Diabetes Advice

From Suffolk,

Before I became diabetic, I was basically unaware of the condition, with the exception that I did know that diabetics couldn’t eat sugar or sweets. I knew a couple of diabetics at work, and they always seemed fine and healthy. So, I guess it never bothered me, I mean what were the chances of me developing diabetes: Practically nil – or so I thought.

So when I had a serious accident in 1996, it was an added shock to my recovery when the doctors told me I was ‘borderline’ diabetic. I was told I needed to eat healthily and reduce my sugar intake. A little while later I was told everything was okay, and I could go back to eating what I wanted.

That was my first real worry of diabetes, until then it was the problem of other people.

Following my discharge from hospital after six months, to say I was happy would be an understatement. At home I was trying to eat healthy, but there were few healthy options that I liked, so the crisps still went to my stomach via my mouth, as too did the biscuits and chocolate.

It was about six months after my discharge from hospital, I began to get thirsty, and no matter how much I drank that thirst would return within minutes – if not seconds. At night my wife was taking up trays of drinks, including cola, water, and squash. Pints of liquids sat by my side as I went to bed: And during the night my wife would dutifully get up and get me more as they rapidly disappeared. The district nurse was still visiting me, and I decided to swallow my pride and mention it to her. I knew inwardly that it sounded like diabetes (following a small amount of research), a home blood test showed my blood glucose levels were far too high, so she arranged for a doctor to come to my house and take a blood test.

A week or so after that visit I got the results, I was officially diagnosed as type 2 diabetic. I HAD DIABETES!

My initial emotions were denial, they had of course got the blood tests mixed up, my parents were diabetes-free as to was my brother. My grandparents never had the condition, so the hospital MUST have mixed the results up. I convinced myself this was the case and told my nurse so. She informed me the results were true, and slowly I began to accept them.

Then the feelings of despair set in, it was like having a death sentence placed on you. I began to read up on the condition, but rather than concentrate on the positives I accepted the negatives. The problems that MIGHT occur, I knew they would occur to me – that was my luck.

As I visited the hospital on a regular basis to try and learn more about the condition that was going to share my life until my dying day I began to realise there was indeed hope, the outlook wasn’t as black as I was painting it.

They initially started me on two types of tablets which worked a little, but my levels were still too high. Finally, I was put on insulin and left on one of the tablets. My condition, along with reforming my diet, was getting under control, and my blood sugars were reading within the acceptable levels.

I slowly began to accept my diabetes more and more, but even now, some seven years or so on, and I still have doubts and worries at times. I think most diabetics think about the possible complications and therefore the outcome at some point or other.

Diabetes is a chronic condition and although you don’t actually die from the condition itself, you can die from its complications. Make know mistake about it is better to try and avoid it from an early age, by eating healthy, exercising, etc., than to have to deal with it when your lifestyle needs changing.

I realise now that by making a few changes in my earlier life, I might have reduced the chances of my contracting the condition later in life. However, the warnings, the healthy lifestyle items and the information just weren’t as freely available then as they are now.

My life was full of drinking cola (no diet type), eating bags and bags of crisps, roast dinners, chips, dripping on toast, and I remember my dad cutting the bread on the thick side, then toasting it over the open fire and spreading it with real butter.

So let’s have a closer look at Diabetes.

¤¤ WHAT IS DIABETES ¤¤

The body produces a hormone called insulin; this is produced by the pancreas. The purpose of the insulin is to keep your blood glucose levels under control. In diabetics, insulin production is severely reduced or in some case stopped, thus allowing the sugar levels to rise.

There are two main types of diabetes:

1. Type 1: Type one diabetes is usually found in younger people (under 40), and is where the body has failed to produce any insulin. This means that a type one diabetic will need to inject insulin into their bodies on a daily basis – often several times a day.

2. Type 2: Type two diabetes usually occurs in older people (over 40) and is where the body produces insulin but that insulin is either not enough or it doesn’t get used by the body properly.

3. There is also a type of diabetes that occurs when you are pregnant; this is known as gestational diabetes.

¤¤ WHAT ARE THE SIGNS AND SYMPTOMS ¤¤

Symptoms of diabetes can vary from person to person, and indeed a million people have the condition but don’t know they do. The main symptoms are:

• Increased thirst (this thirst is probably the most significant symptom, and indeed a consultant once told me that it was by far the most common symptom. That said just because you aren’t thirsty, doesn’t mean you don’t have the condition)

• Trips to the loo all the time – especially at night (Trips to the toilet at night time obviously disturb you sleep pattern and can be very annoying and bothersome)

• Tiredness, weight loss, genital itching or regular episodes of thrush (the tiredness of high blood glucose is dreadful. You literally have to summon every ounce of energy to move your lethargic body. A lump of lead would probably have more energy)

• Blurred vision (luckily something I didn’t really suffer from until my recent diagnosis of Blepharitus) some people find their vision gets blurry, which of course inhibits many aspects of life, particularly driving and machine operation.

