Charterhouse Physiotherapy, Pilates & Lymphoedema Clinic

Diabetes

We thought this spring newsletter would feature diabetes, an increasingly common disease with serious long-term consequences.

Facts

400 million in the world have diabetes.

43 million people in the UK have diabetes.

35 million are diagnosed.

People nowadays can have a full productive life with Type 1. Shining examples are Steve Redgrave and Theresa May. Globally it has been increasing steadily in proportion to the amount of disease in UK and the world. In 1990 it became the 8th most common cause of morbidity.

Insulin was isolated from the Islets of Langerhan in the pancreas (discovered originally by Paul Langerhan in 1867), extracted and purified and found to be the great medical discovery

Ethnicity and Diabetes

Asian origin:- x9 more likely to have diabetes.

African origin:- x6 more likely to have diabetes.

There is also a higher risk of gestational diabetes.

Essence of Diabetes

The body’s need to keep glucose within a narrow perimeter- too much glucose produces high blood sugar levels and too little will causes organs, especially the brain, to malfunction. The ‘B’ cells within the Islets of Langerhan produce the hormone insulin, in response to high glucose levels. Other cells respond to this, by storing energy in the liver, fat cells and muscle.

Type 1 Diabetes (10%of diabetes)

In childhood or early adulthood the ‘B’ cells start to die and stop producing insulin. Without this the body cannot regulate glucose or energy. It is thought that Type 1 may be an autoimmune disease. Genetically if a family member suffers from this then the percentage rises slightly in being passed down to offspring. If the patient has DKA (diabetic ketoacidosis), then as the blood glucose increases so does the ketone level causing the blood to become acidic, which can lead to a coma. If there is a high level of glucose without ketones then infection or illnesses can occur.

Type 2 Diabetes

This can start in middle age. Here the body responds abnormally to insulin production and does not reduce the glucose levels as much as it should. A combination of genes and behavioural element is the cause. 80-85% is accounted for by people being overweight and this in turn can lead to obesity. Link is causal in many cases.

Gestational Diabetes

This can occur in 5% of pregnancies during the 2nd/3rd trimesters, resulting in a heavier baby. Usually it is resolved when the child is born. There is a x7 % risk that the mother can develop Type 2.

Untreated Diabetes (both Type 1 and 2)

Frequency of passing urine

Thirsty

Fatigue

Skin infections such as Thrush

Delayed wound healing

Weight loss

Insulin Treatment

This is usually given by injection or pump. We try to mimic by using insulin to control the glucose levels in the most natural way throughout the day. If too much insulin is administered, then hypoglycaemia can occur and the patient can lapse into a coma. Carrying a Mars bar or similar at all times is a good idea.

Type 2 Diabetes treatment and help

Usually diet is paramount and here the Government can help by:-

Taxing fizzy drinks and sugar.

Restrict direct advertising to children.

Restrict fast food outlets near schools.

Engage with industry.

The aim is not to stop enjoyment but reduce unnecessary energy level intake.

Medication

Is usually Sulphonylureas, which stimulates the pancreas to produce more insulin, or Metformin, which reduces the glucose production and DPP-4i drugs, which inhibit the breakdown of gut enzymes which reduce the production of glucose.

Bariatric surgery is also used, where replumbing the stomach and upper gut can lead to weight loss and drastic increase in glucose control.

 

Written by Caroline Rugman March 2020



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64/65 Long Lane, London, EC1A 9EJ
Telephone: 020 7606 2435

55 Harley Street, London, W1G 8QR
Telephone: 020 7323 4263

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07971 833443

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info@charterhousephysio.co.uk

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