Diabetes

For more detailed information
www.diabetes.org.uk

Diabetes cases pass 2m barrier.

The number of people diagnosed with diabetes in Britain has passed the 2 million mark for the first time. The 2,053,391 total is more than 250,000 higher than previously thought, according to the Government's new database on common chronic diseases.

The growing number of people with Type 2 diabetes is blamed on Britain 's obesity epidemic. Experts warned 'diobesity' is likely to increase further because the nation is getting fatter.

Diabetes UK said: 'We knew the situation was worrying but it is even worse than we thought. Unless the NHS can respond to the massive strain, people's health could spiral.'
September 2005

Type 2 Diabetes

If you are diagnosed with Type 2 Diabetes you must immediately change your lifestyle.

Type 2 diabetes mainly occurs in people aged over 40. The "first-line" treatment is diet and exercise. If the blood glucose level remains high despite a trial diet and exercise, then tablets to reduce the blood glucose level are usually advised. Insulin injections are needed in some cases. Other treatments include reducing blood pressure if it is high, and other measurers to reduce the risk of complications.

What is diabetes?

Diabetes mellitus occurs when the level of glucose (sugar) in the blood becomes higher than normal. There are two main types of diabetes - Type 1 and Type 2

Understanding blood glucose and insulin

After you eat, various foods are broken down in your gut into sugars. The main sugar is called glucose which passes through your gut wall into your bloodstream. However, to remain healthy, your blood glucose level should not go too high or too low.

So, when your blood glucose level begins to rise (after you eat), the level of a hormone called insulin should also rise. Insulin works on the cells of your body and makes them take in glucose from the bloodstream. Some of the glucose is used by the cells for energy, and some is converted into glycogen or fat (which are stores of energy). When the blood glucose level begins to fall (between meals), the level of insulin falls. Some glycogen or fat is then converted back into glucose which is released from the cells into the bloodstream.

Insulin is a hormone made by special 'islands' of cells on the pancreas. (Hormones are chemicals which are released in the bloodstream and work on various parts of the body.)

Type 2 diabetes used to be known as maturity onset, or Non-Insulin Dependant Diabetes. It develops mainly in people older than 40 (but can occur in younger people). In the UK 3 out of 100 people aged over 40, and about 10 out of 100 people aged 65+ have Type 2 diabetes. It is more common in people who are overweight or obese. It also tends to run in families. It is also more common in South Asian and African-Caribbean people (often appearing before the age of 40 in this group).

What are the symptoms of Type 2 diabetes?

The four common symptoms are:

• Being thirty most of the time
• Passing large amounts of urine. (The reason you make a lot of urine and become thirsty is because glucose leaks into your urine which 'pulls out' extra water through the kidneys.)
• Tiredness
• Weight loss

How is diabetes diagnosed?

A simple 'dipstick' test can detect glucose in a sample of urine. If you have glucose in your urine, it is likely that you have diabetes. (Urine does not normally contain glucose. If the blood glucose level goes above a certain level, then some glucose 'spills' through the kidneys into the urine.)

But, some people have kidneys which are more 'leaky' and glucose may leak into urine with a normal blood level. So, if your urine contains any glucose you should have a blood test to measure the blood level of glucose to confirm, or rule out, diabetes.

What are the possible complications of diabetes?

Very high blood glucose level, this is not common with Type 2 diabetes.

Long term complications

If your blood glucose level is higher than normal over a long period of time, it can gradually damage your blood vessels. This may lead to some of the following complications (often years after you first develop diabetes).

• Atheroma ('furring or hardening of the arteries'). This can cause problems such as angina, heart attacks, stroke and poor circulation.
• Kidney damage which sometimes develops into kidney failure.
• Eye problems which can affect vision (due to damage to the small arteries of the retina at the back of the eye).
• Nerve damage
• Foot problems (due to poor circulation and nerve damage).
• Impotence
• Other rare problems.

The type and severity of long-term complications varies from case to case. You may not develop any at all. In general the nearer you blood glucose level is to normal, the less your risk of developing complications. Your risk of complications is also reduced if you deal with any other 'risk factors' which you may have such a high blood pressure.

Treatment complications
Too much insulin or certain medication can make the blood glucose level become too low (hypoglycaemia or 'hypo'). Symptoms of hydroglycaemia include: trembling, sweating, anxiety, blurred vision, tingling lips, paleness, mood changes, vagueness or confusion. To treat hypoglycaemia: take a sugary drink or some sweets. Then eat a starchy snack, such as a sandwich.

Diet and exercise

You can usually reduce the level of your blood glucose.

Eat a healthy balanced diet. A dietician will give you details on how to eat a healthy diet. The diet is the same as recommended for everyone. (The idea that you need special foods for diabetes is a myth.) Basically, you should aim to eat a diet low in fat, high in fibre, and with plenty of starchy foods, fruit and vegetables.

Lose weight if you are overweight. Getting to a 'perfect weight' is unrealistic for many people. But losing some weight will help to reduce your blood glucose level (and have other health benefits too.)

Exercise regularly. If you are able, a minimum of 30 minutes brisk walking at least five times a week is advised.

Many people with Type 2 diabetes can reduce their blood glucose to a target level by the above measurers. However, if the blood glucose level remains too high after a trial of these measurers for a few month, then medication is usually advised.

Medication
There are various tablets which can reduce the blood glucose level. Different ones suit different people. Some tablets work by helping insulin to work better on the body's cells. Others work by boosting the amount of insulin made by the pancreas