Living with diabetes
Living with diabetes

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Living with diabetes

Conclusion

This course has introduced the subject of diabetes and how it is diagnosed. It has discussed the structures and processes in the body that are important for controlling blood glucose levels and described what goes wrong when diabetes develops. The differences between Type 1 and Type 2 diabetes and other forms of diabetes have been highlighted. The concepts of genetics, risk and risk management have been introduced.

Now try to answer the following questions to test your knowledge.

Question 1

In a few sentences, outline how diabetes is diagnosed.

Answer

Diabetes is diagnosed by measuring the plasma glucose level. If the level is 11.1 mmol/l or more on a random sample then the person has diabetes, when symptoms are present. If no symptoms are present the plasma glucose level needs to be abnormal on two separate occasions. A fasting plasma glucose level of 7.0 mmol/l is also used to make a diagnosis of diabetes. Occasionally an oral glucose tolerance test will be used to make the diagnosis.

The type of diabetes is diagnosed by clinical symptoms and signs. People with Type 1 diabetes have often lost a lot of weight and may have ketones in the urine at the time of diagnosis. In contrast, people with Type 2 diabetes may not be diagnosed for quite some time despite their elevated plasma glucose levels. In Type 2 diabetes it is rare to have ketones in the urine. Being thirsty or getting up at night to pass urine may be associated with getting older, not only with having diabetes.

Question 2

Complete Table 1 to compare and contrast Type 1 and Type 2 diabetes (click to acces a printable version of the table [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] ).

Table 1 For use with Question 2

CriterionType 1 diabetesType 2 diabetes
Age at onset
Treatment
Presence of ketones
Cause

Answer

The completed table is shown below.

Answer to Question 2

CriterionType 1 diabetesType 2 diabetes
Age at onsetCan occur at any age, but more commonly in children and young adultsMore common in older people, but can occur in younger people
TreatmentInsulin is the only therapy availableDiet alone, diet and tablets and/or insulin can be used
Presence of ketonesKetones occur if the blood glucose level becomes highKetones uncommon
CauseComplete lack of insulinCombination of not enough insulin and/or resistance to its actions

Question 3

Which hormone is important in the development of diabetes? Briefly describe its role in the development of Type 1 and Type 2 diabetes.

Answer

Insulin is the most important hormone in the development of diabetes.

People with Type 1 diabetes do not produce any insulin at all. They cannot lower their blood glucose level without injecting insulin. They use insulin injections to keep their blood glucose level normal.

People with Type 2 diabetes produce insulin, but not enough to lower their blood glucose level to normal and they may be resistant to the action of insulin.

Question 4

How might you inherit diabetes from your parent(s)?

Answer

You may inherit a condition-causing gene from one parent only and will also have the condition even though the gene from the other parent is normal. This is known as autosomal dominant inheritance. This is different from autosomal recessive inheritance when you must inherit the condition-causing gene from both parents to have the condition yourself. Diabetes is thought to be a multifactorial condition, where many different genes may be important.

Question 5

What factors increase the risk of someone developing Type 2 diabetes?

Answer

The following factors are all important in deciding the risk of someone developing diabetes:

  • ethnicity

  • obesity

  • lack of exercise

  • family history of diabetes

  • increasing age

  • previous gestational diabetes.

Question 6

Explain how obesity is defined and how body mass index is calculated.

Answer

Obesity is defined as greatly elevated body mass index, to an extent which is associated with serious increased risk to health.

The body mass index (BMI) indicates whether an adult is a healthy weight for their height. To calculate BMI divide the weight (in kg) by the height (in metres) multiplied by itself:

A BMI value greater than 30 kg/m2 indicates obesity.

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