Diabetes is linked to issues of weight and diet. Robert Mair investigates.

Diabetes affects 150 million people worldwide and this figure is set to double by 2025. In the UK 2.8 million people are known to have diabetes but it’s thought a further million may have the condition but not be aware of it.

The most common form of the disease is Type 2 diabetes with 90% of diabetic adults having this type. Most experts believe diet and obesity are responsible. For example, chronic obesity leads to increased insulin resistance – the major cause of type 2 diabetes.

Type 2 diabetes differs from type 1 diabetes in one major way. In the case of type 1 diabetes, the pancreas does not secrete any insulin, meaning it can only be treated with injected or inhaled insulin. It is often discovered in the young, and is much rarer than type 2 diabetes.

When you eat, some of the food is broken down into sugars - the most common of which is glucose. This passes into the bloodstream, but to remain healthy blood glucose level needs to be stable – neither too high nor low. To coincide with the rise of glucose in the bloodstream, insulin is released and works on the body’s cells to make them take in sugar.

This glucose is then used by the cells for energy, or stored as fat. In between meals, the blood glucose levels fall, and so does the levels of insulin. Type 2 diabetes could occur because of the following abnormalities:

  • the pancreas does not make enough insulin for the body’s needs
  • the cells in the body become resistant to normal levels of insulin, meaning you need more to keep the blood glucose levels down
  • a combination of the above

The signs

There are four common symptoms of diabetes:

  • Increased thirst
  • Passing a large amount of urine
  • Tiredness
  • Weight loss

However, symptoms may come on gradually over many weeks or months, meaning they can go unnoticed. Sufferers may also find they have frequent infections, such as thrush, or they have blurred vision. However, some people with type 2 diabetes whose blood glucose levels are not too high might not display any symptoms.

Diagnosis

Urine does not usually contain glucose, so a simple ‘dipstick’ test can detect glucose in a sample. This happens because the excess glucose left unchecked by a lack of insulin spills through the kidneys.

However, this doesn’t automatically prove that diabetes is present, so a blood test, which is far more reliable, would also be required. This is usually done in the morning before breakfast, ensuring there is a large gap in between meals. Normally, glucose levels drop overnight, but in diabetes they will be more pronounced – making it easy to spot.

Complications

The closer blood glucose levels are to normal, the less chance there is of complications occurring. But serious, long-term complications of type 2 diabetes can be life-threatening – especially if the condition remains untreated. These include:

  • Atheroma. This is a furring or hardening of the arteries and can lead to complications including angina, heart attack, stroke and poor circulation
  • Kidney disease, leading to kidney failure
  • Diabetic retinopathy. Associated with long-term diabetes, it is one of the major causes of poor vision in the UK
  • Diabetic neuropathy. Long-standing diabetes can have an impact on nerve fibres. This is usually apparent by reduced sensation in the feet. A further complication of diabetic neuropathy is ulcers and infections of the feet
  • An increased susceptibility to infections, such as urinary tract infections

Treatment

Blood glucose levels can be managed by getting them constantly monitored. A test every two to six months is usually required, but some people may carry out their own personal checks on a daily basis.

The doctor will also recommend physical exercise, a healthy, balanced diet and the need to lose weight if overweight. All will help fight diabetes and are sensible and achievable.

High blood pressure and cholesterol can lead to diabetic complications, so it is important they are kept under control. Even mildly high blood pressure is dangerous for a diabetic, so getting treatment is paramount. Smoking should also be stopped, and treatment for high cholesterol is usually advised.

Due to the wide variety of complications that can affect a diabetic, specialist diabetes clinics in hospitals will perform several checks to look for early signs, including eye checks to look for retina problems and glaucoma and urine tests to look for kidney problems. Foot checks will also be carried out to assess any nerve damage, and the doctor may also carry out further blood tests to check for further complications.

Prevention is better than cure

You can reduce your risk of developing diabetes by monitoring and following a healthy lifestyle i.e.

  • Taking regular exercise
  • Balanced healthy diet
  • Maintaining a healthy body weight
  • Monitoring your blood glucose level