Category: Diagnosis type 1 diabetes

What are the different types of diabetes?

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This week marks the beginning of Diabetes Week. This year the main focus is on, the misconceptions people have in terms of what diabetes is and how it affects individuals. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.

There are many myths which surround diabetes, that make it hard for others to believe how deadly diabetes can be. Stereotypes and stigmas have created an inaccurate image of  what the condition really is. As a diabetic blogger, I feel the responsibility to spread the correct message to my readers.  Let’s start by setting the message straight about the different types of diabetes that can occur.

There are many types of diabetes, the main types include; type 1, type 2, gestational diabetes and MODY (Maturity Onset Diabetes of the Young). Diabetes is a long- standing condition that affects the body’s ability to process glucose (sugars). All these types cause blood glucose levels to increase. Glucose levels are high due to the body’s inability to use the glucose properly.

This occurs because the pancreas either:

  • No longer produces insulin
  • The amount of insulin being produced is not enough, or
  • The insulin that is being produced does not work properly (Insulin resistance)

Therefore glucose is not able to enter into the cells and remains in the blood stream.

Type 1

Type 1 is an autoimmune disorder, which occurs due to the body’s immune system attacking and killing beta cells (insulin cells) in the pancreas, where they are made. The reason why this occurs still hasn’t been discovered, however there are researchers constantly working to find out this very reason. This autoimmune disorder is usually diagnosed in children but can also affect people up to the age of 30, resulting in no insulin being produced. People with this condition learn to use insulin therapy to manage their diabetes.

Type 2

Type 2 diabetes is the most common type of diabetes. It occurs due to insulin resistance, where the pancreas either does not produce enough insulin or the insulin that is being produced does not work properly. Type 2 diabetes for some people can be managed through diet and exercise. Some people also need medication to manage their blood glucose levels/ diabetes.

Gestational diabetes

Gestational diabetes affects women during pregnancy. This usually occurs during the second or third trimester. Women who develop gestational diabetes during their pregnancy usually don’t have diabetes beforehand and for some women gestational diabetes disappears after the birth of the baby. Women who are diagnosed with gestational diabetes in the first trimester, there is a possibility that the condition existed beforehand.

During the second trimester blood tests are done to determine whether or not gestational diabetes is present. If gestational diabetes was present in previous pregnancies, then tests are performed earlier.

Pregnancy hormones can affect the body’s ability to allow insulin to function as it should. This can then cause insulin resistance to occur. Pregnancy already puts a huge strain on the body, so this additional strain on the body can sometimes cause some women to develop gestational diabetes.  Woman who are likely at risk include, women who have suffered from gestational diabetes before, overweight or obese women, women who have had very large babies and have had a family history of diabetes.  Ethnicity also plays a huge part in the development of gestational diabetes. If you are of, Caribbean, South Asia, African or Middle Eastern decent, then you are at a higher risk of developing gestational diabetes.

MODY diabetes or Type 3 diabetes

What is this type? MODY stands for Maturity Onset Diabetes of the Young. This type of diabetes is quite different from both Type 1, Type 2 and gestational diabetes. It is strongly present in families and is triggered by a mutation in a single gene. If a person carrying this gene has a child with a person who doesn’t carry the gene, then any children they have will have a 50 % chance of inheriting the gene. If a child inherits this gene they will then go onto develop MODY before they reach 25 years old, whatever their weight, lifestyle or ethnicity. These diabetic also don’t necessarily need to take insulin either.

Types of MODY:

  • HNF1-alpha– this is the most common type of MODY and can be found in populations with European ancestry. It accounts for about 70% of all cases in Europe. People with this type of MODY don’t need to take insulin, instead they take a mixture of sulphonylureas tablets.

  • HNF4-alpha– this type of MODY is very rare and usually affects people whose birth weight was more than 9lbs or suffered a low blood sugar level after birth. People who have this type of MODY are also treated with sulphonylureas tablets.

