Type 2 Diabetes – A growing problem

By Dr Paul Williams, West Norfolk CCG’s Governing Body member responsible for Prescribing and Education and the CCG’s prescribing team.

There are several types of diabetes although Type 1 and Type 2 are the most common. In this article we will focus on Type 2; how diet and lifestyle can help reduce your chances of developing the condition and how to best manage living with diabetes.

When I was training to be a doctor I was taught Type 2 diabetes was a disease of old age; how things have changed. Now it is not unusual to diagnose the condition in people in their thirties or even younger. Although diet and lifestyle can play a role in developing Type 2 diabetes, our genes can also play a part too. It is estimated that 1 in 16 people in the UK have diabetes and this figure is rising! This places great demands on local health services. If diabetes is not diagnosed and managed appropriately, it can cause serious long term health problems such as strokes, heart attacks, kidney failure and blindness.

In Type 2 diabetes the body produces insulin but it doesn’t work properly. I like to think of insulin as a door key; opening the doors that let sugar out of the blood and into the organs that need it as an energy source. In Type 2 diabetes the insulin key seems to no longer fit all the doors, so some don’t open. The sugar can’t get out of the blood stream as quickly as it should and it therefore accumulates in the blood. Small blood vessels can get damaged by having this sticky blood running through them and that damage is what causes the long term complications of diabetes. Blood vessels in the eyes are damaged causing blindness, in the kidneys causing kidney failure, in the heart causing heart attacks and around the small nerves in the feet causing numbness which can end up in leg amputation.

To reduce your risks of developing Type 2 diabetes it is important to follow a balanced diet and maintain a healthy weight. Exercise also plays an important role in reducing the risk of developing Type 2 diabetes as this helps the body to use excess glucose for fuel for energy. Exercise does not have to mean spending hours at the gym or running miles but activities such as gardening, walking, dancing or even housework!

During 2015 West Norfolk spent £3.9million on treatments for diabetes; this figure has been increasing by 7% year on year. Diet and lifestyle changes by patients with Type 2 diabetes can help to reduce this growing figure. If you already have Type 2 diabetes you may well be on tablets and possibly even insulin injections. As we have said in previous articles the cost of a drug doesn’t reflect how good it is and you may be asked to change tablets or insulin to cheaper brands which may even improve your diabetic control. Now that’s a win-win scenario! You may also have been given testing strips to monitor your blood sugar levels. These strips are surprisingly expensive and I just want to make sure you are using them properly. People with Type 1 diabetes use them to guide themselves as to how much insulin to administer. However, not everyone with Type 2 diabetes will need to test their own blood sugar. Blood tests at the doctors every 3 to 6 months are a much better indicator of how well your diabetes is controlled and can be used to adjust your treatment accordingly. So why do Type 2 diabetics need testing strips at all? Well a lot of them don’t! Your doctor or diabetes nurse may recommend testing your blood sugar if you are on insulin or before driving if you are on certain medications to identify if your blood sugars are too low. However, most tablets for diabetes carry a very low risk of hypoglycaemia (low blood sugar) and so testing on a daily basis is not required. Why stab yourself to get a blood sample if you don’t need to? Therefore one box of fifty strips should last a very long time. “Think before you prick!” Check with your doctor or diabetes nurse if you are unsure.