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Diabetes

Types, Causes and Symptoms

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Type 1 and Type 2 diabetes – what is the difference?

Although it is easy to confuse the two types of diabetes (type 1 and 2) since their symptoms are the same, their respective causes are very different. Diabetes is linked to insulin, a hormone produced by your pancreas, which processes sugar, carbohydrates and other foods to give you the energy you need to live on a daily basis.

Type 1 diabetes is an autoimmune disease that represents about 10% of all diabetes cases. It happens when your body is no longer able to produce insulin because the cells that make it have been destroyed by your immune system. Consequently, the sugar levels in your blood go up and your insulin levels go down.

You cannot prevent type 1 diabetes because it is not caused by factors related to your diet or physical activity. It is usually diagnosed in children and youth, and sometimes, though rarely, in people over the age of 40.

The risk factors for type 1 diabetes are not properly understood yet. Studies have shown that genetic predisposition can influence its development, but it is not the only cause of the disease. Some environmental factors may also trigger the autoimmune response.

Type 2 diabetes accounts for 90% of diabetes cases and typically develops during adulthood. It is caused by insufficient insulin production in your pancreas, or by resistance to the insulin produced.

According to Health Canada, the causes of type 2 diabetes are complex and no single risk factor can explain its progression. Ageing, obesity, physical inactivity, certain ethnic origins and a family history of diabetes (or gestational diabetes for women) are all important risk factors.

Symptoms of Type 1 and Type 2 Diabetes

If you have diabetes, you may experience one or more of the following symptoms: you are often thirsty (more than usual), you urinate a lot, you find that you have lost or gained weight without a specific cause, you lack energy and your vision is affected. You may also experience tingling or numbness in your hands and feet.

Impact on your Health

Diabetes-related complications have a common source: too much glucose in the blood. Over the long term, if blood glucose levels remain high, you may have serious health problems and some of your organs may be damaged.

Complications may include:

Vision Problems

Diabetes can lead to progressive deterioration of your vision and can also lead to cataracts and glaucoma, even vision loss.

Neuropathy

Neuropathy includes all abnormalities associated with peripheral nerves. It develops within the first 10 years of diabetes in 40% to 50% of people with type 1 or type 2 diabetes. Neuropathy is the result of poor blood circulation (causing insufficient oxygen supply for nerves) and high glucose levels that alter nerve structure.

Sensitivity to Infections

High blood glucose levels and fatigue sometimes caused by the disease make diabetics more likely to develop periodic infections that are sometimes difficult to cure (infections of the skin, gums, respiratory tract, vagina or bladder). Diabetes can also slow the healing process.

Kidney Disease (nephropathy)

Because diabetes causes vascular problems, the small blood vessels in the kidneys can be affected, leading to progressive kidney deterioration ranging from kidney failure to irreversible kidney disease. Hypertension is also a major contributor to kidney disease.

Cardiovascular Diseases

Cardiovascular disease is 2 to 4 times more common in diabetics than in the general population. High glucose levels contribute to blood clotting and increase the risk of clogging blood vessels near the heart (infarction) or the brain (stroke).

Diabetes is also often linked to complications such as sleep apnea, musculoskeletal disorders and erectile dysfunction.

Prevention of Type 2 Diabetes

By making choices that focus on your well-being every day, you can adopt a healthy lifestyle and help prevent type 2 diabetes, or pre-diabetes, or decrease your risk of developing these diseases. Here are five suggestions for healthy choices that can help guide you:

Maintain a healthy weight

Runner stretch
  • Combine a good balance of physical activity and healthy eating.
  • Consult your health care provider to find out your healthy weight.
  • Learn how to calculate your body mass index (BMI).

Adopt a healthy diet

Click here to consult Canada’s Food Guides.

  • Eat a variety of foods.
  • Eat 5 to 10 servings of fruit and vegetables per day.
  • Increase your fibre intake.
  • Reduce your fat and salt intake.
  • Limit your alcohol consumption.

Why is it so important to eat well for good health? This handy guide clears up some common misconceptions.

Make sure to engage in regular physical activity

Walking for your health
  • Be active at least 30 minutes per day, every day.
  • Choose activities that promote strength, endurance and flexibility.
  • Find activities you like and that you can do as a family.

Do not smoke

  • If you smoke, it’s never too late to stop.
  • Avoid second-hand smoke.

Reduce your stress

Meditation
  • Get sufficient sleep and rest.
  • Be active – physical activity is a great way to reduce stress.
  • Manage your blood pressure, cholesterol and glucose levels.

Screening

Biron offers all diagnostic testing for type 1 and type 2 diabetes including:

Fasting Glucose Levels

This test assesses blood sugar levels at the time blood is taken, not after a meal (assesses the actual level of sugar produced by the liver).

Glucose Tolerance Test

This test is done on a fasting basis. You will be asked to drink a liquid that contains 75 g of sugar. Your glucose levels are then checked again after a 2-hour period.

Glycated Haemoglobin Test (HbA1C)

HbA1c, or glycated haemoglobin, is a particular form of hemoglobin on which a glucose molecule has been attached, providing a proportional link between HbA1c and blood glucose levels. The higher the percentage of glycated haemoglobin in the blood, the higher the average blood glucose level.

The blood level measurement of what is known as glycated haemoglobin gives an idea of the average blood glucose level over the past three months. Its dosage is used to monitor the glycemic balance and thus evaluate and adapt diabetes treatment.

Guidelines

Blood tests Pre-diabetes Type 2 diabetes
Glycemia, fasting Between 6.1 and 6.9 mmol/L (fasting glucose anomaly) 7.0 mmol/L or higher
Glycated haemoglobin (HbA1C) Between 6.0 and 6.4 mmol/L 6.5 mmol/L or higher
Hyperglycemia (oral tolerance test) glycemia, 2 hours after drinking a liquid containing 75 g glucose Between 7.8 and 11.0 mmol/L (glucose intolerance) 11.1 mmol/L or higher
Glycemia, at any time of day -- 11.1 mmol/L or higher with conventional symptoms

Health Canada Statistics

  • In 2008/2009, there were nearly 2.4 million Canadians (6.8%) with diagnosed diabetes. According to blood test data, about 20% of diabetes cases were undiagnosed.
  • Although prevalence increases with age, over half of Canadians with diagnosed diabetes (1.2 million) were working age, between the ages of 25 and 64.
  • If incidence and mortality rates remain at levels observed in the 2008-09 data, it is estimated that the number of Canadians living with diabetes will rise to 3.7 million by 2018-19.
  • People with diabetes are three times more likely to be hospitalized with cardiovascular disease than people without diabetes, 12 times more likely to be hospitalized for terminal kidney failure and nearly 20 times more likely to be hospitalized for the amputation of a lower limb (not caused by trauma).
  • In 2009, diabetes was the leading cause of 34% of new terminal kidney failure cases, resulting in an increased demand for kidney dialysis and transplants in Canada.
  • Since diabetes and other chronic diseases have several risk factors in common, 36.5% of adult Canadians with diabetes indicated they were also suffering from at least two other serious chronic diseases (hypertension, heart disease, chronic obstructive pulmonary disease, mood disorders or osteoarthritis) in addition to diabetes and 12.5% stated they had at least three of them.

For more information on diabetes:

Diabetes Quebec

The Canadian Diabetes Association

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