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diabetes-20-09-12As the UK’s collective waistline expands, so does your risk of developing Diabetes

Every 10 minutes, three people in the UK discover they have diabetes. The number of cases has risen alarmingly, from 1.4 million in 1996 to 2.8 million now, according to the charity Diabetes UK ( the forecast for the future isn’t any better: by 2025, it’s expected diabetes will affect more than four million people.

Around 90% of these will have Type 2 diabetes, which is related to our ageing population and rising obesity rates. Type 2 diabetes in young people was once almost unheard of, but today there are an estimated 500 cases in the UK, mostly in obese teenagers.

Type 1 diabetes, which generally develops in children and young adults, is also rising – at around 3% a year, especially in the under-fives.

Diabetes is serious; it’s the most common condition of the hormone system and occurs when blood sugar levels are consistently raised above the norm. It reduces life expectancy by up to 10 years in Type 2 diabetes and in Type 1 by up to 15 years. This is mainly because diabetes increases the risk of heart disease and stroke. But with the right medications, diet and lifestyle, people with diabetes can stay well and live life to the full.

Type 1 diabetes
This condition is the least common of the two main types and accounts for around 10% of all people with diabetes. It occurs when the pancreas is unable to produce its own insulin.

Without insulin, the body’s cells cannot process the glucose (sugar) they need for energy. Instead, glucose builds up in the blood, where over time it causes damage to nerves, blood vessels and major organs.

Having a parent or sibling with Type 1 diabetes increases the risk, but it often strikes without warning; the peak age for diagnosis is 10 to 14. It’s detected more often in winter than summer, and it’s thought that having a viral or other infection or environmental factors, such as diet, might play a part in making people more susceptible to the condition.

Symptoms and diagnosis
Typical signs of Type 1 diabetes include unexplained weight loss, raging thirst, exhaustion, blurred vision and frequent urination.

Symptoms often get rapidly worse and make the sufferer feel very ill. Type 1 diabetes is diagnosed by testing the urine and blood for glucose and a short stay in hospital is usually needed to stabilise blood glucose levels and start treatment.

Treatment People with Type 1 diabetes need several daily insulin injections or insulin from a pump attached via a needle under the skin to keep their blood glucose level as near to normal as possible. Self-care in the form of eating healthily, exercising frequently, not smoking and regularly checking blood glucose is also a vital part of the treatment.

Type 2 diabetes
This condition develops much more slowly than Type 1 diabetes: it’s estimated that the average Type 2 sufferer has had it for 10 years before receiving a diagnosis. With Type 2 diabetes, the body’s cells become less efficient at responding to insulin – this is called insulin resistance.

Over time, the pancreas produces less insulin, meaning blood glucose levels rise, with the same damaging results that occur in Type 1.

Type 2 diabetes runs in families, and the risk rises with age. Most diagnoses are in people over 40, although people of south-Asian and Afro-Caribbean descent who are over 25 are at greater risk. It’s slightly more common in men than women. Unlike Type 1, there is a very strong link between lifestyle and developing Type 2. Being overweight or obese – especially carrying fat around the waist – smoking, having untreated high blood pressure, being physically inactive and eating unhealthily are all associated with an increased risk of Type 2 diabetes.

Symptoms and diagnosis
The warning signs of Type 2 diabetes are similar to Type 1, but they may be quite mild, such as feeling tired, and going to the loo at night; weight loss is rare. Many people are only diagnosed as a result of routine screening. A urine sample will be tested to see if it contains glucose.

If it does, you will then have a blood test – though you may need more than one blood test, and possibly an oral glucose tolerance test to confirm the diagnosis of diabetes.

Treatment The first line of action for treating Type 2 diabetes is often a ‘lifestyle prescription’ – losing excess weight, eating more healthily, taking up exercise and giving up smoking.

Several types of glucose-lowering drugs are also available, as well as technology to check glucose levels such as Mendor’s blood glucose metre system (

As Type 2 diabetes is a condition that usually gets worse over time, many people find they need to start taking insulin at some point. Recently, weight reducing surgery has shown potential as an effective treatment for Type 2 diabetes and may be an option for overweight people.

What are ‘hypos’?
Feeling weak or shaky? You could need more glucose

Insulin treatment is an inexact science, so a side effect is hypoglycaemia or ‘hypos’, when blood glucose runs too low. Mild hypo symptoms, such as shaking, sweating or loss of concentration can be inconvenient or embarrassing, but someone having a severe hypo, which can result in a blackout, will need help to raise their blood glucose back up.

In anticipation of hypos, people with Type 1 diabetes nearly always carry supplies in the form of tablets, sugary drinks or a gel that can be rubbed inside the mouth to deliver a quick dose of glucose. There are numerous products available for help with hypos at all good pharmacies.

Image – Shutterstock

This article was first published in at home’s ’Ask the Doctor with Dr Chris Steele’ in Sept 2012. [Read the digital edition here]

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