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Diabetes - a lifelong condition
Diabetes is a lifelong condition that causes a person´s blood sugar level to become too high. It is also known as diabetes mellitus.In the UK, around 2.9 million people are affected by diabetes. There are also thought to be around 850,000 with undiagnosed diabetes.

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Types of diabetes
There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is often referred to as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early-onset diabetes because it often develops before the age of 40, usually during the teenage years. In type 1 diabetes, the pancreas (a small gland behind the stomach) does not produce any insulin. Insulin is a hormone that regulates blood glucose levels. If the amount of glucose in the blood is too high, it can seriously damage the body´s organs. If you have type 1 diabetes, you will need to take insulin injections for life. You must also make sure that your blood glucose levels stay balanced by eating a healthy diet, taking regular exercise and having regular blood tests. In type 2 diabetes, the body does not produce enough insulin, or the body´s cells do not react to it. This is known as insulin resistance.


Diabetes symptoms
Diabetes can cause various symptoms, including:

  • feeling very thirsty
  • urinating frequently, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk (in type 1 diabetes)

Causes of type 1 diabetes
Type 1 diabetes occurs because your body is unable to produce insulin. Insulin usually moves glucose out of your blood and into your cells, where it is converted to energy. However, in type 1 diabetes, there is no insulin to move glucose out of your bloodstream and into your cells.Without insulin, the body breaks down its own fat and muscle (leading to weight loss). In type 1 diabetes this can lead to a serious short- term condition where the bloodstream becomes acidic along with dangerous dehydration (diabetic ketoacidosis).Type 1 diabetes is an autoimmune condition, where your immune system (the body´s natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them.

Treating type 1 diabetes
It is important that diabetes is diagnosed as early as possible so that treatment can be started. Diabetes cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible, and control your symptoms to prevent health problems developing later.
If you are diagnosed with diabetes, you will be referred to a diabetes care team for specialist treatment. Your care team will be able to explain your condition to you in detail and help you understand your treatment. They will also closely monitor your condition.

As your body cannot produce any insulin, you will need to have regular insulin treatment to keep your glucose levels normal. You will need to learn how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do. This skill needs to be practised and learnt gradually. Many centres now provide courses to teach these skills.

Insulin comes in several different forms, each of which works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but do not last very long (rapid-acting). Your treatment may include a combination of these different insulin preparations. Some people with type 1 diabetes may benefit from a fairly new procedure known as islet transplantation. It involves implanting healthy islet cells from the pancreas of a deceased donor into the pancreas of someone with type 1 diabetes. Islet transplants have been shown to be an effective way of reducing the risk of severe hypoglycaemic attacks or ‘hypos’ (where a person’s blood sugar falls to an abnormally low level). So far, the results of islet transplants carried out in the UK have shown a significant reduction in the number of hypos, from 23 per person per year before transplantation to less than one per person per year afterwards.

Complications
Left untreated, diabetes can cause many different health problems. Large amounts of glucose can damage blood vessels, nerves and organs. Even a mildly raised glucose level that does not cause any symptoms can have damaging effects in the long term. Having diabetes means that you are more likely to develop problems with your feet, including foot ulcers and infections from minor cuts and grazes. This is because blood glucose can damage the nerves in your feet. To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly and see a podiatrist or chiropodist (a specialist in foot care) regularly so that any problems are detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that does not start to heal within a few days.

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