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What is diabetes?

Learn how to spot the signs, and how you can lower your risk

Most of us know diabetes is something to do with not being able to process sugar properly, but the disease has a bigger impact on the body – and the NHS – than simply necessitating the avoidance of sweets.

Diabetes UK, the country’s leading diabetes charity, says 3.9 million Britons have diabetes, while the NHS spends around £10bn every year treating the disease. Unfortunately, both sets of figures are set to rise and an estimated 11.5 million of us are believed to be at increased risk of getting Type 2 diabetes.

What is Type 1 diabetes?

Type 1 diabetes is thought to be an autoimmune disease that cannot be reversed, and it means you don’t produce any insulin. The condition is managed with daily insulin injections. It affects 10% of those with diabetes and is primarily first identified in younger people. This disease isn’t caused by lifestyle factors.

What is Type 2 diabetes?

According to Diabetes UK, one in ten people over 40 are living with Type 2 diabetes, however it is increasingly being identified in younger people too

Type 2 means you either don't produce enough insulin or the body is resistant to the insulin produced. Either way, this means you cannot break down sugar (glucose) properly, so it builds up in the bloodstream, causing health problems.

“Some people may not have any symptoms at all when they are diagnosed with type 2 diabetes,” says Douglas Twenefour, a clinical adviser for Diabetes UK. Several risk factors can make you more likely to develop type 2:

  • being over 40 years old

  • being overweight or obese, especially weight carried around your middle

  • sedentary lifestyle

  • obesity, or being overweight

  • having high cholesterol

  • if you’ve ever had high blood pressure, a heart attack or stroke

  • a family history of diabetes

  • coming from an African-Caribbean, Black African, Chinese, or South Asian background and being over 25

Experts say these risk factors are not indicators just for diabetes. Professor Anthony Barnett, emeritus chair of medicine at Birmingham University and a consultant physician and diabetologist, says, “They’re also markers of an increased risk of heart disease and some common cancers, such as bowel cancer, kidney cancer and gynaecological cancers.” So, reducing your diabetes risk factors potentially has a wider effect on your health.

What are the symptoms of Type 2 diabetes?

If you think you could be at risk of Type 2 diabetes, it’s important to know the warning signs. Some symptoms to look out for include:

  • Needing to urinate a lot more than usual, especially at night

  • Feeling thirstier, so drinking more

  • Feeling much more tired than usual

  • Having cuts and bruises that take longer to heal

  • Suffering frequently from fungal infections, i.e. thrush, athlete’s foot

  • Losing weight without trying.

If you’re experiencing any of the above, make an appointment with your GP for a blood test as soon as possible.

How serious is diabetes?

Managed well, people with diabetes live full and happy lives.

“If diabetes is not managed properly, unfortunately, the cost to the person and their family can be devastating,” says Douglas Twenefour at Diabetes UK. Diabetes can lead to blindness (it’s the leading cause of preventable sight loss in people of working age in the UK), kidney diseases, nerve damage, heart disease and stroke.

It can also cause problems with the feet and possibly amputations – if small cuts or wounds on the feet do not heal properly, it can lead to the loss of the leg. The cost of diabetes is financial, too. The NHS spends some 10% (£10bn) of its entire budget treating diabetes every year, with some £8bn on related conditions.

How can I manage Type 2 diabetes?

If you have Type 2 diabetes, there’s more to managing it than just taking your medications. Some of the ways that you can live well with diabetes include:

  • Eating a wide range of foods – including fruit, vegetables, and some starchy foods like pasta

  • Keeping sugar, fat, and salt to a minimum

  • Eating breakfast, lunch and dinner every day – don’t skip meals

  • Trying to be active for 2.5 hours (150 minutes) every week – anything that gets you out of breath counts, including fast walking, climbing stairs and more strenuous household chores. Check out our ideas for 10 ways to burn 100 calories.

  • Talking about your feelings with your family and friends – they may be concerned and wish to help.

  • Examine your feet regularly between reviews or ask someone you know to check them for you.

  • Attend your appointments or rearrange them as soon as possible.

  • Carry some form of medical identification about your diabetes.

  • Get the information you need. The more you know, the more confident you will become and the easier it will be to manage your diabetes.

How can I avoid diabetes?

It is not inevitable you will develop Type 2 even if you have several risk factors, including raised blood glucose. This is sometimes called “pre-diabetes” or “borderline diabetes” – your blood sugar levels are elevated but not high enough to be called diabetic.

A study published in the BMJ in 2014 estimated that a third of the UK’s adult population has pre-diabetes, but the term is not actively used in the UK. Professor Anthony Barnett says, “Over the next five years, 40 percent of those with pre-diabetes will develop diabetes, but 30 percent will revert to normal. It proves you can reduce your risk, even at this point.”

Protect yourself by making some simple lifestyle changes:

  • Giving up smoking

  • Losing weight

  • Exercising more.

Being overweight is the single biggest risk factor for type 2 diabetes, while “the best way of improving insulin resistance is exercise”, according to the professor.

Ask your GP to refer you to a dietician for help with weight loss or healthy eating ideas and aim for around 150 minutes of exercise a week – although this doesn’t have to be all at once. A 30-minute brisk walk or swim, at least five times a week, is just as effective.

Choose wholegrains over highly processed starchy foods like white bread or pasta. Eat more fruit and vegetables, nuts, and oily fish, and up your pulses, too. Cut down on items high in added sugars, such as cakes, biscuits, and fizzy drinks. Overall, read food labels and watch your portion sizes. Douglas Twenefour says, “It might sound boring, but it works!”

While Type 1 diabetes has nothing to do with lifestyle and cannot be prevented, up to 80% of Type 2 cases can be delayed – or avoided altogether – with some simple lifestyle changes. Now that’s one diabetes statistic that is good news.