Three hour course covering causes, different types (type 1 & type 2), typical symptoms, treatment and the implications for care planning. It will also identify coping strategies and look at how the persons conditions can be managed effectively, problems can be identified and seen to in a quicker time, ensuring that the sufferer gets the best treatment in the shortest time possble

A Common Problem

Diabetes arises because the body can't use glucose properly, either because of a lack of the hormone insulin or because the insulin available doesn't work effectively. Not only is excess sugar found in the blood but it may appear in the urine too.

The full name 'diabetes mellitus' derives from the Greek word 'diabetes' meaning siphon - to pass through, and 'mellitus,' the Latin for honeyed or sweet. It refers to a major symptom of diabetes - sugar in the urine - and is a far more acceptable name than the one it was known by in the 17th century - when it was called the 'pi*sing evil'.

Diabetes has been a recognised condition for over 3,500 years. About 2,000 years ago, it's said that Arataeus of Cappadocia described diabetes as 'a melting down of the flesh and limbs into urine.' This reflected the weight loss and excess passing of urine that occurs in acute, undiagnosed diabetes.

Diabetes is common, and more than 2 million people in the UK are known to have the condition (statistics supplied by Diabetes UK). However, at least one million people are believed to have diabetes but don't realise it. More than three-quarters of those with diabetes have what is now called 'type 2 diabetes mellitus'. This used to be known as 'non-insulin dependent diabetes mellitus (NIDDM)' or 'maturity-onset diabetes mellitus'. The remainder have 'type 1 diabetes mellitus', which used to be known as 'insulin-dependent diabetes mellitus'.

Types of diabetes

There are two main types of diabetes:

• In type 1, the body's unable to produce any insulin. This usually starts in childhood or young adulthood. It's treated with diet control and insulin injections. Type 1 diabetes used to be called 'insulin-dependent diabetes'.
• In type 2 diabetes, not enough insulin is produced or the insulin that is made doesn't work properly. This tends to affect people as they get older, and usually appears after the age of 40. It used to be known as 'maturity-onset diabetes' or 'non-insulin dependent diabetes (NIDDM)'.

Normal blood sugar control

In the body, glucose is converted into energy. This glucose comes ready-made in sweet foods such as sweets and cakes, or from starchy foods such as potatoes, pasta or bread when they're digested. The liver is also able to manufacture glucose.

Under normal circumstances the hormone insulin, which is made by the pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells to absorb enough glucose from the blood for the energy, or fuel, that they need. Insulin also stimulates the liver to absorb and store any glucose that's left over. After a meal the amount of glucose in the blood rises, and this triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too. A second hormone manufactured by the pancreas is called glucagon. It stimulates the liver to release glucose when it's needed, and this raises the level of glucose in the blood.

Insulin is manufactured and stored in the pancreas, which is a thin gland about 15cm (6in) long that lies crosswise behind the stomach. It's often described as being two glands in one, since in addition to making insulin it also produces enzymes that are vital for digestion of food. These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.

This article was last medically reviewed by Dr Rob Hicks in January 2006.
First published in April 2001.

Dependant on duration

3 or 6 hours

1 -15

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