Diabetes is a common life-long health condition. There are 2.9 million people diagnosed with diabetes in the UK and an estimated 850,000 people who have the condition but don’t know it.
Diabetes is a condition where the amount of glucose in your blood is too high because the body can-not use it properly. This is because your pancreas does not produce any insulin, or not enough, to help glucose enter your body’s cells – or the insulin that is produced does not work properly (known as insulin resistance).
Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy so we can work, play and generally live our lives. It is vital for life.
Glucose comes from digesting carbohydrate and is also produced by the liver. Carbohydrate comes from many different kinds of foods and drink, including starchy foods such as bread, potatoes and chapatis; fruit; some dairy products; sugar and other sweet foods.
‘Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly.’
If you have diabetes, your body cannot make proper use of this glucose so it builds up in the blood and isn’t able to be used as fuel.
Diabetes Type 1
Insulin is the key that unlocks the door to the body’s cells. Once the door is unlocked glucose can enter the cells where it is used as fuel. In Type 1 diabetes the body is unable to produce any insulin so there is no key to unlock the door and the glucose builds up in the blood.
Nobody knows for sure why these insulin-producing cells have been destroyed but the most likely cause is the body having an abnormal reaction to the cells. This may be triggered by a virus or other infection. Type 1 diabetes can develop at any age but usually appears before the age of 40, and especially in childhood.
Type 1 diabetes accounts for between 5 and 15 per cent of all people with diabetes and is treated by daily insulin injections, a healthy diet and regular physical activity.
Balancing your diet when you are diagnosed with diabetes can be challenging. Although the food choices you make and your eating habits are important in helping you manage your diabetes, you should be able to continue enjoying a wide variety of foods as part of healthy eating.
Diabetes Type 2
Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance).
Insulin acts as a key unlocking the cells, so if there is not enough insulin, or it is not working properly, the cells are only partially unlocked (or not at all) and glucose builds up in the blood.
Type 2 diabetes usually appears in people over the age of 40, though in South Asian and black people, who are at greater risk, it often appears from the age of 25. It is also increasingly be-coming more common in children, adoles- cents and young people of all ethnicities.
Type 2 diabetes accounts for between 85 and 95 per cent of all people with diabetes and is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin is often required.
SYMPTOMS
Knowing and understanding the symptoms of high and low blood sugar should be essential for both diabetics and their friends and families.
Hyperglycaemia, or high blood sugar, is common amongst diabetics. It occurs when a diabetic person eats too much food, and has too little insulin to regulate their blood sugar. Sometimes stress can cause diabetes. Being aware of the following symptoms and staying alert for their presence, whether you are a diabetic or a family mem- ber or friend, should be essential:
- Need for frequent urination
- Drowsiness
- Nausea
- Extreme hunger and/or thirst
- Blurring of the vision
Hypoglycemia, or low blood sugar, occurs when a diabetic has not eaten enough food, or has too much insulin within his or her body.
Symptoms occur because some or all of the glucose stays in the blood and it isn’t being used as fuel for energy. The body tries to reduce blood glucose levels by flushing the excess glucose out of the body in the urine.
The main symptoms of undiagnosed diabetes can include:
- passing urine more often than usual, especially at night
- increased thirst
- extreme tiredness
- unexplained weight loss
- genital itching or regular episodes of thrush
- slow healing of cuts and wounds
- blurred visionIn Type 1 diabetes the signs and symptoms are usually very obvious and develop very quickly, typically over a few weeks. The symptoms are quickly relieved once the diabetes is treated and under control
In Type 2 diabetes the signs and symptoms may not be so obvious, as the condition develops slowly over a period of years and may only be picked up in a routine medical check up. Symptoms are quickly relieved once diabetes is treated and under control.
EATING WELL
You should try to include a good variety of foods to ensure you are getting the right amount of the nutrients and vitamins you need.
- Eat three meals a day: avoid skipping meals and space your breakfast, lunch and evening meal out over the day. This will not only help control your appetite but will also help control your blood glucose levels.
- Include starchy carbohydrate in your diet: the amount of carbohydrate you eat is important to control your blood glucose levels. Especially try to include those that are more slowly absorbed (have a lower glycaemic index) as these won’t affect your blood glucose levels as much. Examples of these include: pasta, basmati or easy cook rice, grainy breads such as granary, pumper-nickel and rye, new potatoes, sweet potato and yam, porridge oats, All-Bran and natural muesli.
- Cut down saturated fats: a low fat diet benefits health. Choose unsaturated fats or oils, especially monounsaturated fat (e.g. olive oil and rapeseed oil) as these types of fats are better for your heart. As fat is the greatest source of calories, eating less will help you to lose weight if you need to.
- Eat more fruits and vegetables: aim for at least five portions a day to provide you with vitamins, minerals and fibre to help you to balance your overall diet.
- Include more beans and lentils: including kidneys beans, butter beans, chickpeas or red/green lentils. They have less of an effect on your blood glucose levels and may help to control your blood fats.
- Aim for at least two portions of oily fish per week: these include mackerel, sardines, salmon and pilchards. Oily fish contains a type of polyunsaturated fat called omega 3, which helps protect against heart disease.
- Limit sugar and sugary foods: using sugar-free, no added sugar or diet fizzy drinks/squashes, instead of sugary versions can be an easy way to reduce the sugar in your diet.
- Reduce salt intake: 6g or less per day. More than this can raise your blood pressure, which can lead to stroke and heart disease. Limit the amount of processed foods you eat (as these are usually high in salt) and try flavouring foods with herbs and spices instead of salt.
- Drink alcohol moderately: maximum of two units of alcohol per day for a woman and three units per day for a man. Never drink on an empty stomach, as alcohol can make hypoglycaemia (low blood glucose levels) more likely to occur when taking certain diabetes medication.
- Managing your weight: managing your weight is the most effective treatment for Type 2 diabetes if you are overweight. But, making realistic long-term changes to your lifestyle can bring other rewards.
- Keeping active: being active is good for all of us but is especially important for people with diabetes. Muscle movement leads to greater sugar uptake by muscle cells and lower blood sugar levels. Physical activity, combined with healthy eating and any insulin or diabetes medication that you might be taking, will help you to manage your diabetes and prevent long-term diabetes complications.
- Diabetes medication: will not cure your diabetes and most people will have to take them for the rest of their lives, but medication will help you to feel better by relieving the symptoms of diabetes and reducing your risk of complications. If you take medication, it is important to know how it works, and to be aware of the potential side effects you may have. It is important to remember that the medication is not instead of diet and physical activity: you will still need to continue with this.
- Insulin treatment: all people with Type 1 diabetes will require insulin and eventually, some people with Type 2 diabetes find that despite having their diabetes medication adjusted, their blood glucose levels remain too high and insulin treatment is recommended. Insulin can be given in different ways via an injection, using a syringe, pen device or via an insulin pump.
- Living with diabetes can be challenging, but you can still lead a near normal life with a controlled diet and lifestyle which are key components in living healthily with diabetes.