Diabetes

Question 1

Define Diabetes Mellitus

Answer 1

A metabolic disorder. It is the absence, deficit or resistance to insulin leading to hyperglycaemia

Is a group of conditions caused by a problem with the secretions or actions of insulin resulting in high levels of blood glucose or hyperglycaemia

Question 2

Prevalence of Diabetes

Answer 2

In the UK there are over 2.5 million people with Diabetes and another 500,000 who have the condition, but have not been diagnosed.

Question 3

What is type 1 diabetes and what is its associated risk factors?

Answer 3

Type 1 (IDDM) - Insulin dependent diabetes mellitus
Risk factors - Family history (autoimmune disease), viral infection

Type 1 diabetes is caused by an autoimmune process where the body attacks the pancreas stopping the production of insulin.
Due to Beta cell destruction predominantly by autoimmune process that can be of viral origin
Main thought is that the body’s immune system destroys the beta cells
Incidence - 10% (250,000) of diabetics diagnosed
Usually diagnosed in children and young adults

Question 4

What is type 2 diabetes and what is its associated risk factors?

Answer 4

Type 2 Diabetes (NIDDM) - Non-insulin dependent diabetes mellitus (linked with obesity, age & ethnicity)
Risk factors - obesity, hypertension, poor lifestyle, diet

Type 2 diabetes is caused by either an insufficient level of insulin or insulin resistance, where the insulin is produced but does not work properly. This is usually associated with obesity
Multifactorial causes both genetic and environmental that affect beta cell function and the tissues sensitivity to insulin
Incidence - 90% (2 million) of diabetics diagnosed, 500,000 - 1 million undiagnosed type 2 cases
Can be prevented or delayed through life style changes

Question 5

Medical diagnosis of diabetes

Answer 5

Diabetes is diagnosed by performing a fasting blood sugar analysis.

Question 6

Medical management of diabetes

Answer 6

Lifestyle changes (type 2) – “HIITS” & “Starvation diets” - normal weight loss diets first
Insulin injections (type 1)
Insulin tablets (type 2) - if had some damage to pancreas

Question 7

Physiotherapy treatment for diabetes

Answer 7

1. Secondary to complications - too much blood sugar ultimately will damage arterial walls leading to atherosclerosis, high BP predisposing patients to higher risk of CVAs and heart attacks
2. Awareness of complications e.g. healing process delayed, hyperglycaemia
3. Education on life style changes (exercise, diet etc.)
4. Higher musculoskeletal pain - exacerbated in injuries
5. Falls - related to peripheral neuropathies = XS blood glucose leads to damage to nerves, particularly in peripheries leads to lack of sensation in peripheries, predisposing patients to higher risk of falls
6. Amputees - AVN long term affect; usually associated with severe diabetes. Ulcers in peripheries which they cannot feel due to peripheral neuropathies plus slow healing process lead to ulcers worsening drastically resulting in toes/feet/fingers/hands amputation

Question 8

Prognosis of Diabetes

Answer 8

Untreated the course of type 1 diabetes is rapid and will result in hyperglycaemia, coma and death. The consequences of type 2 is much more gradual whilst some insulin is being created, but will ultimately reach the same end stage.

Long term or chronic complications of Diabetes include effects on the small blood vessels in the eyes, heart, kidneys, nerves and feet.