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Diabetes is a disease where the body is unable to produce or use the hormone insulin, which is necessary for the uptake and utilisation of glucose. Glucose is essential for the production of energy in cells and any perturbations to blood glucose levels – if it is too high (hyperglycaemia) or if it is too low (hypoglycaemia) can affect a person’s ability to reason. In diabetics, glucose builds up in the blood leading to hyperglycaemia, which in turn can lead to heart, kidney and nerve disease. People with diabetes also have an impaired ability for wound healing. There are two types of diabetes: Type 1 and Type 2. Type 1 (juvenile diabetes) starts at an early age and is an autoimmune condition, where the body produces antibodies against the cells that produce insulin. Type 2 diabetes is a common condition, where the pancreas produces reduced quantities of insulin, which are insufficient to take up glucose from blood. In recent years, it has been clear that there is a link between obesity and type 2 diabetes. If diabetes is untreated it can lead to diabetic ketoacidosis, a state where the body is so low in insulin it uses fat as fuel and as fats are broken down they produce ketones, which can make the body acidic. Hyperosmolar syndrome is the result of very high blood glucose levels and dehydration.

Risk factors for type 2 diabetes: age, overweight, BMI>25, high blood pressure, abnormal blood fats, very high or very low birth weight and a sedentary lifestyle.

Symptoms of hyperglycaemia: fatigue, frequent urination, extreme thirst, loss of weight, increased appetite and issues with eyesight.

Symptoms of hypoglycaemia: hunger, dizziness, confusion, palpitations, numbness, tingling of the lips, trembling, double vision, disorientation and eventually a coma.

Symptoms of ketoacidosis: sweet breath, difficulty breathing, nausea, confusion and eventually a coma.

Symptoms of hyperosmolar syndrome: confusion, tiredness and eventually a coma.

Who to consult: Dietician, endocrinologist, GP, naturopath, optometrist, ophthalmologist, podiatrist.