What is diabetes?

All your body cells need energy, and their primary source is glucose, which requires the hormone insulin to enter the cells. In diabetes, there is a lack of insulin, or insulin cannot do its job correctly, which causes various symptoms and health problems. If you have diabetes, your body cannot control your blood glucose effectively. In diabetes, glucose in the blood cannot get into your body cells, and they are deprived of their usual energy source. Your body tries to remove excess glucose in the blood by excreting it in urine, and it uses fat and protein (from muscle) as alternative energy sources. This disrupts your body processes and leads to the symptoms of diabetes i.e, frequent urination and excessive thirst.

How the body uses glucose

When you eat carbohydrates, they are broken down into glucose, which passes from the digestive tract into the bloodstream and from there, into body cells, where it is used to provide energy. Some glucose is also stored in the liver and muscles in the form of glycogen. The

glucose level in the blood is controlled by two main hormones: insulin and glucagon. These work together to keep your blood glucose level within a narrow range. Both hormones are produced in the pancreas by clusters of cells called the islets of Langerhans. There is a constant background level of insulin, but extra insulin is released when your blood glucose rises. Insulin acts like a key, unlocking body cells so glucose can enter. When your blood glucose falls, your pancreas releases more glucagon, which converts glycogen in your liver back to glucose. This enters your bloodstream, and blood glucose rises again.

What is different in diabetes

When you have diabetes, you do not produce any insulin, produce too little of it, or your body cells are resistant to its effects. As a result, glucose builds up in the blood and causes symptoms such as passing large amounts of urine due to your body removing the excess glucose by filtering it into the urine. Because your body cannot use glucose for energy, it uses its muscle and fat stores instead, which can cause symptoms such as weight loss. Other diabetes symptoms include thirst, blurred vision, slow-healing wounds, sexual dysfunction, tiredness, cystitis and thrush, and lack of energy.

DIAGNOSING DIABETES (NON-GESTATIONAL)

Although a urine or fingerstick test can reveal a raised blood glucose level, you need one or more of the three laboratory blood tests to diagnose diabetes: the random or fasting blood glucose test and, if necessary, the oral glucose tolerance test. Your results are assessed with your symptoms. If you don’t have any symptoms, but your results are slightly elevated, you will need a repeat blood test carried out on a different day.

- A1c 6.5% or higher; Whether or not you have symptoms, an A1c

result of 6.5% or higher indicates diabetes. A fasting blood glucose test may also be done to confirm the diagnosis

- Random blood glucose test above 11.1 Mmol/l; If you have symptoms and your blood glucose result is above 11.1 Mmol/l, you are diagnosed

with diabetes. If you have no symptoms, or the result is lower than this, you may have a repeat test while fasting or be given an oral glucose tolerance test.

- Oral glucose tolerance test; If your 2-hour test result is above

11.1 Mmol/l, you are diagnosed with diabetes. You do not eat or drink overnight; you are given a glucose drink in the morning. If your 2-hour test result is above 11.1 Mmol/l, you are diagnosed with diabetes.

- Fasting blood glucose test; If you have symptoms and your blood glucose result is above 7 Mmol/l (8 hours after your last meal) you are diagnosed with diabetes. If you have no symptoms or the result is lower, and you have symptoms, you may have a repeat test or be given an oral glucose tolerance test.