Over the past 20 years, the number of people diagnosed with diabetes in the UK has more than doubled from 1.4 million to almost 3.7 million.
This dramatic rise has put an extreme burden on the NHS, costing £8.8 billion each year.
“As the number of people with Type 2 diabetes continues to grow, there’s a risk that these costs will rise to unsustainable levels,” warns Pav Kalsi, senior clinical advisor at Diabetes UK. Unlike irreversible Type 1 diabetes, where the body can’t produce insulin, 10% of the NHS budget is spent on Type 2 diabetes – that’s £1 million an hour.
“The good news is that Type 2 diabetes is a reversible condition for a lot of people, so costs could be saved,” says Dr Campbell Murdoch, GP and medical officer for diabetes.co.uk.“The challenge now is to empower as many people as possible.”
Diabetes: the different types
Type 1 diabetes
This is an autoimmune disease where your body attacks and destroys insulin-producing cells. “Your pancreas shuts down and you don’t produce any insulin, causing the glucose to rise in your blood,” says Natasha Marsland, senior clinical advisor at Diabetes UK. This is why symptoms – including feeling thirsty and tired, needing to pee more often, unexplained weight loss and blurred vision – are often more obvious. The reason for Type 1 diabetes, which affects around 10% of all cases, is not yet known, although family history can be a factor. A misconception is that people are born with it, but the peak age for diagnosis is 10 to 14 years old.
Type 2 diabetes
With the more common Type 2 diabetes, your pancreas may still produce insulin “but the amount may be reduced or the insulin it produces doesn’t work properly, meaning symptoms develop gradually,” explains Natasha. Our waistlines are mainly to blame, although there are other factors that can put you more at risk (see Q&A). “Symptoms often creep up on people,” says Dr Ian Lake, medical officer at diabetes.co.uk. “You might be more tired than normal, have central obesity, be getting up more at night to urinate, possibly have increased thirst and need to sleep more after a big meal. A lot of people also mention brain fog – so things that we put down to ageing.”
Type 3c diabetes
This is where part of the pancreas is not producing enough insulin, sometimes caused by inflammation. Typical symptoms include vague abdominal pain, loose fatty stools and vitamin deficiencies. It’s thought that far more people are likely to have Type 3c diabetes than diagnosed at present, as may have been misdiagnosed with Type 2, but the condition is still being researched. “Although lifestyle measures may help improve health, insulin therapy may also be needed,” says Dr Murdoch
Diabetes symptoms: which are the most common?
- Excessive thirst and hunger
- Frequenturination (from urinary tract infections or kidney problems)
- Weight loss or gain
- Blurred vision
- Slow-healing wounds
How will I be diagnosed?
You need to see your GP for a urine and blood test. “Type 2 diabetes is diagnosed by detecting persistently high blood levels of glucose and HbA1c, which reflects blood glucose levels over the past three months,” says Dr Melanie Wynne-Jones.
“If you have borderline results (known as “pre-diabetes”), you should be rechecked annually.”
What happens next?
“You’ll need regular checks on your blood pressure, cholesterol, kidneys (blood/urine tests), feet, eyes and circulation to see whether you need more intensive treatment to prevent complications,” says Dr WynneJones.
“If you’re prescribed tablets or (occasionally) insulin, you’ll need to learn the symptoms of dangerously low blood sugar (sweating, hunger, irritability, confusion and/or unconsciousness), and tell the DVLA if you’re a driver. You may be offered weight loss surgery.”
My children are overweight, are they at risk of diabetes?
With the Health and Social Care Information Centre revealing that one in five children in England leave primary school obese, it won’t be long before Type 2 diabetes affects more under 18s. “Numbers are increasing,” warns Pav.
All food or drink high in fat, salt or sugar was banned across all children’s media in summer 2017, but it’s still too early to see if it has made a noticeable effect.
How can I cut my risk of diabetes?
Being a healthy weight is key. Women should keep their waist size below 31.5 inches/80cm. Reduce your intake of high-sugar, starchy foods,especially sugary drinks (including fruit juices and smoothies), confectionery, cakes and biscuits. Plus, make sure you get moving – 30 mins five times a week if you can (brisk walking is a great way to start), and 10 mins of standing and stretching for every hour of sitting.
Can natural cures for diabetes work?
“Before prescribing any medicines for Type 2 diabetes, your doctor may suggest you try natural approaches, such as improving your lifestyle,” says Dr Brewer. “During this phase, your GP may be willing to support you taking ayurvedic herbal medicines (including bitter melon, fenugreek, amla fruit, gymnema and turmeric), which can improve insulin release in the pancreas, reduce insulin resistance and suppress cravings.”
What happens if I ignore diabetes symptoms?
“Diabetes damages small arteries, and can lead to heart attacks, strokes, kidney damage, blindness and limb gangrene/amputation, so careful monitoring and effective lifestyle changes/treatment are vital,” says Dr Wynne-Jones.
What is the treatment for type 2 diabetes?
“Metformin is one of the main drugs prescribed to treat Type 2 diabetes, especially in overweight patients,” says Dr Sarah Brewer. “It helps to lower blood glucose levels and, while most people tolerate Metformin well, it can cause side effects.
"Doses are often gradually increased to help avoid taste disturbances, nausea, diarrhoea, loss of appetite or abdominal pain. If these occur, they tend to improve after a day or two, but tell your doctor.”
Will the Sugar Tax help?
In April last year, the Government launched the sugar tax, with 18p per litre on drinks with more than 5g of added sugar, and 24p for added sugar of 8g or more. But with 33% of us having no interest in quitting sugar, despite worrying about its effect on Type 2 diabetes, will it make a difference?
“It has had patchy success,” says Dr Lake. “The good news is that manufacturers are cutting sugar in their products to beat the tax. It is predicted to raise £1 billion per year (in the first seven months it raised £154 million), presumably to spend on complications of diseases made worse by added sugar. The bad news is that pure fruit juices and sugar added to milk are exempt.”