Type 1 diabetes is a lifelong condition. We still aren’t sure what causes it, and it isn’t currently preventable. When you have Type 1 diabetes, your body can’t produce any insulin, the hormone produced by the pancreas which enables the glucose in our blood to enter our cells and fuel our bodies.
Type 2 diabetes, on the other hand, can be prevented in the majority of cases and – in some people – can even be put into remission. When you have Type 2 diabetes, the insulin your body produces either doesn’t work properly or your body doesn’t produce enough insulin.
The importance of management:
Everyone’s diabetes is different, so everyone’s diabetes management is different. It’s vital that people with diabetes develop a tailored diabetes management plan with the help of their healthcare team that is realistic and works for them, so they can stay healthy and avoid complications.
The complications of diabetes are the same regardless of which type of the condition you have. Some of the more common – but devastating – complications associated with diabetes include sight loss, nerve damage and stroke. Complications are caused by persistently high blood glucose levels, which over time damage your blood vessels and stop blood travelling to the places it needs to. That’s why keeping your blood glucose levels in a healthy range is so important.
Managing Type 1 diabetes:
When you have Type 1 diabetes, you need to get insulin into your body by injecting it using an insulin pen or by using an insulin pump. You also need to check your blood glucose levels regularly to make sure they aren’t too high or too low using a blood glucose testing device.
When you inject insulin, your blood glucose levels go down, but if you inject too much insulin it can cause you to have a ‘hypo’ (hypoglycaemia), which is the result of your blood glucose levels dropping too low. People experiencing regular hypos might be on the wrong dose of insulin and should speak to their healthcare team.
Also fundamental to managing your Type 1 diabetes and avoiding complications is keeping a close eye on your long term blood glucose levels (also known as HbA1c). Knowing and understanding this number will help you stay in control of your diabetes, and help your healthcare team tailor your management plan to suit your needs.
All people with diabetes are entitled to a set of annual diabetes health checks for free on the NHS. Diabetes UK calls these ‘The 15 Healthcare Essentials’. These include blood glucose tests, eye screenings, foot and leg checks, diabetes education courses, advice on diet and a kidney test to name a few. There is more information on these at: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/15-healthcare-essentials/what-are-the-15-healthcare-essentials
Making the most of these checks and tests will help you stay on top of your condition and reduce your risk of developing serious diabetes complications. For example,attending your annual foot check and having your feet looked at by a healthcare professional could be the difference between keeping and losing a toe, foot or leg.
Managing Type 2 diabetes:
If you’re living with Type 2 diabetes, you might need to use medication to help you manage your blood glucose levels. The most common medication given to people with Type 2 diabetes is metformin, but there are many others. A lot of people with Type 2 diabetes don’t need to take any medication, and instead manage their diabetes through lifestyle, generally by eating healthily and being more physically active.
Eating healthily and moving more will help you manage your blood glucose levels, as well as helping you to eventually achieve a healthy weight. There’s nothing you can’t eat if you have Type 2 diabetes, but there are certain foods that you should limit your intake of and some that you should eat more of.
People with Type 2 diabetes should – as everyone should – try to eat a healthy and balanced diet that includes a wide range of foods like fruit, vegetables, wholegrains, pulses like beans, lentils and peas, nuts and seeds and oily fish, while cutting back on red and processed meat, refined carbs like white bread and sugary drinks and foods.
If you’re living with Type 2 diabetes, physical activity can help you achieve or maintain a healthy weight, increase the amount of glucose used by your muscles and help your body use insulin more effectively. It also has various other health benefits that include strengthening your bones, reducing stress levels and improving your sleep.
As with Type 1 diabetes, it’s vital that people with Type 2 diabetes keep track of their levels, and attend all the health checks they are entitled to as part of the 15 Healthcare Essentials.
It is also possible for some people who have Type 2 diabetes and are overweight to put their Type 2 diabetes into remission. Recent research, like the Diabetes UK DiRECT trial, has shown that by following a specific weight management programme and losing a significant amount of weight – with the support of a healthcare professional – some people can put their Type 2 diabetes into remission. This means your blood glucose levels are healthy without you needing to take any diabetes medication at all. There is more information on remission on the Diabetes UK website: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/type2-diabetes-remission
Preventing Type 2 diabetes:
As many as three in five cases of Type 2 diabetes can be prevented through lifestyle changes. With one person being diagnosed with Type 2 diabetes every three minutes in England and Wales and the number of people living with diabetes in the UK having doubled in the last 20 years, urgent action must be taken to stem this rise and alleviate some of the burden Type 2 diabetes places on our already stretched NHS.
The rising prevalence of Type 2 diabetes has been fuelled by the obesity crisis. Three in five adults in the UK are currently overweight or obese. While individuals do have a responsibility for their own health, it’s equally important to create an environment in which the healthy choice is the easy choice. Sadly, this isn’t currently the case.
For individuals, the first step towards avoid avoiding Type 2 diabetes is understanding your risk. Once you know your risk, you can take the necessary steps to reduce it. Anyone can find out their risk of developing Type 2 diabetes, and why they are at risk, using the Diabetes UK Know Your Risk online tool at https://riskscore.diabetes.org.uk/
If you’re at increased risk of developing Type 2 diabetes because you’re overweight, losing weight will be a vital part of you reducing your risk and preventing – or at least delaying – a diagnosis of Type 2 diabetes.
As with managing diabetes, eating better and moving more are vital in helping to avoid Type 2 diabetes. Small changes can make a big difference. No one can be expected to become a marathon runner overnight. Start by taking the stairs instead of the lift, or get off the bus a stop early and walk. There are also lots of simple, healthy meal swaps and ingredient substitutes available on the Diabetes UK website: https://www.diabetes.org.uk/preventing-type-2-diabetes/im-at-risk-of-type-2-diabetes
The NHS England Diabetes Prevention Programme is the first of its kind globally. It identifies people at high risk of Type 2 diabetes, and then refers them on to a behaviour change programme which helps them minimise their risk through lifestyle changes. If you’re at high risk, it’s worth taking a look at what the Diabetes Prevention Programme can offer you at: https://www.england.nhs.uk/diabetes/diabetes-prevention/
But preventing Type 2 diabetes isn’t just down to individuals. Equally important is tackling the obesity epidemic, and making the healthy choice the easy choice. Being overweight is the most significant modifiable risk factor for developing Type 2 diabetes, so it’s vital that action is taken to tackle the obesogenic environment in which we live if we are to curb the rising prevalence of Type 2 diabetes.
Diabetes UK has been campaigning to make this a reality through our Food Upfront campaign, which is calling on the Government to mandate calorie labelling in restaurants, cafes and takeaways.
We are also urging the Government to act on the proposals set out in its ambitious Childhood Obesity Plan Chapter Two. These include mandating calorie labelling in the out of home sector, introducing restrictions on price promotions for unhealthy foods and restricting junk food marketing aimed at children.
Government has been consulting on some of these measures in the year since Chapter Two of the Childhood Obesity Plan was published. We are calling on the Government to publish the outcome of the calorie labelling consultation, and commit to a clear timeline to implement the proposals to help tackle the obesity crisis and curb the rising prevalence of Type 2 diabetes.