Diabetes affects millions of people across the UK, but most people don't fully understand how the condition works and what the risks are if you have it.
Understanding the basics about diabetes
What is diabetes?
Diabetes is a condition where your body has too much glucose (a type of sugar) travelling around in your bloodstream. This is because your pancreas is making little or no insulin, or your body has become resistant to it.
Insulin is a hormone, which acts like a bridge between your bloodstream and your cells. Glucose is packed with energy, so insulin takes it from your bloodstream and moves it into the cells of your body so they have enough energy to function properly.
What are the signs and symptoms?
- Feeling thirsty a lot of the time
- Going to the toilet more than usual, especially at night
- Weight loss you can't explain
- Feeling very tired
- Cuts or wounds taking longer to heal
- Itching or thrush around your genitals
- Blurred vision
Contact your GP if you notice any of these symptoms.
There are two main types of diabetes
Type 1 – the body doesn't produce any insulin. This isn't because of diet or lifestyle, but because the body has attacked the cells in the pancreas that make insulin. This type of diabetes is usually diagnosed at a younger age – in childhood or early adulthood.
The symptoms usually come on quickly, over a few days, and need diagnosing and treating urgently.
Type 2 – the body doesn't produce enough insulin, and can also be resistant to it. This is the most common form of diabetes and is closely linked to diet and lifestyle. It tends to develop quite slowly. It needs diagnosing and treating to prevent complications later on.
Pre-diabetes (or insulin resistance)
Pre-diabetes, also known as insulin resistance, is the stage which comes before Type 2 diabetes. It's when your body is becoming less responsive to insulin and your blood sugar is too high, but not high enough to be diagnosed with diabetes. At this stage, you can delay or prevent Type 2 diabetes from developing with lifestyle changes and medicines.
Diabetes can cause complications across your entire body.
- A higher risk of heart attacks and strokes
- Eye problems
- Foot problems
- Kidney disease
- Nerve damage
These complications can be very serious. That's why it's important to find out if you are at risk of diabetes and to manage your blood sugar levels.
Treatment and lifestyle changes
These are important for managing your blood sugar levels and preventing complications.
- Changes to diet – these are important for anyone with diabetes. Changes to your diet can include anything from following a generally healthy diet to having to carefully restrict your intake of certain types of food. Speak to your GP or dietitian about this and services available in your area.
- Physical activity – keeping active can help to stabilise your blood sugar and lower your cholesterol and blood pressure. It can also help you lose weight if you're overweight.
- Losing weight if you are overweight – this is very important for managing diabetes.
- Medications – many people will eventually need medication to control their blood sugar levels. Diabetes UK have more information.
- Insulin – some people will need insulin to control their blood sugar levels – even for Type 2 diabetes. Learn more from Diabetes UK.
- you're overweight or obese – especially if you carry excess fat around your middle
- you're inactive
- there is a history of Type 2 diabetes in your family
- you have high blood pressure or high cholesterol
- you're a smoker
- you come from a South Asian or Black African or Caribbean background.
Find out if you're at risk
To find out your risk, speak to your doctor, use Diabetes UK's Know Your Risk tool, or have an NHS Health Check.
If you're at moderate to high risk, speak to your GP about a blood test to check your blood sugar levels. This means you can take action now to prevent diabetes from developing and avoid and complications and medications.
Can diabetes be reversed?
For some people with Type 2 diabetes, it's possible to go into diabetes remission. This means that your blood sugar is within a healthy range and you don't need medications any more.
People usually achieve diabetes remission by making changes to their lifestyle and losing weight, by eating healthily and being physically active. If you qualify for weight loss surgery and chose to have it, and lose a significant amount of weight, this can also put their diabetes into remission.
It's important to remember that remission isn't possible for everyone. But making changes to your lifestyle will still have significant benefits whether you go into remission or not.
If you go into remission but gain weight again then your diabetes can return, so it's important to keep going with your healthy lifestyle changes.
Cholesterol and diabetes
- Diabetes damages the lining of your arteries. This means it's more likely that cholesterol will stick to them, making them narrow or even blocked.
- Your levels of HDL (good) cholesterol are usually lower if you have diabetes, and your levels of LDL/non-HDL (bad) cholesterol are usually higher. This means your arteries are more likely to become narrow or blocked.
Treating diabetes and cholesterol lowers your risk of heart attacks and strokes:
- People with diabetes should keep their levels of cholesterol within a healthy range, which is often a lower level than most people.
- Many people with diabetes will take statins to help reduce their cholesterol and their overall risk of having a heart attack or stroke.
- Drugs used to treat diabetes, such as SGLT2 inhibitors (drugs ending in '-gliflozin'), have been shown to reduce deaths from diseases of the heart and blood vessels and circulation in clinical trials.