Diabetes is a group of conditions which cause high levels of glucose (sugar) in the blood. This is primarily because the pancreas (an organ at the back of the abdomen) is not producing any or enough insulin. In many instances, especially where people are overweight, there is also resistance to insulin’s action in many body cells, particularly in the liver and muscle.

There are two main types – Type 1 and Type 2. We see people with both these types, as well as some less common causes. 

Type 1 diabetes is less common than Type 2 and accounts for around 5 -10% of the population. It is an auto-immune condition where the body recognizes the pancreas as “foreign” and attacks it. The pancreas thus makes less and less insulin, sometimes none at all. This type can occur at all ages, but is found most commonly in children, adolescents and young adults. People with Type 1 diabetes require regular insulin injections to maintain healthy blood sugar levels. (Insulin cannot be given in tablet form.)

Type 2 diabetes makes up about 90% or more of those with diabetes. In this case the pancreas is still producing insulin but the production is reduced and gets progressively less with time. The body is also resistant to the insulin to varying degrees; being overweight is almost always the cause of insulin resistance. Those with Type 2 diabetes usually require lifestyle (weight, dietary and exercise) changes then often tablets. Most people will eventually require insulin injections.

Both of these types of diabetes can cause serious health problems if the blood sugars are not “controlled” i.e. kept as normal as possible.

Potential problems include:

• Eye damage, called “retinopathy” which can eventually lead to blindness if not treated
• Kidney damage eventually leading to renal failure and the need for dialysis
• Foot problems including ulcers, painful feet and, sometimes, amputation
• Premature heart attacks and strokes.

The good news is that these problems can be largely avoided or delayed by maintaining healthy blood sugar levels, having regular checks of the eyes, kidneys, and feet and for heart risk factors. There are effective treatments for many of these problems if detected early.

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