With 3.9 million people living with diabetes in the UK, Consultant Endocrinologist, Dr Richardson explores how to manage this metabolic disorder which affects blood sugar levels

Conservative MP Derek Thomas recently came under fire for claiming diabetes is “completely avoidable through good diet and exercise”, while the official line from the NHS asserts it is time to tackle poor lifestyle - a major factor behind the rise of diabetes in Britain. Some confusion surrounding the condition is understandable as there are multiple types of diabetes, but all cause a person’s blood sugar to increase to a dangerous level.

Insulin is required in the body for two purposes; it allows the body to deal with the carbohydrates in the food we eat and to use the glucose for energy. If there is more sugar in the body than it needs, insulin helps store the glucose in the liver so that it can be released when the blood sugar level is low. Without insulin, the body cannot cope with carbohydrates so when a sufferer eats carbohydrate such as bread, potatoes, rice, or cake for example, their body can’t control blood sugar, which rises and makes them unwell.

The second purpose of insulin is to control the metabolism of the fats within our bodies-particularly around the liver. Without insulin, fat is broken down into harmful by-products, which is also dangerous.

While it can develop at any time, type 1 diabetes is the most common type of childhood diabetes, generally occurring in teenage years. While the cause is unknown it is likely to be the result of a viral infection in someone who is genetically predisposed to it. Type 1 diabetes is an autoimmune condition, where the body’s immune system attacks the cells in the pancreas, stopping them from functioning and producing insulin. If left untreated, type 1 diabetes is life threatening, but the effects can be reversed quickly once the patient is given insulin.

The most common is type 2 diabetes, which occurs in 40 per cent of cases whose parents or grandparents have type 2 diabetes, and 85-90 per cent of the time it is related to weight around the tummy.

With type 2 diabetes the patient has insulin in the body, but it’s less effective. If you are overweight, the insulin is dealing with the fat around the tummy and subsequently there is no spare insulin to cope with the carbohydrates that are eaten, which results in high blood sugar. Type 2 diabetes can potentially be reversed if the sufferer loses weight, thus releasing more insulin to deal with their meals.

Whilst not everyone can lose enough weight to totally reverse their type 2 diabetes, healthy eating and regular exercise can improve blood sugars and thus reduce the long term problems that are associated with diabetes.

Previously known as type 1 and a half diabetes, secondary diabetes is a less common type of the condition. It is caused by damage to the pancreas due to a number of factors such as alcohol excess, removal of the pancreas by surgery or other conditions that harm the pancreas so it is unable to produce enough insulin to deal with ordinary life.

Diabetes is unfortunately the commonest cause of kidney failure, blindness and amputation in the UK in under 65’s and can have a significant effect on peoples’ quality of life. Diabetes really can affect everything.

If dealt with well in the first five years, there is increasing evidence that the body develops a metabolic memory of how it is treated in the beginning, resulting in fewer complications later on. Therefore, taking diabetes seriously right from the beginning is paramount. Tackling it early will pay dividends, and for me there’s nothing better than seeing a patient reverse the condition.

The best results come from an all-round approach. So as well as diabetes expertise, there needs to be lifestyle interventions and input from other experts - vascular, cardiology, stroke and neurology - that can help manage the effects of the condition. By treating diabetes in this holistic way there is a much better chance of quickly addressing any complications that may arise.

Common symptoms of Type 2 Diabetes

• Frequent urination (particularly at night)

• Constantly thirsty

• Tiredness

• Unexplained weight loss

• Prone to infections

• Blurred vision

Do’s and don’ts

• Try to avoid excesses – not overeating or undereating

• Exercise to a sensible level which can be maintained

• Choose a healthy diet which is low in sugar and includes plenty of fresh vegetables and some fresh fruit

• Make sure your healthy diet works with your lifestyle

READ ON

• Dorset Police and Crime Commissioner on the importance of public volunteers - Martyn Underhill, Police and Crime Commissioner for Dorset, explains the increasing importance of the role played by public volunteers in supporting our local police force

• The idea behind the Hens ‘n’ Guns 2016 calendar - Lisa Macdonald-Smith reveals why the ladies of the Hens ‘n’ Guns were prepared to bare all to create a stylish calendar to raise money for a Dorset charity