  • HNF1-beta – People with this type of MODY develop several problems which can include; renal cysts, abnormalities in uterine, gout as well as diabetes. With this type of MODY, if diabetes develops insulin treatment becomes essential. A healthy diet and exercise must also be followed to manage diabetes better.

  • Glucokinase – This gene once present and functioning allows the body to recognise increase in blood glucose levels. If this gene isn’t working then the body isn’t able to detect high blood glucose levels, allowing the BG level to go higher than it should. The BG level is only slightly higher between ( 5 – 8 mmols/l). There are no noticeable symptoms and it can only be detected through routine tests. No treatment is needed for this type of MODY.

It’s extremely important to know if you have any of these MODY types. If treatment is needed then you can then get it. Also if you have the gene, there is a 50 % chance that you could then pass this gene onto your children. Therefore genetic testing usually is extended to other family members.

I hope that this has helped you to understand the different types of diabetes that can occur.  For more information on the prevalence of diabetes and also if you want to help to spread the correct message, then click the links below.

Diabetes Facts and stats 

Diabetes Awareness Poster (print and share)

You can also follow me on twitter, instagram and facebook.

Thanks for stopping by friends

Amina xx

Are children not getting the recommended diabetes checks?

imageWhen I was a child, I remember having several check-ups every time I’d attend my diabetes appointments. After my diagnosis my check-ups were every 3 months and then it became every 6 months. These checks covered everything from, cholesterol testing, blood tests, feet check-up. Both of these tests would also be checked at my GP surgery once a year.  My eyes were tested at my opticians, annually.

Nevertheless all the results from these check-ups would then be sent over to my consultant at my diabetes clinic. Every appointment the doctor would have the most recent results from these check-ups. Appointments moved swiftly and results were explained in as much or as little detail needed. Any concerns or advice were given and time for listening was also given. Everything was in order and none of my check-up were ever missed.

However, a recent study of children ages 12 to 24 with diabetes, attending paediatric diabetes units in England and Wales proposed that, nearly 75 % of these children are not getting the necessary health checks.

70 % of these children are in fact type 1 diabetics, who are insulin dependent and require these check-ups to be carried out at least annually, routinely and efficiently.

From the study, data was collected from 27, 682 children and young people, which outlined that only 25.4 % of these children (ages 12 to 24) were having the seven recommended annual checks.

 “Guideline from NICE (The National Institute For Health and Care Excellence) state all children with diabetes should have their blood sugar levels checked every year and those over the age of 12 should also have six other health checks.”

These checks for this age group should include:

  • Measurement of growth
  • Blood pressure
  • Thorough eye tests, examining the backs of the eyes in detail
  • Cholesterol testing
  • HbA1C
  • Feet check-ups
  • Kidney function

The study also found that, from this age group (children age 12 to 24 years old), those who were considered to have “excellent diabetes control” of 7.5mmol/l, had in fact risen to 15.8mmol/l in 2012 and then by 2014 -15 this had risen even further to 23.5%.

These results are extremely disturbing and it clearly shows that there is a failure within the basic support and care of children and young people living with diabetes. These check-ups should be routine and frequent enough so that both the patient and the doctor are aware of the patients diabetes management.

As alarming as these results are, the report carried out also showed that at least 98.7% of these children in this age group had their HbA1c tested. However, only 23 % had started to increase their chances of not developing complications due to poorly managed diabetes.

On the other hand, the most frequently missed checks amongst children age 12-24, involved foot examination, eye screening and cholesterol testing.  All these tests are crucial when it comes to managing diabetes treatment and the regularity of these tests being done will only aid in the detection of any signs of diabetes complications or any damage being done to organs. Detecting signs for complications such as (blindness and kidney damage) early could potentially help to avoid or lessen the effects of the complication and if treatment is necessary then it can be administered at an early stage.

The study also showed that children from poorer areas were found to have worst HbA1c test results whilst children in more prosperous areas were found to have better HbA1c results.

