by Richard Brierley
Type 2 diabetes. Am I at risk and how do I prevent it?
Almost 3.7 million people in the UK have been diagnosed with type 2 diabetes. A further 1 million have the condition but are yet to be diagnosed, and around 12 million are at increased risk of developing diabetes in the future. If anything can be described as a modern affluent plague, it is type 2 diabetes. The good news? In most cases it can be entirely prevented.
For almost all of us, starvation and physical exhaustion are problems we will never even have to consider. That’s great, but the opposite also causes problems. The availability of plenty of cheap food, the tendency to drive wherever we want to go, and so many jobs (mine included) that involve sitting for hours every day, all conspire against us, particularly putting up our risk of developing type 2 diabetes.
Its an insidious condition, creeping up on us, often with no symptoms until it is quite advanced. It can sometimes take 10 years from its onset to it getting diagnosed. The earlier it is detected, the more likely it can be treated to prevent complications, and in many cases the condition can be reversed.
Whenever we eat sugar or starch (potatoes, bread, pasta, rice etc.) our pancreas releases insulin which helps the body process this food. However if we have more of this type of food in our diets than is healthy, our bodies start to struggle to deal with the constantly high levels of insulin until the system starts to fail and the sugar levels in the blood start to rise. This then causes damage to a range of tissues and organs in the body, often resulting in permanent harm.
There are a number of things that put up your risk of diabetes. The most important is age. Most people are over 40 when they are diagnosed. However if you have other risk factors, it can start earlier. You are 3 times more likely to develop diabetes if you have a parent or sibling with the disease, and you are 4 times more likely if you are of Afro-Caribbean, Black African or South Asian descent. Being overweight is a very important risk factor especially if that weight is carried around the belly area. High blood pressure and smoking also push the risk up. The more risk factors you have, the more seriously you should take that risk.
So how do we test for diabetes?
There is a very simple test done on the blood called HbA1c which is a measure of the average blood glucose level over the previous 2-3 months. If the result is below 42, that’s normal, if it’s between 42 and 48, its borderline (often called pre-diabetes), and if it’s consistently above 48, that’s diabetes.
If you are over 40 (or over 25 and Afro-Caribbean, Black African or South Asian), and you don’t know your HbA1c, then book yourself an NHS health check with your GP practice to have it checked (along with your cholesterol and blood pressure while your at it), especially if you have any of the other risk factors or you are getting some of the symptoms of diabetes such as excessive thirst, frequent urination, tiredness or unexplained weight loss.
However, more importantly, don’t wait until you have an abnormal blood test result before doing something to reduce the risk as by the time it is diagnosed, damage has often already been done. There aren’t many body tissues that don’t suffer some damage from diabetes, but the main ones are the heart (heart attacks), the brain (strokes, depression and dementia), the eyes (retinopathy and blindness), the nerves (reduced sensation), the blood vessels (blocked arteries leading to amputations), the kidneys (kidney failure), and the penis (erectile dysfunction).
A major priority for all of us as we are getting older is to make sure we are minimising these risks, and it is really quite simple. Eat more healthily and move around more.
I am often asked about what a diabetic diet is, and the answer is that there is no such thing. A diabetic diet and a healthy diet are identical. We all know what things are unhealthy to eat, and if we are regularly eating cakes, puddings, chocolate, sweets, biscuits, and the like, then cutting them out will make a huge difference to our health. What people often don’t understand though is the role of starch. Starchy foods include bread, pasta, rice, and potatoes. When we eat these, the body converts them very quickly into sugar, so eating large portions of these can be just as harmful, so these need to be limited in our meals to smaller portions. Try to follow the portion size recommendation on the side of the packet of pasta or rice, and keep potato quantities to no more than the size of your fist in any one meal.
As regards to exercise, we can all do a bit more. The important thing is to choose something you enjoy and make sure you build it up slowly. It doesn’t have to cost anything to get fit and again makes a huge difference to overall health, as well as self esteem and a general positive outlook to life.
Finally, for those who already have diabetes, the main message is, don’t ignore it. It is a very serious condition, but one that can be fully controlled and even cured with a combination of hard work from you and input from your doctor/specialist nurse.
Don’t neglect attending for regular check-ups, and blood tests and don't ignore that all important lifestyle advice.
There is a wealth of high quality information on the Diabetes UK website.
(www.diabetes.org.uk).
Richard Brierly is a freelance GP who works in the Eastbourne area.
Richard is married with three sons, and is particularly interested in the natural world; he loves spending time out in the beautiful Sussex countryside.
Richard and his family live in Eastbourne, East Sussex.