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Module 5.1: Pressure Ulcers/ Injuries

DIABETES MELLITUS

Diabetes is a group of metabolic diseases characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. Insulin, the hormone produced in the pancreas, regulates the storage and release of energy from food. High plasma glucose levels caused by diabetes can damage blood vessels and nerves (Vuolo, 2009; NICE, 2016).

Diabetes can occur from the failure of the pancreas to produce enough insulin or from the development of insulin resistance, resulting in high blood glucose levels (hyperglycaemia). There are two main types of diabetes mellitus: Type 1 and Type 2. Both are progressive, resulting in long-term complications (McIntosh & Newton, 2006; Diabetes UK, 2020).

Type 1

Type 1 diabetes is an autoimmune disease that causes the insulin-producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin to adequately regulate blood glucose levels.

Type 1 diabetes may sometimes be referred to as juvenile diabetes, but this is seen to be outdated, whilst it is commonly diagnosed in children, the condition can develop at any age.

Insulin-dependent diabetes is another term that can be used to describe type 1 diabetes.

As type 1 diabetes causes the loss of insulin production, it requires regular insulin administration either by injection or by insulin pump (Diabetes.co.uk, 2017, 2022).

Type 2

Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycaemia due to the body being ineffective at using the insulin it has produced; also known as insulin resistance and/or being unable to produce enough insulin.

Type 2 diabetes is characterised by the body being unable to metabolise glucose, leading to high levels of blood glucose, which, over time, may damage the organs of the body.

Following a healthy balanced diet that promotes good glucose control, good blood fat levels, good blood pressure as well as maintaining a healthy weight can help reduce the need for medication and any potential long-term complications.

Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide (Diabetes.co.uk, 2017, 2022).

Risk factors for developing type 2 diabetes:

  • Being overweight or obese
  • Increasing age
  • Having a waist size of 31.5 inches or more (women) or more than 37 inches (men)
  • Eating an unhealthy diet
  • Physical inactivity
  • Having a first-degree relative with type 2 diabetes
  • Having high blood pressure or raised cholesterol levels
  • Being of South Asian and African-Caribbean descent
  • Smoking

The likelihood of developing type 2 diabetes is also influenced by genetics and environmental factors. For example, research shows that:

  • If either parent has type 2 diabetes, the risk of inheritance of type 2 diabetes is 15%
  • If both parents have type 2 diabetes, the risk of inheritance is 75%

(Diabetes.co.uk, 2017, 2022)