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What is Diabetes? - (Information sheet 1)
Diabetes Mellitus is a chronic and progressive disease that impacts upon almost every aspect of life.

Diabetes comprises a group of disorders with many different causes, all of which are characterised by a raised blood glucose level. This is the result of a lack of the hormone insulin and/or an inability to respond to insulin. Insulin in the blood, produced by the pancreas, is the hormone that ensures glucose (sugar) obtained from food can be used by the body.

It can affect infants, children, young people and adults of all ages and is becoming more common.

Diabetes can result in premature death, ill health and disability, yet these can often be prevented or delayed by high-quality care.

There are two main types of diabetes: Type I diabetes and Type II diabetes.

Type I Diabetes
In people with Type I diabetes, the pancreas is no longer able to produce insulin because the insulin-producing cells (b-cells) have been destroyed by the body's immune system. Without insulin, to move glucose from the bloodstream to the body's cells, glucose builds up in the blood and is passed out of the body in the urine.

Type I Diabetes develops most frequently in children, young people and young adults. About 15% of people with diabetes in England have Type I diabetes. Although it is far less common than Type II diabetes, it is more immediately evident. The symptoms of Type I diabetes can develop very rapidly. These include increased thirst and urine production, weight loss despite increased appetite, tiredness and blurred vision. Type I Diabetes is usually diagnosed as a result of the presence of a combination of characteristic symptoms plus a high blood glucose level.

People with Type I Diabetes need daily injections of insulin to survive. To prevent acute complications they also need to maintain their blood glucose within certain limits, which will require adjustments in their diet and lifestyle. Failure to take insulin can result in diabetic ketoacidosis. (Hyperglycaemia – very high blood sugar)

If the balance between diet, physical activity levels and insulin dosage is not maintained, this can lead to hypoglycaemia (very low blood glucose). Both conditions can lead to coma and, if untreated, death.

Type II Diabetes
In people with Type II diabetes, the b-cells are not able to produce enough insulin for the body's needs. The majority of people with Type II diabetes also have some degree of insulin resistance, where the cells in the body are not able to respond to the insulin that is produced.

Type II Diabetes is most commonly diagnosed in adults over the age of 40, although increasingly it is appearing in young people and young adults. About 85% of people with diabetes in England have Type II diabetes, which in many cases could either have been prevented or its onset delayed.

Glucose builds up in the blood, as in people with Type I diabetes, but symptoms appear more gradually and the diabetes may not be diagnosed for some years. As the blood glucose levels rise, symptoms may develop which include tiredness, frequent urination, increased thirst, weight loss, blurred vision and frequent infections. Thus, Type II diabetes is often detected during the course of a routine examination or investigation of another problem.

People with Type II diabetes need to adjust their diet and their lifestyle. Many are overweight or obese and will be advised to lose weight. Some will also need to take tablets and/or insulin to achieve control of their blood glucose level.