Diabetes

The hormone insulin is made by the pancreas and controls your blood sugar levels by shifting glucose from the blood into our cells. Here, it’s broken down to give us energy. If you have diabetes, this process doesn’t work and the body can’t convert glucose into energy.

The main symptoms associated with diabetes are:

• feeling very thirsty
• urinating more than usual, especially at night
• extreme tiredness
• losing weight
• itching around the genitals, or infections like thrush
• slow healing cuts

If you experience a range of these symptoms it’s important to see a consultant as soon as possible, as type 1 diabetes can develop quickly.

Diagnosing both types of diabetes usually involves:

• blood tests to check blood sugar levels
• urine tests

Over time, high glucose levels in your blood can lead to complications in your kidneys, heart, eyes and feet. People with diabetes are at much greater risk of foot disease and foot ulcers. This is because diabetes can cause nerve damage known as .

Signs of foot problems in diabetes include:

• swollen feet
• numbness or tingling sensations
• loss of feeling
• sores that don’t heal

Your consultant will look for these signs and develop a personalised care plan if they detect any foot problems developing.

Type 1 diabetes

If you have type 1 diabetes you need to take insulin by injecting with an insulin pen or using an insulin pump. Other treatment includes incretin memetics (medication that helps the body to produce insulin when it’s needed).

Type 2 diabetes

If you have type 2 diabetes you may need to take insulin or medication such as metformin. This is the first line drug in the management of the condition. Diet and exercise can also be instrumental in keeping blood sugar levels under control.

More recently metabolic surgery, which changes the anatomy of the gastrointestinal tract, has been proven to be a powerful treatment for Type 2 diabetes. This is a NICE approved surgical option (using bariatric procedures) for individuals with Type 2 diabetes and obesity. Performed laparoscopically, (keyhole surgery), the procedure alters metabolic function to improve glycaemic control, and 50% of patients become diabetes-free. The benefits include a reduction in medication usage, a lowering of cardiovascular disease risk, greater weight loss and ultimately a better quality of life. For more information visit London Bridge Hospital’s Metabolic and Bariatric Centre. 

Diabetic foot

Treatment for diabetic foot disease may include:

• offloading (a plaster cast is used to take the pressure off and help with healing)
• clearing away any dead, damaged and infected skin (debridement)
• vascular surgery to ensure the foot has adequate blood supply
• In severe cases, orthopaedic surgery to reconstruct ‘diabetic foot’ is now effective and at preventing the need for amputation