Diabetes Mellitus is a condition that most of us will have heard of. In 2008, Diabetes UK identified that known cases of diabetes affected approximately 2.5 million people in the UK, however there are still many people who do not know that they have diabetes and this figure is rising rapidly.

So, What Is Diabetes Mellitus?

Diabetes generally can be divided into two main categories; Type I and Type II, and although these types of diabetes have similarities, there are differences in their presentation and treatment.

Diabetes is the inability for the body to use glucose properly for energy. When we eat carbohydrates, our bodies break down the food into glucose so it can be used, with the help of a hormone called insulin, in different cells around the body. Generally, in diabetes, when the body cannot use this glucose properly problems occur, as the amount of glucose in the body is too high.

Type I Diabetes

Type I diabetes occurs when the body is unable to produce any insulin, and is usually diagnosed before 40. Type I diabetes is not preventable and you cannot help having it, however lifestyle changes are beneficial to help control the condition after diagnosis. Only a small proportion of all cases are Type I diabetes, affecting between 5 and 15% of sufferers (Diabetes UK).

Type II Diabetes

Type II diabetes is much more common in the UK, and occurs either when there is not enough insulin being made in the body to have enough effect on glucose in the blood, or when the insulin that is produced isn't working properly. Unlike Type I diabetes, there are measures that can be taken to prevent Type II diabetes, and the most common risk factor for developing the condition is being overweight.

We can define whether we are overweight or not through working out our body mass index (BMI) and this can be done quite simply with the help of your doctor, nurse or dietitian. Alternatively you could try this link to the Food Standards Agency website: http://www.eatwell.gov.uk/healthydiet/healthyweight/bmicalculator/

Type II diabetes is most common in those over 40, but it is becoming more and more common in younger people, and has even been seen in children, with the rates of obesity rising rapidly.

Symptoms for both Type I and Type II diabetes are similar, however they may appear much more slowly in Type II diabetes. The most common symptoms that you may want to keep an eye out for are:

• Being more thirsty than usual
• Going to the toilet more often, particularly at night
• Tiredness
• Losing weight
• Blurry vision

What if I Have Diabetes?

If you are a diabetic and want to start a family, then it is particularly important that you understand how to control the condition.

Preconception

If you are thinking about starting a family then it is wise to book an appointment with your nurse to discuss your options and any changes you may have to make to ensure a healthy pregnancy for you and your baby. Generally, we recommend that you plan your pregnancy; most importantly having excellent control of your blood glucose levels for 3 to 6 months before conception. It is vital that you maintain this control throughout your pregnancy and after birth too (American Diabetes Association).

Conception and Pregnancy

Whether you are controlling your diabetes through diet control, medication or insulin injections, good control of your blood glucose levels during conception and pregnancy is vital, and you will receive regular support from your diabetes nurse during these times.

During pregnancy, guidelines state that keeping your fasting glucose levels to between 3.5 and 5.9 mmol/litre is ideal, and by achieving and maintaining good control, you will reduce chances of developmental problems with your baby, and complications during for you whilst giving birth.

If you do not manage to control your blood glucose levels whilst pregnant, you are putting your baby at risk. Uncontrolled blood glucose means that there will be extra glucose available to your baby, possibly making them larger than average, making giving birth difficult. A dependency on the extra glucose supply can also mean that your baby's pancreas produces too much insulin, which can carry on after birth (American Diabetes Association).

Maintaining a healthy lifestyle is also important during pregnancy, especially if you are diabetic. Advice will be provided for you by health care professionals at this time; including your diabetes nurse and dietitian, in order to make sure you and your baby are cared for as well as possible.

You may be told by your doctor or nurse that you should take Folic Acid supplements whilst trying to conceive, and during the first 12 weeks of pregnancy. As a diabetic, you will be prescribed 5mg to take daily. Don't worry about this, all ladies trying to become pregnant and within their first trimester are prescribed this to help prevent your baby from developing spinal cord problems.

Eating a healthy balanced diet, and exercising regularly is also recommended, and following the tips in the During Your Pregnancy section of our website will help you do this properly. Remember, it's never too late to start leading a healthy lifestyle, and a lot of our suggestions can be applied after you have given birth as well.

Recommendations published by the National Institute for Health and Clinical Excellence in 2008 state that alcohol should not be drunk during pregnancy, as blood glucose levels can be affected, and drop to below normal.

What Else Should I Think About?

As a diabetic, regular check-ups with your optician and podiatrist should be common place, alongside your nurse monitoring your blood pressure and blood glucose control. During pregnancy, extra pressure can be put on your body, especially your eyes, so it is worth making sure you are up to date with your check ups, especially if you already have retinopathy.

If you have any concerns however, talk it through with your nurse. A healthy lifestyle and good diabetic control is key to ensuring both the health of you and your baby is at its best. Remember that your doctor, nurse and Dietitian are here to help and support you, and that no question or worry is too small.