DESCRIPTION: Excessive levels of glucose in the blood. Glucose is used as fuel by every cell in the body. When glucose is eaten, it is absorbed into the blood from the small intestine. Once it reaches a cell, it must cross the fine membrane that forms its outer skin. This is normally impermeable to all substances, but insulin has the ability to combine with glucose and transport it across the membrane from the blood into the interior of the cell. Insulin is made in pancreas, which sits in the centre of the abdomen. There are two different types of diabetes – juvenile diabetes (type 1 or insulin dependent diabetes mellitus – IDDM) and maturity onset diabetes (type 2 or non-insulin dependent diabetes mellitus – NIDDM). Diabetes affects approximately 2% of the population, with 90% of diabetics suffering from the maturity onset form. The cause and treatment of two types is quite different.
CAUSE OF TYPE 2 Maturity onset diabetes: More common in obese patients. There is adequate insulin production, but cells throughout the body fail to respond to the insulin.
SYMPTOMS: Thirst and urinary frequency, and more visual problems, skin infections and sensory nerve problems. Many patients are totally without symptoms when the diagnosis is discovered on a routine blood or urine test.
INVESTIGATION: Blood and urine glucose levels are high in untreated or inadequately treated patients.
A blood glucose tolerance test (GTT) is performed to determine the severity of both types of diabetes.
By measuring the amount of glucose in certain blood cells, the average blood glucose level over the past three months can also be determined.
The level of insulin can also be measured in blood.