Norwich and Norfolk Diabetes Trust
Welcome to the Norwich and Norfolk Diabetes Trust
Elsie Bertram Diabetes Centre, Norfolk & Norwich University Hospital
Waiting / Education room at the Elsie Bertram Diabetes Centre
Checking for diabetic foot complications
An examination to check for eye complications
Mobile Eye Screening Unit (funded by NNDT) at the Norfolk & Norwich University Hospital
Diabetes is a disorder caused by an accumulation of sugar (glucose) in the blood stream. It is due to an absolute or relative deficiency of a hormone called insulin, which is normally produced by the pancreas and allows glucose to enter the tissues where it can be metabolised.
• Are there different types of diabetes?
The two main types of diabetes are Type 1 diabetes, which is more acute and occurs in young people. Patients usually need treatment with insulin injections. The other main type is Type 2 diabetes, which generally occurs in older patients. It is less acute and can often be managed by diet and tablets.
• How common is diabetes?
Diabetes affects between 2% and 5% of the population. About one fifth has type 1 and the remainder have Type 2. In recent years there has been a rapid increase in the number of diabetic patients, mostly of the Type 2 variety. It is estimated that there are more than 1 million diabetes patients in the UK and at least 100 million worldwide. It is predicted that these numbers will double over the next decade. Much of this increase appears to be due to the development of obesity in the general population. Being overweight makes diabetic patients more resistant to insulin and also to diabetes treatments.
• What diabetes treatments are available?
Type 1 patients are treated with insulin injections. There is ongoing research to produce better insulins and easier ways of giving them. Type 2 patients can usually be treated successfully with tablets but there is no single treatment currently available that will completely control all aspects of diabetes and prevent complications. There is much ongoing research to develop new methods of treatment. A "cure" for either type of diabetes is some years away.
• What problems does diabetes cause?
When diabetes is out of control this can result in thirst, weight loss and eventually coma. In the longer term, it can damage the eyes, the kidneys and the major blood vessels. Serious problems are only really seen in patients with poorly controlled diabetes over a long period.
• Can diabetes complications cause serious problems?
Unfortunately, despite improvements in treatment, diabetes remains a leading cause of blindness, kidney failure, leg amputation and heart attack. However it should be emphasised the proportion of diabetic patients developing serious problems is small.
• What can be done about complications?
Good control of diabetes and other risk factors, such as blood pressure, will prevent many of the complications of diabetes. However when they do occur it is important that they are detected early, so that effective treatment can be delivered. A good example is the early detection of eye complications (retinopathy) using retinal photographs. If potentially serious eye complications are detected they can often be treated with a laser to seal leaking blood vessels and prevent loss of vision.
• How is diabetes care organised in the UK ?
The majority of patients treated with insulin and those with more serious complications, attend specialist clinics such as The Elsie Bertram Diabetes Centre. Many patients with Type 2 diabetes, treated with diet and tablets are looked after by their GPs. In some cases care is "shared" between Specialist and GP. There is a lot of work being done to develop effective integration between all parts of the diabetes service and provide 'seamless' care for all patients. One of the objectives of NNDT is to assist this process by providing material and educational support to improve specialist skills amongst primary care staff.
