We have a positive epidemic of diabetes in the UK. Numbers have doubled in 15 years, and almost 3.5 million people in the UK now live with a diagnosis of diabetes. But it's estimated that about 549,000 people in the UK have diabetes but don't know it. Knowing you're at risk lets you access help to keep healthy and avoid complications - so you need to know the score on diabetes.
What's the difference between type 1 and type 2 diabetes?
When I was a medical student in the 1980s, type 1 diabetes was the one we focussed on. It has nothing to do with lifestyle - it's an auto-immune condition, where your body's own immune system turns on itself. In type 1 diabetes, the pancreas, which produces insulin, is targeted, and blood sugar rises fast. It usually starts in childhood or young adulthood, and most often presents with dramatic symptoms that develop quickly, which include rapid weight loss, intense thirst, passing lots of urine and sometimes collapse.
Back then, type 2 diabetes was thought to be much less serious. It usually comes on later in life than type 1 and in the early stages, symptoms are often mild - tiredness, feeling a bit more thirsty, needing to pass water more often, minor boils and recurrent thrush. For the first few years at least, blood sugar can sometimes be controlled with diet and lifestyle. Tablets are added in as needed. But little did we know, just a few short decades ago, how much we underestimated the impact type 2 diabetes can have.
What are the serious health risks linked to type 1 and type 2 diabetes?
One of the most serious short term risks of type 1 diabetes is ketoacidosis - your blood sugars rise dangerously high, causing collapse and life-threatening illness. This virtually never happens in type 2 diabetes. But it's only in recent years that we've realised quite how much type 2 diabetes raises your risk of heart attack and stroke. And, like type 1 diabetes, it also increases the chance of damage to your eyes (with the risk of blindness), kidneys (kidney failure) and nerves (foot ulcers, leg pain and amputations).
How can we keep complications of type 2 diabetes in check?
In recent years, there has been an explosion in type 2 diabetes in the UK. Ninety per cent of people in the UK with diabetes now have type 2. Rates for some of the complications of diabetes have doubled in just five years, and we now spend over 10% of the NHS budget on diabetes, up from just 5% a decade ago. One in six hospital beds is occupied by someone with diabetes.
So no, type 2 diabetes is very much not 'the mild kind of diabetes'. Fortunately, as knowledge of the complications has progressed, so have medical developments on preventing them. Keeping blood pressure and cholesterol, as well as blood sugar and weight, well controlled are all important. Each can improve your chance of avoiding long-term complications, and added together the benefits are dramatic. The NHS invests millions in support services to help people with diabetes understand more about their condition. And taking control of your condition, to avoid complications, has never been easier.
Could you have type 2 diabetes - or prediabetes?
But to access this help you need to know you have diabetes. And because the symptoms of type 2 diabetes are often very mild at first, many folk put their tiredness down to the normal stresses and strains of life. That's why there are over half a million people in the UK who have type 2 diabetes and don't know it. Everyone with diabetes is offered annual eye screening - but did you know your optician can spot signs before you're even diagnosed?
Still more people have 'pre-diabetes' - and knowing you've got this is important for your health too. Getting help to change your lifestyle could actually stop you going on to get type 2 diabetes. In fact, in several big studies, making changes to diet, weight and exercise together cut the risk by nearly 60%.
Type 2 diabetes is closely linked to weight - the more you weigh, the greater you chance of getting it, especially if you carry excess weight around your midriff. It often runs in families too, so if other people in your family have type 2 diabetes, you should be on the look-out for signs. You're also at higher risk if you're of South Asian origin. While many people today are diagnosed with type 2 diabetes in their 40s or even 30s, it's still more likely with age. The good news is that lifestyle changes, such as regular exercise, a healthier diet and weight loss if you're overweight, can protect you for years to come. If in doubt, check it out - your GP will be happy to help.
With thanks to 'My Weekly' magazine where this article was originally published.
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Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.