What is Type 2 Diabetes? 

 

When we eat and drink our bodies break the food into chemicals that we can use as building blocks for growth.  The body uses everything that it can and anything that the body cannot use gets disposed of as waste in our urine, stool and sweat.  The chemicals from the food and drink are absorbed from our stomach and intestine into our bloodstream to be transported around our body to wherever they might be needed.  Once at their destination, the chemical leaves the blood stream to cross into a cell where it is used for growth or maintenance.   

 

One of the major building blocks taken from the things we eat and drink is glucose.  Soon after eating or drinking, the glucose level in our blood stream rises. However, before the glucose can become useful to our bodies it needs to move from the blood stream into a cell where it is utilised as an important source of energy.   

 

 

Type 2 diabetes mellitus is a disease where the body is no longer able to efficiently get glucose from the blood stream into the cells of the body. 

 

When the glucose is in the blood stream, it cannot be used as energy and is poisonous.   

 

Patients who suffer from Type 2 Diabetes are called Diabetics. 

 

If glucose stays in the blood stream at high levels for too long it damages everything it touches, like a poison.  It might be useful to imagine the organs in the body of a diabetic as irritated and fragile as it will help to understand why Diabetes pre disposes and accelerates other disease processes such as heart and kidney problems.  If an organ in the body is already damaged, irritating it further will make it worse. 

 

The aim of the treatment for Diabetes is not just to reduce the blood sugar (poison) levels but also to reduce irritation of all the major organs and try to reduce the risk of other related problems.  In particular, it is important to have a healthy blood pressure and cholesterol level to reduce the heightened risk of heart attacks and strokes seen in Diabetics. 

 

Glucose is carried around the body in the blood attached to red blood cells.  A spot test can tell us roughly how much sugar is being carried in the blood at any one time. This is often referred to as a BM an can easily be tested using a small device and a finger prick to get access to the blood.  Using laboratory tests and a blood sample we can also measure how much glucose has been attached to the red blood cells over their life span, which is around 120 days or 3 months.  We call this the HBA1C, or IFCC. 

 

 

 

 

Treatment aims 

 

  • Optomise blood sugar 

 

  • Optomise blood pressure 

 

  • Optomise cholesterol 

 

 

 

Treatment options to reduce blood sugars 

 

  1. Diet 
  1. Exercise 
  1. Tablets 
  1. Injections 

 

There is no one size fits all in Diabetes treatment.  There are multiple things to think of when deciding which treatment is best for you, but generally we consider the following points…  Think MOWA 

 

Medical Problems 

Not all medications are safe to use together and some medications worsen other medical conditions.  It is important to choose a treatment type that best suits your other medical problems.  Your Doctor or Pharmacist can help you understand which medicines will be safe options for you. 

Occupation 

Some diabetic medications increase the risk of low blood sugars or “hypo’s”.  As hypo’s impair your ability to think and be alert they may not be safe for occupations where alertness is critical.  Drug’s that cause hypo’s must also be used with caution with anyone who drives.  This is especially import with drivers who hold special licences, such as HGV drivers. 

 

Age 

The elderly are at increased risk of falls and are more susceptible to suffering the dangerous effects of low blood sugars or “hypos”.  The rapid correction of high blood sugars levels in the elderly can also be quite dangerous, so a more cautious approach is recommended. 

 

Weight 

Some diabetic medications increase body fat.  Given that higher levels of body fat makes it more difficult for for glucose to leave the blood and get into cells, it is usually not wise to use these types of drugs when you are struggling with excessive weight.