Bridget Turner, director of policy and care improvement at Diabetes UK, said, “There remains considerable variation in the level of care provided. This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life threatening complications in adult life such as amputations, blindness and stroke.”

Since the report, The NHS (National Health Service) are working to improve the delivery of effective integrated diabetes services with the help of clinical commissioning groups across Wales and England.

I hope that future reports will show that children within this age group suffering with diabetes are being taken care of and not going without these fundamental check-ups, regardless of their economical status.

Amina xx

Talk about your medicines month

This month of October marks the calendar as “Talk About Your Medicines” month. The American Recall Center invited me to talk about the medicine I use. I hope that this will help to spread further awareness for diabetes.

What’s my medicine?

My Medicine is Insulin. Insulin is a hormone which is produced in the pancreas.
As a type 1 diabetic, I am unable to produce insulin and must administer a synthetic engineered form into my body. It is essential that I inject insulin into my body on a daily basis. I greatly depend on it and it is vital for my survival.

“I am insulin dependent.”

My insulin therapy started over 20 years ago now and it will be with me for the rest of my life. You may or may not have gathered yet but insulin is not a cure for diabetes. As Dr F Banting once said, “Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates, so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life.”

Having this chronic disease means that I have no choice but to take this medicine if I want to live a healthy lifestyle. It allows me to live in general. Without it I would be extremely ill and my day to day functions would be limited.

When I was first diagnosed, without my natural insulin production, it took a matter of a week before I became a skeleton. I was weak, constantly consuming what seemed to be gallons of water and daily living became a struggle. The lack of insulin in my body meant that I couldn’t function well. “I was wasting away!”

Starting my insulin therapy impacted me greatly. I had to learn to accept it and trust that this medicine would help me be well again and allow me to be myself again. It was a big change in my life, but remembering the feeling of sickness I had felt before my diagnosis, made me want to be healthy and normal again.

How do you remember to take your medicine?
Remembering to take my medicine can be difficult at times. However after 20 years of living with this condition, there really is no room for forgetting to take your insulin. I’ve made it a priority and it has become a part of my daily routine. Having to calculate carbohydrates I consume forces me to remember to take my insulin. I won’t lie, I have on occasion forgotten to take my insulin. However, I usually remember during my first few bites of a meal and quickly give myself a bolus(dose of insulin). It really isn’t an easy job at all. It’s constant, everyday, night and day. You can’t really escape it or say, “Ok I’ve had enough” or, “oh no! I skipped that dose. Never mind I’ll take another dose tomorrow.” It just doesn’t work like that.

Where do I go for medical support?
For medical support I usually attend a Diabetes clinic. If I have any concerns I tend to reach out to the clinic and also to my GP. I am free to make contact with them during the week. Nevertheless, medical support during the weekend is limited to going to the hospital.

Advice for others
As a newly diagnosed patient about to start a course of insulin therapy. My advice to you is to remember, diabetes and insulin therapy is an enormous and daunting prospect to come to terms with. The concept that you will have to take this medicine for the rest of your life is a lot to contend with. Accepting that this is now your fate, is key to maintaining and managing your diabetes. You must make it your business to learn as much as you can about this condition and its treatment if you want to live a healthy life.
Take it step by step and try to do the basics, e.g. taking your insulin before meals, testing your blood glucose levels and taking note of what your levels are at certain times. Don’t be afraid to ask questions, consult your doctors about the insulin therapy your about to commence. Something that really helped me was to connect with other diabetics both newly diagnosed and diabetics who had been living with the condition for years.

What drug interactions must you be aware of?
When I was first diagnosed I had no idea about different drugs interacting with my insulin. It wasn’t till later in my diabetes life, that I began to understand that there are many drugs which in fact can interact with insulin, drugs such as Aspirin, oral contraceptives, anabolic steroids, thyroid medication and many more. Consulting with your GP is the best thing to do. They will be able to tell you exactly what drugs can interact with the type of insulin you are taking.

