Diabetes is a common life-long health condition. There are 2.8 million people diagnosed with diabetes in the UK and an estimated 850,000 people who have the condition but don’t know it.

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).

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 and potatoes, 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 can’t be used as fuel.

There are two types of Diabetes

Type 1 Diabetes is when the body becomes unable to produce insulin. This type requires that a person inject insulin into their body to compensate. Most people who are affected are healthy when they develop Diabetes Type 1. Type 1 diabetes can affect children or adults.

Type 2 Diabetes is when your body becomes insulin resistant. Either the cells are unable to properly use the insulin produced and/or there is reduced insulin made by the body. Type 2 diabetes is more common than Type 1.

Pre-diabetes is when a person's blood sugar levels are higher than normal but not so high that they are diagnosed with Type 2 Diabetes. The goal when someone is diagnosed with pre-diabetes is to prevent Diabetes from developing. See below for tips for minimising the risk of developing this disease.

Once Diabetes is diagnosed, the goal is to keep blood sugar levels as close to normal as possible through diet, exercise and medications. Medications used are insulin for Type 1 Diabetes while Type 2 Diabetes can be controlled through both oral medication and insulin.

People with well-managed blood sugar levels are at a much lower risk of developing complications. It is important that the person understand the disease and how to manage it. This will increase their active participation in their care - which is essential.

Diabetes in the Elderly

Diabetes is prevalent in older adults with almost half of those having type 2 being over the age of 60.   Many people are unaware they have the type 2 condition and may go years before they are diagnosed. This can be especially true in the elderly, whose symptoms can be less apparent, overlooked as "normal aging" or not apparent at all.

The elderly who are at higher risk are those who:

•   Have a family history of Diabetes
•   Are of Aboriginal, Hispanic, Asian, South Asian or African descent
•   Gave birth to a baby weighing over 4kg (9lbs) or had gestational diabetes

Signs and Symptoms

Symptoms may be hard to detect or absent with Type 2 Diabetes

•   Frequent urination
•   Increased and unusual thirst
•   Lack recognition of thirst with subsequent dehydration
•   Increased hunger
•   Blurred vision
•   Increased depression
•   Impaired cognitive function
•   Extreme fatigue, nausea, vomiting
•   Change in weight (loss or gain)
•   Impaired physical function
•   Greater number of injurious falls
•   Cuts and bruises that are slow to heal
•   Tingling or numbness in the hands and feet
•   Increased incidence of pressure ulcers
•   May have increased infections of the bladder, skin, vaginal areas
•   With extremely high blood sugar levels: coma
•   For men, trouble getting or maintaining an erection

Diagnosis

Your Doctor will be able to arrange a blood test. It is recommended that all individuals over the age of 40 should have a blood test every three years, with those with other risk factors undertaking the test annually.

A greater risk is placed upon elderly diabetics of developing vascular dementia.  Vascular dementia  is caused by one or more strokes. Strokes are blood clots that block one of the arteries supplying blood to the brain.

An annual eye exam with dilation of the pupils can often detect Diabetic Retinopathy before symptoms and damage appears. This recommended for anyone with a family history of Diabetes or Retinopathy.

Poorly controlled Elderly Diabetes can lead to nerve damage in the feet, which can affect an elderly person's balance and increase falls.

Men who have vascular problems may not get enough blood flowing to the penis. Nerve damage from elderly diabetes can cause erectile problems. In over 50 % of men who are diabetic, the first sign of the illness is decreasing firmness of erections.

Minimising the Risk

Making simply, healthy lifestyle changes can help prevent the onset of type 2 Diabetes

•   Don't smoke or stop smoking
•   Achieve and maintain a healthy weight
•   Be physically active
•   Limit your intake of fat and sugars
•   Eat regular, balanced meals
•   Keep cholesterol low

If You Have Diabetes

To keep well and healthy, everyone with diabetes needs regular healthcare checks. Effective treatment and ongoing management are essential to help reduce the risk of developing the long-term complications of diabetes such as stroke or eye disease.

Routine healthcare will aims to:

• Help you obtain the right information and skills to enable you to manage your diabetes and make healthy lifestyle choices
• Monitor your cholesterol
• Provide you with safe, effective and personal medical care
• Support and provide you with proper foot care – diabetic shoes and socks may be recommended by a podiatrist or Doctor