10 diabetes facts

We will now go through 10 facts about diabetes.

1. What is diabetes?

It is a lifelong condition that causes the blood glucose (sugar) level to become too high.

There are two main types of diabetes:

Type 1 (10%) – DM1 – where the pancreas does not produce any insulin. This type is usually diagnosed when you are young
Type 2 (90%) – DM2 – where the pancreas does not produce enough insulin or the body’s cells don’t react to insulin. This type usually affects older people.

Also, type 2 diabetes is strongly inherited, especially in Asian people. In fact, if you are Asian, and one parent has DM2, you have a 50% chance of getting it yourself (90% with both parents).

Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

2. How common is diabetes?

Diabetes is a very common disease, affecting 2-5% of the country – and upto 10% of Black and Asian people.

3. Type 1 vs Type 2 diabetes

90% of people have Type 2 diabetes (DM2) and 10% Type 1(DM1)/other – e.g. gestational (pregnancy-related)

4. What is the definition of diabetes?

Normal blood glucose (sugar) is 4-6 mmol/L. Diabetes is diagnosed if you have a fasting blood glucose of 7 mmol/l or above, or a random blood glucose of 11 mmol/L or above (twice).

5. Is diabetes preventable or reversible?

Yes, both. Well, Type 2 diabetes is both preventable and reversible.

So, back to the question .. how can I improve my diabetes? There is a lot you can do.

6. How can I prevent or reverse DM2?

Yes. And even if its not, it is controllable.

Weight loss. Being overweight can cause diabetes, or make it worse if you have it. So weight loss is vital. Some patients can even get rid of their diabetes completely by controlling their diet and weight. If you cannot lose weight by dieting etc, you should consider bariatric surgery.
Detect DM early – especially if you think you are higher risk, e.g. Black or Asian, with a family history (= one or both parents, or grandparents, have it). So, have your blood sugar levels measured every 6 months, if you think you are in this group.
Family tendency to diabetes. If you (or your partner) have DM2, your children should have a blood glucose check every 6 months, from the age of 30 years – especially if either parent is Black or Asian.
Check your blood pressure. This should be done weekly until stable, then monthly, then every three months (again, if within target and stable). The target BP for people with diabetes (or prediabetes, even if it has reversed), is under 130/80 all the time; no matter who measures it (you, or at your GPs or hospital).

Even if its not reversible, there is a lot the you, and the NHS can do.

7. How is diabetes treated?

If your diabetes cannot be prevented or reversed, there is alot of effective treatment available.

Type 1 diabetes – is treated with insulin injections or an insulin pump
Type 2 diabetes – is managed by diet, exercise and sometimes medication. This may be tablets initially, and later tablets and insulin.
New treatments and monitoring equipment. Talk to your health professionals below about these. DM care is changing all the time. For example, ‘Freestyle libre’ is a new automatic monitoring device that is put on your arm; so you do not have to prick your finger all the time. It may not be free.

8. What can the NHS can do to help my diabetes?

GP Practice Nurse. Many NHS GPs have a diabetes management clinic run by a practice nurse or pharmacist. Ask for three monthly review there.
Hospital diabetes consultant. Your GP may refer you to a hospital specialist if your diabetes is causing serious problems. You should see a consultant or their deputy called a registrar. If you are seen, only let the hospital discharge you when you feel confident with diabetes self management. In the meantime, ask for review every 3-6 months – this can be virtual. The hospital may arrange for you to be seen by a Diabetic specialist nurse (DSN) and/or a DM dietitian who may also help you with weight loss.
Community diabetic specialist nurse. These exist but there are not many of them. They work with the hospital DSNs. They can be very helpful and may visit you in your home. Your practice nurse (or hospital consultant) can link you up. They may work with community DM dietitians.

9. What are the complications of diabetes?

The main reason to improve diabetes is to prevent or slow its long term complications.

Eye problems (retinopathy). Some people with diabetes develop an eye disease called ‘diabetic retinopathy’ which can affect their eyesight. If retinopathy is picked up early, it can be treated and sight loss prevented with laser (and other) treatment.
Foot problems. Diabetes foot problems are serious and can lead to amputation if untreated. Nerve damage can make it slower for sores and cuts to heal. That’s why it’s important to tell your GP if you notice any change in how your feet look or feel.
Kidney problems (diabetic nephropathy). This is known as diabetic nephropathy or kidney disease, and can cause Chronic Kidney Disease (CKD). This is particularly related to poor blood pressure control. A few patients will develop advanced CKD (CKD4 or CKD5) and need dialysis or a kidney transplant, or a kidney-pancreas transplant (DM1 only).
Heart attack and stroke. When you have diabetes, this can lead to heart attacks and strokes.

10. How can I prevent the complications of diabetes?

HbA1C. Have a HbA1C blood test every three months to get an idea of whether your DM is well controlled.
Kidney blood tests. To monitor for CKD, you should have a 6 monthly (more if necessary) blood test called ‘U+E’. This includes blood creatinine and GFR. Creatinine should be 60-120 mcmol/L, and GFR under 60 ml/min. If it is above 150 mcmol/L, or GFR under 45 ml/min (CKD3B), you may have a kidney problem, and need to be discussed with a kidney specialist (nephrologist). If creatinine is above 200 and/or GFR under 30 ml/min (CKD4), you should see a nephrologist.
Foot and eye examinations. You need to make sure that these are done regularly – again 6 monthly, more if necessary.

Summary

We have described 10 diabetes facts. If you do all of the above, you will get better care. It may even reverse the diabetes. If that is not possible, it may help prevent (or at least delay) complications of DM, like heart attacks, strokes, blindness, amputation and kidney dialysis.

Other resources

10 CKD facts
10 IHD facts
10 CHF facts
10 cholesterol facts

Last Reviewed on 27 May 2024