How Glucose Gets Into The Cells:
After a meal, blood glucose levels are controlled by the action of insulin
on fat and muscle cells; the binding of insulin to its receptor causes
numerous glucose transporter proteins to move from storage sites within
each cell to the cell surface, where they act as pores that allow glucose
This process requires the interaction of a complicated array of proteins
known as SNARE
complexes; the defective assembly and regulation of these complexes
is thought to underlie the Insulin Resistance that causes Type 2 Diabetes;
however, the exact mechanisms by which this occurs are, as yet, poorly
Diabetes Mellitus is now escalating in the UK; over 2.9 million people
are already diagnosed as diabetics and around a million more are thought
to have Diabetes without knowing it; it is one of the most common of
diseases in all populations and age groups and is the commonest cause
of blindness in the UK population.
Diabetes is split into four main types:
Type 1 – Also known
as insulin dependent Diabetes Mellitus or Juvenile Diabetes.
Type 2 – Also known as non
insulin dependent Diabetes Mellitus.
Type 3 – Maturity Onset
Diabetes of the Young, known as MODY.
Type 4 – Gestational Diabetes,
which develops or is discovered during pregnancy.
Out of the above four types of Diabetes, more people are at risk of
developing Type 2 than any other type of Diabetes and Type 2 Diabetes
is the main type of Diabetes that can be brought on by lifestyle choices.
Who Is At Risk Of Developing Type 2:
Those with a family history of Diabetes.
Those who are overweight.
Those who are not physically active.
Those who are of Asian, African, or Afican Caribbean origin.
Along with meal planning and physical activity, many diabetics have
to take Diabetes Medication as well; diabetes
pills help people with Type 2 Diabetes or gestational diabetes to keep
their blood glucose levels on target; several kinds of pills are available
and each works in a different way; many people take two or three kinds
of pills and some people take combination pills, which contain two kinds
of diabetes medicine in one tablet and some people take both pills and
Target millimoles per liter (mmol/l) Blood Glucose Levels:
mmol/l is a unit of measure that shows the concentration of a substance
in a specific amount of fluid; in most of the world, except for the
United States, blood glucose test results are reported as mmol/l; in
the United States, milligrams per deciliter (mg/dL) is used; everyone
is different, therefore, the following Diabetes UK Blood Glucose Level
recommendations are to be used as a general guide only; you should discuss
your target levels with your healthcare team.
Adults With Type 1 Diabetes:
Aim for a target of (4 to 7) mmol/l before meals and no more than 9 mmol/l by 2 hours after meals.
Adults With Type 2 Diabetes:
Aim for a target of (4 to 7) mmol/l before meals and no more than 8.5
mmol/l by 2 hours after meals.
Aim for a target of (3.5 to 5.9) mmol/l before meals and no more than 7.8 mmol/l by 1 hour after meals.
Children (under 16) With Type 1 Diabetes:
Aim for a target of (4 to 8) mmol/l before meals and no more than 10 mmol/l by 2 hours after meals.
Children (under 16) With Type 2 Diabetes:
Individual targets should be discussed with your healthcare team.
What To Do When You Are Ill:
Some forms of illness affect your diabetic control by raising your blood
glucose levels; when you are ill, your body reacts by releasing more
glucose into the bloodstream and by increasing the Insulin Resistance,
stopping it from working properly; this happens even if you are eating
less food than normal or vomiting, which means that you end up with
higher than normal blood glucose levels.
At these times you need to test your blood glucose levels more often
than normal, or at least four times a day and during the night when
you wake up; if your blood glucose levels are above 13.5 mmol/l, then
you are at risk of developing Keytones
and you need to be tested.
Whilst ill you need to eat little and often and to be drinking plenty
of water and sugar free drinks; though, if you are throwing up a lot
you need alternative drinks such as milk, fruit juice and sugary drinks
like flat cola and flat lemonade.
High Blood Pressure Warning:
According to 'Diabetes UK' rates of Stroke and Kidney Failure in people
with Diabetes have reached record levels in England; figures from the
2009/2010 National Diabetes Audit (NDA) show a 57% rise in Stroke victims
in people with Diabetes since 2006/2007 and if we use these figures
as a representative of the rate accross England, it means that more
than 16 000 people with Diabetes had a Stroke
in 2009/2010; in the case of Kidney
Failure, there was a 31% rise in Kidney Failure in people with Diabetes
since 2006/2007 and if we use these figures as a representative of the
rate accross England, it means that more than 8 800 people with Diabetes
had a Kidney Failure in 2009/2010.
A recent 'Diabetes UK' survey revealed that around 22% of people with
Diabetes were unaware of having their Kidney Function checked within
the previous year and whilst around 91% had had their Blood Pressure
checked, NDA figures reveal that only 50.7% of people with Diabetes
met their Blood Pressure targets in 2009/2010.
High Blood Pressure - The excessive pressure
on your artery walls caused by High Blood Pressure can damage your blood
vessels, as well as many organs in your body; the higher the Blood Pressure
and the longer it goes uncontrolled, the greater the damage and uncontrolled
High Blood Pressure can often lead to Aneurysms, Atherosclerosis, Cognitive
Problems, Eye Problems, Heart
Failures, Metabolic Syndrome and Strokes.
Aneurysm - An increased Blood Pressure can
cause your blood vessels to weaken and bulge, forming an aneurysm; if
an aneurysm ruptures, it can be life threatening.
Atherosclerosis - An increased blood pressure
can cause the hardening and thickening of the arteries, which can reduce
or slow the blood flow.
Cognitive Problems - High blood pressure can
cause problems with memory and/or understanding concepts, it may also
affect your ability to think, remember and learn.
Eye Problems - High blood pressure can cause thickened,
narrowed or torn blood vessels in the eyes, which can result in vision
Heart Attack - In order to be able to pump
blood against the higher pressure in your vessels, your heart muscle
thickens; eventually, the thickened muscle may have too hard a time
pumping enough blood to meet your body's needs, which can lead to Heart
Kidney Failure - High blood pressure leads
to weakened and narrowed blood vessels in the kidneys, which can prevent
the organs from functioning normally.
Metabolic Syndrome - This is a cluster of
disorders based around your body's metabolism, including increased Waist
Circumference, High Triglycerides, Low or High-Density Lipoprotein (HDL),
or 'Good Cholesterol', High Blood Pressure and High Insulin Levels;
if you have High Blood Pressure, you're more likely to have other components
of metabolic syndrome and the more components you have, the greater
your risk of developing Diabetes, Heart
Disease or Stroke.
Diabetes Related Information Leaflets