When you think of diabetes you may think of tedious daily injections, erratic blood sugar levels and the risk of falling into a coma but with care, this common condition can be successfully managed.

Diabetes is a disorder caused by a lack of the production of the hormone insulin by the pancreas. Insulin is responsible for absorbing glucose into the bloodstream, where it is available for body cells to use for growth and energy.

There are two major forms of diabetes– type 1 and type 2. Both tend to run in families, although only 10% of type 1 patients will have a family history of diabetes; in type 2 diabetes, this figure rises to 30%.

Type 1
This is known as insulin-dependent diabetes (IDDM) and though most often seen in children or young adults, can actually appear at any age. It occurs when the body produces little or no insulin.

Type 2
Also known as non insulin-dependent diabetes (NIDDM), this is the most common type– 90% to 95% of people with diabetes have this type. In type 2 the pancreas usually continues to produce some insulin, but the body cannot use it effectively. It is most common in adults over the age of 40 and in those who are overweight or have high blood pressure.
What are the symptoms?

People with type 1 diabetes usually develop symptoms over a relatively short period. Symptoms in those with type 2 are not as instantly noticeable and often diagnosed by chance through routine medical check-ups. The most common symptoms are-
* Increased urination.
* Increased appetite or
loss of appetite.
* Excessive thirst.
* Weight loss.
* Blurred vision.
* Skin infections.
* Fatigue.
* Vaginal infections or infections of the foreskin in uncircumcised men.

Diabetes is diagnosed by examining glucose levels in blood samples using a random glucose test, fasting glucose test or glucose tolerance test.

Treatment
Type 1 diabetes will require insulin treatment while type 2 may be sufficiently controlled by diet and exercise alone.

Insulin therapy
This is the main treatment for type 1 diabetes which aims to control the amount of insulin in the bloodstream so that glucose levels are normal. In addition to daily self-injections of insulin, diabetics must also check their blood sugar level every day to ensure they receive the right dosage of insulin.

Diet is essential in both types of diabetes. A dietician may be assigned to a patient to help design a diet that includes a lot of carbohydrates and high-fibre food, and minimises the intake of sugar-rich foods.

Exercise is also very important and can help to control blood sugar level although the amount of insulin taken may have to be adjusted according to the amount of exercise.

Oral medications
These lower the blood sugar by increasing the amount of insulin secreted by the pancreas or by increasing the action of insulin in the body or by delaying the absorption of glucose.

Routine check-ups
Routine check-ups ensure you are getting the right treatment and allow for careful monitoring and treatment. GP’s will need to see diabetics every three to six months to check the amount of long-term glucose in the blood, take blood pressure, evaluate home glucose readings, and discuss diet and exercise.

Other checks will need to be done including the lipid levels in the blood, urine tests for protein, blood tests for kidney function, eye examinations and regular examinations of the feet.