While people with diabetes cannot currently be cured, with the right treatment, however, blood sugar levels can be controlled so that complications do not arise. Diabetes is a serious condition, so it is important to understand the risks and follow advice about treatment once you have been diagnosed. If diabetes remains untreated, it can damage the heart, kidneys, eyes, nerves, skin, limbs and joints.

According to Diabetes UK, 2.3 million people have diabetes in the UK, while an estimated 750,000 more have the condition but are unaware of it ⁽¹⁾.

Are there different types of diabetes?

Type 1 (insulin-dependent diabetes)

Type 1 diabetes is responsible for approximately one in 10 cases only. People who develop this kind of diabetes are typically under 40, often developing the condition as teenagers.

Type 1 diabetes is an autoimmune disease which destroys the insulin-producing beta cells in the pancreas, leaving the body unable to make enough insulin. The cause is currently unknown; it may be inherited or may result from an infection or environmental factors.

People with Type 1 diabetes must take insulin regularly to control their blood sugar levels and stay healthy. They also keep healthy by controlling their diets and taking regular exercise.

Type 2 or non-insulin-dependent diabetes

In the UK, 95 per cent of people with diabetes have this form of the illness. Typically, people with Type 2 diabetes are over 40 and overweight, although there are increasing numbers of children with the condition ⁽²⁾.

South Asian or Afro-Caribbean people in the UK are five times ⁽³⁾ more likely to develop diabetes than other ethnic groups, and are particularly at risk at any age over 25.

In Type 2 diabetes, the body either does not make enough insulin, or the insulin produced does not work properly because the body has developed a resistance to it. The resistance is made worse by being overweight.

Type 2 diabetes can usually be managed by losing weight, exercising and, if necessary, taking anti-diabetic medication.

While symptoms of Type 1 diabetes typically develop rapidly over a few days or weeks, with Type 2 diabetes symptoms are often absent or can develop gradually, so may not be noticed.

What are the symptoms of diabetes?

• Frequent need to urinate
• Feeling very thirsty
• Weight loss and/or muscle loss
• Recurring skin, gum, bladder or vaginal infections, such as thrush
• Dry or itchy skin, especially around the genitals (vagina or penis)
• Loss of sensation or tingling in hands or feet (neuropathy)

Am I likely to develop diabetes?

Do other people in your family have Type 1 diabetes?

If so, you are more likely to develop diabetes.

Are you overweight?

Eight out of ten people ⁽⁴⁾ with Type 2 diabetes are overweight, with fat around the waist especially common. The more you weigh, the higher your risk of developing diabetes. A good way to assess this risk is by measuring your waist. If it is more than 31.5 inches (women), 35 inches (Asian men) or 37 inches (white men), you are more at risk. Overweight women who have Polycystic ovary syndrome (PCOS) also have an increased chance of developing diabetes.

Are you over 40 and white, or over 25 and from a minority ethnic background?

The incidence of Type 2 diabetes increases with age and is greater for Afro-Caribbean, Middle Eastern or South Asian people. Having a close relative with Type 2 diabetes also increases your chance of developing it.

Have you had high blood pressure, myocardial infarction (heart attack), stroke, high cholesterol or circulation problems?

People with diabetes are at greater risk of developing these conditions. Diabetes can also cause impaired vision or blindness, kidney disease, impotence in men and skin ulcers.

Have you given birth to a large baby or suffered from gestational diabetes?

If you have experienced these factors, they may increase your chances of developing diabetes in the future.

What should I do, if I think I have diabetes?

If some of these risk factors apply to you, or if you are experiencing any symptoms, ask your GP to test you for diabetes. The test involves giving a urine sample, which is tested for glucose. You will then be given a blood test which can more accurately diagnose whether you have diabetes. The blood test may also give some idea of the cause.

Glucose level readings can sometimes be inconclusive. If this is the case, your GP will give you a glucose drink and test your blood over a two-hour period to check how your body processes the glucose (oral glucose tolerance test).

What is hyperglycaemia?

Your glucose levels must be kept under control. If they get too high, you can develop various serious health problems because excess glucose in the blood blocks up blood vessels or causes them to leak, damaging organs and nerves.

Even if the amount of glucose is only slightly above normal and there are no short-term symptoms, the damage can show up in complications years later. It is extremely important, therefore, for people with diabetes to maintain a stable blood sugar level at all times.

If glucose levels in the blood get too high, the body can become hyperglycaemic. Sufferers become sleepy, dehydrated and have a frequent need to urinate. If insulin isn't taken, the body starts to break down fats instead of sugar for energy (ketoacidosis), which can lead to unconsciousness or death.

What is hypoglycaemia?

A hypoglycaemic attack happens when the body has too little blood sugar. It can happen when a person with diabetes has taken too much insulin or has over-exercised.

If you have hypoglycaemia you will feel shaky or irritable and will need to raise your blood sugar levels by eating or drinking a swift-acting carbohydrate, such as a sugar cube or sugary drink.

How do I live with diabetes?

As long as you follow a treatment plan, you should be able to lead a healthy life and a reduced risk of complications. You will also be given regular check-ups with your GP, which will involve blood, urine and blood pressure tests. You will also need checks on your eyes, feet and nerves, as well as generally monitoring your treatment.

If you are overweight or obese, you body will find it harder to respond to insulin, so achieving a healthier weight is important. Your GP should be able to give you advice on any lifestyle change, such as losing weight, quitting smoking, eating a healthier diet and exercising more.

The focus on lifestyle change is concentrated on eating healthily and building up activity levels in a sustainable, long-term way. There's usually no need to cut out sugar or only eat 'diabetic' foods. Once you start to lose weight, your medication may need to be readjusted. Diabetes UK has useful information on diet and food.

What should my blood sugar levels be?

If you have either type of diabetes, you need to monitor your glucose levels, which are measured in millimoles per litre (mmol/l). You must make sure that you stay in the normal range of four to seven mmol/l before meals, and less than 10 mmol/l two hours after meals.

A simple test can reveal your levels. A spring-loaded needle will prick your finger, then you put a drop of blood on a testing strip to check the level of glucose using a special meter. There is also a urine test you can do yourself.

Treatments for Type 1 diabetes

People with Type 1 diabetes will need to take insulin for the rest of their lives. Most inject insulin two to four times every day (your GP or nurse will show you how). Also, a healthy diet and an active lifestyle are also important in lowering the levels of glucose in the blood.

Are there needle-free ways of taking insulin?

For those who do not like needles, there is the insulin jet system, which forces a jet of insulin against the stomach, thighs or buttocks at such a high speed it enters the skin.

Insulin pump therapy is where the insulin supply is inserted under the skin, so injections are no longer needed. This treatment method is not yet widely available in the UK.

Medication to reduce blood sugar levels in Type 2 diabetes:

• Insulin
• Metformin
• Sulphonylurea
• Thiazolidinediones
• Nateglinide and repaglinide
• Acarbose

Infolink:

• Diabetes UK