The risks and benefits of taking insulin?
The major risks involved in taking insulin are taking too much or too little. This can have a severe effect on your blood glucose levels and can cause hypoglycaemia or hyperglycaemia. Taking the correct dosage is very important.
The benefits of taking my insulin is that I am healthy. Even though I am dependant on it, without it I wouldn’t have been able to achieve many things in my life thus far. Would I be the adult that I am now without it? In all honestly I don’t think I would be the strong, determined individual I am today. This medicine has been instrumental in helping me face my condition. Without my insulin I would not have been around to encounter all of life’s challenges.

What do you wish you knew before taking insulin?
I wish at the time of my diagnosis I knew more about insulin and how it worked. Also I wish I had a better understanding of how soon my insulin/s peaked.

Taking you medicine is crucial when you are a diabetic. However, it is also very important to know more about the medicine you are taking. Don’t take it blindly without knowing more about it and how it will affect you. Being a diabetic is extremely arduous but try to stay positive, be patient, stay determined, reach out to others when you need the support and most of all remember to take your insulin.

Amina xx

The invisible Diabetes

When I first meet someone, I don’t introduce myself as, the type 1 diabetic, who has an insulin pump and pricks her fingers between six to eight times a day.

To look at me, you’d just see Amina. The girl, who stands at 5ft 6 and 1/2 inches tall. The girl, from the northwest, with a strong manccunian twang. Always trying to smile, but sometimes frowning. Sometimes boring others to tears with her talk of science.photo (1) Never missing an opportunity to mention the latest K drama she’s engrossed in that week.

The girl, that works out from time to time, the mother, the wife, the part time gardener. Most of all, the girl who tries her best to stay patient and positive at all times, because the one thing you don’t see about me, is “My diabetes”.

Type 1 diabetes is a chronic illness. However, it isn’t something that is visible to the human eye. I don’t have any external apparent scars, or disfigurements which would indicate that I have a life long illness, or that for every day for the past 19 years I’ve been fighting, this never ending battle of diabetes. Some days I feel fine. Sometimes I find, I have the perfect blood sugars in the morning, and then it all changes just as quickly, limiting my day to day activities.

invisible

To my surprise, I recently discovered that quite a few people who I know, had no idea I even had diabetes. Some of these people, I went to school with and others I’d worked with. Although it may be invisible to others, for me, the one living and fighting each day to stay strong and healthy, it is more visible than ever. It is a part of my life, but not the only thing in my life. It has grown with me, matured with me, been there with me during the good and bad. It has moulded that part of me that makes me, me.

Even when experiencing low or high blood sugars, it still isn’t visible. My appearance to others might be that I’m absolutely fine. The people close to me, who have experienced me, during these times, may be more receptive to my symptoms, than others. They may understand that my ramblings, my shift in mood, might be a low or high blood sugar. Even still, it sometimes still isn’t that obvious. I may actually just be rambling like I do, or I may be angry about something. It doesn’t always mean I’m having a hypo. OK most of the time it does, but there’s that small window of a time, in which I’m just expressing my feelings.

LOVED ONE:  AMINA! DID YOU CHECK YOU’RE SUGAR?

ME: NO, WHY? (ANGRY TONE)

LOVED ONE: ARE YOU HAVING A HYPO? I THINK YOUR SUGAR MIGHT BE DROPPING!!

ME: (GETTING ANGRIER, BECAUSE IN THAT MOMENT MY THOUGHTS ARE JUMBLED. I FIND MYSELF RESPONDING WITH), MY SUGARS ARE JUST FINE. IT’S NOT MY SUGAR, IT’S YOU! JUST LEAVE ME ALONE. THIS WILL THEN MAKE ME CHECK MY SUGAR.

During a hypo I feel antagonised, and always seem to pick a fight or defend myself. Something as small as asking me about my blood sugar during that moment can become a fixation and can be blown out of proportion. I become increasingly frustrated, words become confused,  and I feel a strong need to express my  emotions.

