To have understanding of diabetes

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1 Diabetes

2 Aim To have understanding of diabetes

3 Define diabetes Objectives Identify normal and abnormal blood glucose ranges Outline the risk factors associated with diabtes Identify the importance of documentation Identify the importance of documentation and reporting to a registered practitioner

4 Diabetes Diabetes is a common life-long health condition. There are 2.8 million people p diagnosed with diabetes in the UK and an estimated 850, people who have the condition but don t know it. (Diabetes UK 2011)

5 Diabetes Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly. This is because your pancreas does not produce any insulin, or not enough, to help glucose enter your body s cells or the insulin that is produced does not work properly (known as insulin resistance).

6 Type 1 diabetes Type 1 diabetes develops when the insulinproducing cells in the body have been destroyed and the body is unable to produce any insulin.

7 Type 2 diabetes Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance).

8 Insulin is the hormone produced by the pancreas that allows glucose to enter the body s cells, where it is used as fuel for energy so we can work, play and generally live our lives. It is vital for life. Glucose comes from digesting carbohydrate and is also produced by the liver. Carbohydrate comes from many different kinds of foods and drink, including starchy foods such as bread, potatoes and chapatis; fruit; some dairy products; sugar and other sweet foods. If you have diabetes, your body cannot make proper use of this glucose so it builds up in the blood and isn t able to be used as fuel.

9 Normal Ranges Normal adult range FASTING Glucose = mmol/l RANDOM Glucose = mmol/l Diagnosis of DM WHO Criteria:» Two of the following» * Fasting Glucose >7.0 mmol/l» * Random Glucose > 11.0 mmol/l» * Oral glucose tolerance test 2 hour glucose >11 mmol/l» * Symptoms of diabetes» Symptoms of diabetes Impaired glucose tolerance >6.1 but <6.9 mmol/l Diagnosis gdm > 6.1 mmol/l or 2 hour glucose > 9.0 mmol/l.

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14 Hypoglycaemia Hypoglycaemia, or hypo, is the medical term for low blood glucose levels that is a blood glucose level of less than 4 mmol/l. This is too low to provide enough energy for your body s activities.

15 What causes a hypo? too much insulin / too much diabetes medication delayed or missed meal or snack not enough food containing carbohydrate unplanned or strenuous activity drinking too much alcohol or alcohol without food sometimes there is no obvious cause.

16 Diabetic Ketoacidosis In the short term, consistent high blood glucose levels can lead to a condition called diabetic ketoacidosis (DKA) Why does this happen? This happens because of a lack of glucose entering the cells where it can be used as energy. The body begins to use stores of fat as an alternative source of energy, and this in turn produces an acidic by-product known as ketones. How ketones affect the body Ketones are very harmful and the body will immediately try to get rid of them by excreting them in urine. Consequently, when ketones are present and blood glucose levels are rising, people often become increasingly thirsty as the body tries to flush them out. If the level of ketones in the body continues to rise, ketoacidosis develops (ketoacidosis means acidity of the blood, due to an excess of ketones in the body). Their harmful effect becomes more apparent, and nausea or vomiting may start. In addition, the skin may become dry, eyesight blurred and breathing deep and rapid.

17 HbA1c HbA1c The most common test is the HbA1c test, which indicates your blood glucose levels for the previous two to three months. The HbA1c measures the amount of glucose that is being carried by the red blood cells in the body. HbA1c targets For most people with diabetes, the HbA1c target is below 6.5 per cent, since evidence shows that this can reduce the risk of developing diabetic complications, such as nerve damage, eye disease, kidney disease and heart disease. Individuals at risk of severe hypoglycaemia y should aim for an HbA1c of less than 7.5 per cent. However, any reduction in HbA1c levels (and therefore, any improvement in control), is still considered to have beneficial effects on the onset and progression of complications.

18 Reference and useful resource

19 Any Questions?

Hyperglycemia. This reference summary helps you better understand hyperglycemia. It discusses symptoms, causes, treatment and prevention.

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