/or stroke
  • Kidney disease
  • Poor nerve function
  • Ulcers that affect the limbs
  • Blindness

Poorly managed diabetes is a common cause of limb amputations (due to the resultant poor blood flow and nerve function) and there is a strong association between diabetes and anxiety and/or depression.

The key to managing DM in any form is an early diagnosis. The beauty of seeing a physiotherapist regularly is that we are constantly monitoring your conditions and general health. If we suspect there may be an underlying problem that needs medical attention, we will discuss this with you and help direct you to the right person to ensure you receive the correct diagnosis and treatment. Diseases like diabetes are usually diagnosed under supervision of your GP.

If you have any questions relating to DM, and how this may affect your ability to exercise, please speak to your practitioner next time you are in. We hope you found this blog informative and interesting. The key to managing disease and injury is to first understand it. If you have any questions, let us know and we’ll be happy to put your mind at ease!