Tag: Glucose

What are the different types of diabetes?

diabetes-week2016-11

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

Avoid retinopathy

Let’s prevent retinopathy

How can we avoid these complications? Here are some of the steps I try my best to take to avoid complications.

1.      BLOOD SUGARS, BLOOD GLUCOSE LEVELS, BLOOD SUGARS. Get them as tight as possible. Stay within the target levels.I can’t stress how important this is. I try to test my BGL at least 8 – 10 times in a day.

Type 1 diabetic (adult) before meals should be aiming for 4-7mmol/l

Two hours after meals try to aim for less than 9mmol/l

Type 1 diabetic (child) before meal should be aiming for 4-8mmol/l

Two hours after meals try to aim for less than 10mmol/l

2.      HbA1c, A1c = Try to get this between 48 – 58mmol/mol (6.50% – 7.50%)

3.  Make sure blood lipids (fats) are in a healthy range.

4.      Get your eyes tested, every 6 months to a year. Let’s avoid any complications occurring.

5.      If you have high blood pressure, get this checked frequently.
125/80 (healthy range)

6.      I always try to eat healthy.

.   Stay Active. Get that blood circulating

8.  I always attend my annual diabetes check ups.

9. Look after your feet

ClearlyHealth

HbA1c!!!

HbA1c WHAT'S YOURS

HbA1C! When I first became diabetic I had no idea what this even meant. I just knew that every 3 to 6 months I would have blood taken from my arm. This blood sample, which seemed like gallons of blood, would then come back to me, a few weeks later in a percentage format. The doctors and my parents seemed happy and that made me happy. “I felt a sense of achievement.”

Let’s start with a few basics!

The blood stream is made up of red blood cells these red blood cells contain haemoglobin or Hb. Red cells can live for 8 – 12 weeks before they are replaced. Hb carries oxygen in the blood from the lungs and then to the rest of the body.

“So what did it all mean?”

As I developed a better concept of science and my diabetes, I began to understand, that this HbA1c was an average measurement used to identify the level of control I had maintained over a prolonged period of time.

HbA1c occurs when haemoglobin binds (Hb) with glucose in the blood stream. The glucose and the haemoglobin molecule form a glycated haemoglobin molecule.  This is known as A1c or HbA1c.

 

Hb + Glucose = HbA1c

 

Someone without diabetes produces normal levels of glucose and therefore produces a normal level of glycated haemoglobin (HbA1c). The more glucose in the blood stream, the more haemoglobin A1c or HbA1c in the blood. Higher levels of glycated haemoglobin in diabetics would suggest poor blood glucose level control.

These high levels of HbA1c are associated with diabetic complications such as retinopathy (eye complications)  and neuropathy (nerve damage). There are many other complications, which I will touch on in my next post. HbA1c levels do not ensure that complications will develop or will not develop. However it has been proven, that having good control and a good HbA1c will reduce the chances of these complications arising.

What should your HbA1c be??

  HbA1c in mmol/mol (new unit) % HbA1c (old unit)
Non diabetic  30 mmol/mol 4.90%
Diabetic 48 mmol/mol 6.50%
Diabetic prone to hypoglycaemia 58 mmol/mol 7.50%

HbA1c testing in diabetics depends on the individual and how well they control their blood glucose levels.  A diabetic prone to hypos, but is trying their best to achieve tighter control on their diabetes, HbA1c test is carried out every 3 months.Once the individual is able to control and retain good control, HbA1c testing should then be carried out every 6 months. Since I had my son, I’ve suffered a great deal with low blood glucose levels. Currently I have my HbA1c tested every 3 months, due to my nocturnal hypoglycaemia. This is something I’m working hard to get rid of and maintain a good level of control, as I always have.

 

My current HbA1c = 7.4%  57mmol/mol

My dream HbA1c = 5.0%   31mmol/mol

Pregnancy HbA1c = 6.4%  46mmol/mol

Print

 

Amina xx

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If you have bad control, or perhaps your HbA1c wasn’t so great the last time.Its not the end of the world. Stay positive and please don’t give up. Keep on striving for a better HbA1c. Use your diabetes team and get them to help you. However you must help yourself first by, taking regular notes of your sugars and create a picture of what is happening with them. The only way to make changes and achieve a good HbA1c is to take the steps to control your blood glucose levels.

