Introduction
In this blog, we’ll look at what diabetes is, its symptoms, the differences between type 1 and type 2 diabetes, what pre-diabetes and gestational diabetes are, how to prevent type 2 diabetes, and how it is diagnosed and treated.
What is diabetes?
Diabetes is a chronic condition that occurs when your pancreas doesn’t produce enough insulin, or when your body cannot effectively use the insulin it produces.
Insulin is a hormone that regulates blood glucose (sugar). Ordinarily, when food is digested and enters your bloodstream, insulin then moves glucose out of your blood and into cells, where it’s broken down to produce energy. Diabetes prevents your body from breaking down glucose into energy either because (1) there is not enough insulin to move the glucose or (2) the insulin being produced isn’t working properly.
If diabetes isn’t managed appropriately, it can result in raised blood sugars (hyperglycaemia), which over time can lead to serious issues and conditions such as:
- Organ damage.
- Vision loss due to damaged vessels in the eyes.
- Neuropathy (nerve damage).
- Amputation of fingers, toes, or limbs due to poor blood circulation.
- A higher risk of heart attack, stroke, and kidney failure.
- Gastroparesis (issues with stomach emptying).
- Coma.
- Death.
What are the symptoms of diabetes?
Some symptoms of diabetes may occur suddenly, while in other cases, symptoms can be mild and take years to truly be noticed.
It is very important for diabetes to be diagnosed as early as possible, because it’s likely to get worse if left untreated and can cause severe long-term health problems.
Symptoms of diabetes can include:
- Feeling very thirsty
- Urinating more often than usual, especially at night
- Blurred vision
- Feeling very tired
- Unintentionally losing weight
- Loss of muscle
- Itching around your genitals, or frequent episodes of thrush
- Cuts or wounds taking longer to heal
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes (sometimes also still referred to as insulin-dependent, juvenile, or childhood-onset diabetes) is a lifelong condition characterised by deficient insulin production, which is the result of the body’s immune system attacking and destroying the cells that produce insulin. The cause and prevention of type 1 diabetes is unknown, and its symptoms often develop quickly, in weeks or even days. It requires the daily injection of insulin.
Type 2 diabetes is when either the body does not produce enough insulin, or when the body’s cells don’t properly react to insulin. This type of diabetes is often preventable by ensuring that you maintain a proper body weight, eat healthily, and get enough exercise, but genetics can also play a role. The onset of symptoms for type 2 diabetes are often slow and even mild in nature. In some instances, there are no symptoms at all.
In the UK, of all people who have diabetes, over 90% of them have type 2.
You may be more at risk for developing type 2 diabetes if you:
- Are overweight or obese
- Are not very physically active
- Do not have a healthy diet
- Have a family history of type 2 diabetes
- Are over 40 years old
- Are of Asian, Black African, or African Caribbean origin
- Take certain medicines, such as steroids, for a long time
- Have high blood pressure
- Have had gestational diabetes during pregnancy
You can use this Know Your Risk tool from Diabetes UK to help find out your risk of developing type 2 diabetes.
Non-diabetic hyperglycemia (pre-diabetes)
Many people have high blood sugar levels that are outside the normal range, but which are not high enough for them to be diagnosed with diabetes. These people are pre-diabetic.
If you are pre-diabetic, you are at an increased risk of developing type 2 diabetes, and it is important to make lifestyle changes to reduce this risk. You should have regular blood tests every year (or more often, as recommended by your doctor) to monitor your blood sugar levels.
You may be eligible for the NHS Diabetes Prevention Programme, which helps people to make lasting lifestyle changes and thus prevent type 2 diabetes.
Gestational diabetes
Sometimes, gestational diabetes can occur during pregnancy. With gestational diabetes, blood glucose values are above normal but are below those of typical diabetes.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. While gestational diabetes usually goes away after birth, later in life, they and possibly their children are at an increased risk of developing type 2 diabetes.
Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Prevention of type 2 diabetes
Lifestyle changes are key to preventing or delaying the onset of type 2 diabetes.
To help prevent the development of type 2 diabetes, you should:
- Reach and maintain a healthy body weight
- Stay physically active, ideally with at least 30 minutes of moderate exercise each day
- Eat a healthy diet, avoiding sugar and saturated fats
- Avoid smoking
Second Nature and Xyla Health both provide lifestyle management apps that can help you get on track for a healthier diet, maintain an exercise routine, and ensure that these changes are for the long term–taking charge of your health when it matters most.
Diagnosing diabetes
If you are concerned that you may have diabetes or are at a higher risk of developing type 2 diabetes, you should contact your GP.
One of the things your GP may do is arrange a blood test for you, which will check your blood sugar levels. If the levels are raised, your GP will explain the results and what happens next. If you aren’t experiencing any symptoms, you may be tested again.
Treating diabetes
People with type 1 diabetes must take insulin injections for the rest of their life.
People with type 2 diabetes should maintain a healthy lifestyle, such as eating healthily, exercising regularly, maintaining a healthy weight, quitting smoking, and cutting down on alcohol. They should have regular checks including blood tests, as type 2 diabetes can get worse over time.
The Freestyle Libre 2, Freestyle Libre 3, and the newly released Freestyle Libre 2 Plus are advanced glucose monitoring systems designed to assist people with diabetes in managing their blood sugar levels effectively.
Those with type 2 diabetes may also need to take medicines to manage their blood sugar levels. This can (in rare instances) be insulin injections or (more commonly) other medicines such as metformin, sulfonylureas, and SGLT-2 inhibitors. The specific medicine or dose may change over time.
People with diabetes also often need medication to lower their blood pressure and statins, which will help to reduce the risk of complications. They also may require foot care, screening and treatment for kidney disease, and eye exams to screen for retinopathy (which causes vision loss and blindness), all of which can be effects of diabetes.
It is possible for some people with type 2 diabetes to put their condition into remission by losing weight, where their blood sugar is reduced to below the diabetes range. This may be done through a reduced-calorie diet, but this is not suitable for everyone and medical advice should be sought first.
In summary
Type 2 diabetes is the most common form of diabetes in the UK, with symptoms such as feeling thirsty, urinating frequently, feeling tired, and losing weight unintentionally often coming on slowly and mildly over a period of time.
It’s incredibly important to diagnose diabetes as soon as possible to prevent long-term health issues such as nerve and blood vessel damage and vision loss.
While medication may be prescribed to treat type 2 diabetes, some of the most effective measures you can take now–both to prevent and manage it–include eating healthy and exercising regularly to maintain an appropriate body weight.