The truth is, without suffering from this condition, it’s hard to really understand the internal effects that those lows and highs have on me. The weakening and almost debilitating feeling, which accompanies the shift in blood sugars, just can’t be put into simple words.

I’ve even found myself in situations where I have had to prove my condition and the way I’m feeling to others, because they aren’t able to physically see my diabetes.

This first happened to me when I became diabetic. I started high school and one of the lessons we all had to take part in was P.E (Physical Education). I’d gone for several weeks without having any hypos at all.  All teachers we’re made aware that I was diabetic, well so I thought. Then, it just so happened that the day I had a hypo we had to do cross country running. This involved running around our huge school grounds about 8 to 10 times. For someone who loved to run it was a killer. The race started, and off I went. As hard as it was, I always seemed to be one of the ones at the front of the race.  Lap 6, “I got this!” I continued on and all of a sudden, I started to feel myself slowing down. I realised that my sugar was dropping and that I had to pull myself out of the race. As I ground to a halt, I heard in a loud tone, “AMINA, why aren’t you running?” It said. I turned, it was the teacher. I started to walk towards her at this point she was shouting at me. Asking me why I’d stopped?

“Miss”, I said. “I can’t go on anymore”. Her expression said it all. Almost disgusted by my words, she told me to go back to the race. Which is when I decided to say, “I’m diabetic.” “no go back to the race!”, she said.  “stop telling lies to get out of this race”. At this point I collapsed to the ground, begging her to let me go inside to get my emergency hypo supply.

One of my close friends, who knew I was diabetic, came towards us. “Are you ok Amina?” She asked. ” Is it your blood sugar?” she asked. “yes”, I said. She ran past the teacher and went to grab my emergency hypo supply. The teacher was shocked!

She did finally believe me and apologised for not listening. She wasn’t aware that I was diabetic and really did think I was making up an illness to get out of the race. From then on, she had supplies for me and always made me bring my emergency hypo bag out with me.

This story is a true example of how invisible diabetes is. The moral of the story is, that you should never take a person at face value. If someone tells you they aren’t feeling well, diabetic or not , never doubt them because their outwards appearance may not reflect what is going on internally.

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My Diabetes……

How it all started

At the age of 11, I was diagnosed with Type 1 diabetes. The symptoms were very subtle to start with. Sheer exhaustion was the first to hit me. My mother began to question ”why was I always tired?” I went to the doctors and was told I was anaemic and needed iron tablets. I took them but still the tiredness continued. A few weeks later, the symptoms came on rapidly over a course of a week. I was constantly exhausted, carrying 2Litre bottles of water around with me unable to quench my never ending thirst. Waking up several times during the night became routine and not to mention the drastic weight loss which occurred over that week. I was a walking skeleton!!

Diabetes is a common trait with the women in my family which made both me and my mother more aware of some of the symptoms at the time. Knowing some of these symptoms are really important as it can affect anyone of us and it may make a difference in saving someone’s life. But to this day, I still believe that the little knowledge and experience we had helped us take action which helped me get the treatment that I needed.

My diagnosis at such a young age was a great shock and difficult to understand at first. I knew that I had to accept and deal with it if I wanted to be healthy. I can honestly say that I’ve had a great support network from my family, friends and some of the nurses and doctors. On the other hand, even with their support I’ve still had my ups and downs and ultimately I’ve realised that it’s my diabetes and my responsibility. I’ve learnt that my condition is something that I shouldn’t hide from or be ashamed of, but something that is a part of me but does not define me. Living with type 1 diabetes, even with its difficulties, I can definitely say that it has taught me the virtue of patience and being patient.

Diabetes UK have a campaign which is designed to raise more awareness for Type 1 diabetes. Its called 4T’s.

4Ts A4 Poster

Please click on the highlighted link above, print and post the poster somewhere so everyone can see it and learn these symptoms. Thank you.