Test your sugar girl!

Blood glucose  levels = diabetes management

BE HEALTHY KNOW YOUR BGLA major aspect of being able to manage my diabetes is to regularly test my blood glucose levels. This involves inserting a test strip into a blood glucose machine, pricking my finger to draw blood and applying my blood to a test strip.

Testing blood glucose levels (BGL)  is a way for a diabetic to gauge what sort of  levels they are working with. For someone without diabetes this isn’t necessary,  as the body is able to keep the levels in a healthy range automatically. The body produces insulin and allows glucose to be released as energy.

What are the healthy ranges you ask?

In order for me to explain the levels a bit better. Please refer to my table below.

 Type Before Meal  2 hours After Meal
Non diabetic 4.0 – 5.9mmol/L Under 7.8 mmol/L
Type 1 4.0  -7.0mmol/L Under 9.0 mmol/L
Type 2 4.0 – 7.0mmol/L Under 8.5 mmol/L

For a person without diabetes, a normal blood glucose level usually ranges between 4.0mmol/l (72mg/dL)  – 6.1mmol/L (110mg/dL). After a meal, blood glucose levels may increase for a short period of time up to 7.8mmol/L (140mg/dL). With Type 1 diabetes there is the risk of blood glucose levels either raising (Hyperglycemia– this is when an excessive amount of glucose circulates in the blood) or dropping (Hypoglycemia – this is a  diminished amount of glucose in the blood.)

After years of testing, it’s something that you don’t really get use to. For me, it became something that I had to do, even though at times it can be painful, it can leave marks and has hardened my finger tips. The harsh reality is,  that it is a crucial part of being able to manage your diabetes.

How I manage my blood glucose levels

From the very beginning (at the age of 11), I tried as much as I could to take and record my BGL by myself. This was something which was encouraged during my time in the hospital and also at the diabetic clinic. However my parents supported me with this, but never pressured me. I felt comfortable to check my BGL and even inject in front of them and my siblings. They continued to except me for me, and never made me feel any different to them regardless of my condition.

Throughout my 19 years as a diabetic, I’ve gone through my fair share of blood glucose machines. There is such a wide variety of blood glucose machines out there. Most blood glucose machines work in the same way. In the sense that you get a blood sample and a blood glucose result in the end.My first blood glucose machine was big and bulky, required a large sample of blood and  took much longer to produce a blood glucose reading. I was advised by my diabetes team to test my glucose before and 2 hours after my main meals. My blood glucose levels (BGL) would then be recorded in a log book like this.

log book 3

The log book  allowed me to make notes of my insulin doses for that day, week etc. Also any general notes I wanted to jot down could be written in there. Now that I use an insulin pump my log books have changed and I tend to test a lot more frequently.

LOG BOOK

My blood glucose machines now are a lot more advanced and allow me to study the data a lot more closely. I enjoy formulating patterns and occurrences in blood glucose levels etc. (I think this is just the scientist in me). However, it does help me make changes or suggestions to my diabetic healthcare team during appointments.

The right machine

Here are the machines I’m using at the moment.

BGL MACHINE1

It’s always good to have a backup machine. Choosing the right machine is extremely important, because essentially it will allow you to know what is happening with your BGL and help  you to keep within a healthy range.  Personally, I prefer something that is small, easy to carry and requires a small blood sample.

Some insulin pumps, like the (Animas vibe) have the capability to continuously monitor blood glucose levels. These continuous CGM (Continuous Glucose Monitoring) glucose sensors are connected to the body and work with the insulin pump to retrieve blood glucose results. With the BGL’s retrieved, the CGM is able to formulate graphs. This comes in handy when it isn’t possible to test i.e. during the night, early morning, during a workout etc. The CGM is able to alert the user when blood glucose levels are increasing or decreasing. I hope to get my CGM sensor soon and will definitely share my experiences using one.