Ostrobothnia Diabetes Unit

Diabetes refers to a group of metabolic energy disorders associated with a high blood sugar level. The cause of the increase in blood sugar is either a disturbance of insulin secretion, a decrease in the effect of insulin (insulin resistance) or both.

Diabetes is detected using a fasting glucose test, glucose tolerance test or an HbA1c test.

Before the fasting glucose test, you must fast (not eat) for 12 hours. In the glucose tolerance test, a blood sample is first taken, the so-called fasting blood sugar level, after which a liquid containing glucose is drunk, and after 2 hours the blood sugar level is measured again. HbA1c (so-called long-term blood sugar level) does not require fasting.

n Finland, about 500,000 people suffer from diabetes, of which 400,000 have type 2 diabetes and about 53,000 have type 1 diabetes. Gestational diabetes is diagnosed in one in five mothers.

There are about 10,000 people with diabetes in the municipalities belonging to the Wellbeing Services County of Ostrobothnia.

The WHO classification for different types of diabetes:

• type-1 diabetes: due to insulin-producing β-cell destruction in the pancreas as a result of an autoimmune inflammation, leading to a total insulin deficiency.
• type-2 diabetes: a number of diseases in which either insulin function is impaired (insulin resistance) or insulin secretion is disturbed, or both.
• gestational diabetes: due to an increased need for insulin, due to hormonal changes, which the body cannot respond to with sufficient insulin production.
• secondary diabetes: e.g. pancreatitis, post-pancreatic surgery, hemochromatosis (iron overload disorder)

In addition, several other forms of diabetes are known to exist:

• LADA (Latent Autoimmune Diabetes in Adults): a condition that begins in adulthood, much slower than type 1 diabetes, which usually leads to insulin deficiency.
• MODY (Maturity Onset Diabetes of the Young): a so-called monogenic form of diabetes with a genetic defect in one of the individual MODY genes. These genetic defects often cause diabetes already at an early age.

According to Current Care Guidelines, the main goals for diabetes treatment and self-care guidance are:

• to support the patient’s physical, mental and social wellbeing and readiness to influence their own wellbeing without unnecessary restrictions
• to prevent acute complications (including severe hypoglycaemia and ketoacidosis) and deaths caused by them
• to prevent symptoms due to hyperglycaemia and hypoglycaemia
• to prevent long-term micro- (retinopathy, nephropathy, neuropathy) and macrovascular complications with good treatment of the components found in blood sugar and metabolic syndrome.