• Weight loss (People often feel happy about losing weight for no apparent reason, until they find the reason)

¤¤ Diagnosis and Prognosis ¤¤

If you think you are showing any signs of diabetes, it is very wise that you get checked out. Your GP can offer you a test if he/she feels it appropriate. Alternatively some pharmacists offer a simple test, or you can opt to buy a blood glucose meter and test yourself (though be warned the test strips are heavily priced and only available free on prescription to registered diabetics). They can be bought at most chemists or online and prices start at around a fiver, which usually includes several test strips to get you going. Blood glucose readings should read between 4.0mmol and 7-8mmol. Anything above this figure needs checking by your GP. So diagnosis is fairly straightforward, but what is the prognosis for people with diabetes?

If you keep to a good diet, and remain fairly active, as well as take medication as and when required, prognosis is extremely good. However, it’s not always easy to keep your blood glucose under control and complications can develop. These complications include: heart disease, kidney problems, strokes, blindness (the leading cause of blindness in the UK), and more.

It is worth pointing out that people with diabetes are more prone to infections, and are often slower to heal than people without diabetes. This was explained to me: People with diabetes usually have more sugar floating around their bodies, so if you get a cut, your blood is on the surface of your skin. A diabetic’s blood is sweet and therefore attracts bugs, which in turn carry infection. Think of it like insects that will go out of their way to find a crumb on a surface.

The NHS spends around £165 PER SECOND on diabetes care, and it takes some 9% of the total NHS budget. This includes all aspects of care.

¤¤ What care can a diabetic expect ¤¤

All diabetics can expect a good standard of care, particularly now that we have a national standard framework. This means that wherever you are in the country your care should be the same. Each year you can expect to have a special diabetic eye test, which involves having drops to dilate your pupils. This allows the doctor to check for any damage at the back of your eye. Speaking as Britain’s biggest coward, I can assure you it doesn’t hurt at all: though you can feel a little discomfort when the drops are put in.

In addition, each year you should have your feet checked out by a chiropodist. Diabetics can suffer from neuropathy, and may not feel pain in their feet, thus infections might be present without realisation.

A doctor will also see you each year and you will have a blood test called HbA1c. This blood test is sent to the labs, and checked to see your average daily blood glucose level over the past two to three months. The results are in the same format as your daily readings: i.e. 4.3mmol. This test proves valuable information to your doctor as he/she can see just how good or bad your control has been.

If you are on medication for your diabetes, you are entitled to free prescriptions, you may also get free eye tests with your high street opticians. If you buy something which is for your diabetes (i.e. blood glucose meter) you are exempt from paying VAT which you can claim back (or the shop may deduct it there and then).

¤¤ TREATMENT ¤¤

Whichever way your diabetes is treated, you WILL be advised about your diet. Healthy eating is a key part of your treatment, and this will be told to your at your check-up. Plenty of fresh fruit and vegetables is the order of your life. That of course doesn’t mean to say no chocolate or treats, you can have a treat and most diabetics keep some chocolate in the house for ‘emergencies’.

Treatment is dependable on the type of diabetes you have, mostly type two is treated with diet and or tablets: Though I am on tablets, insulin and diet: Type one is treated with insulin, which may be injected several times a day.

There are several types of tablets and insulin on the market: some tablets help the insulin your body does make work more effectively, while others help stimulate the pancreas into producing more insulin. All insulin works similarly by simulating the body's own insulin production.

If you have a fear of needles then don’t worry, help is at hand, and you will be helped with your fear.

¤¤ HOLIDAYING WITH DIABETES ¤¤

This can be a nightmare if not planned! Personally I have been away at least twice and forgotten to take my insulin and tablets. Luckily I was able to see a local GP who prescribed the correct medication. However, if you are going abroad things are not quite as easy, you will be unlikely to request a prescription for your usual medication if you forget it. For that reason, it is vitally important to write a list of things to remember to pack, and strike them out when you’ve packed them. This way it is doubtful you’ll forget anything.

Other things to consider include the weather which can affect blood glucose level, insurance (some companies refuse Diabetics), keeping your insulin cool in hot weather, things to boost your sugar levels if they drop, and never forget to take your meter.

¤¤ DISCRIMINATION ¤¤

While it sounds daft to think that diabetics are discriminated against I can fully vouch that it is a sad state of affairs that it is true. I recently wanted insurance for travel; a yearly policy was what I wanted. I rang several companies who told me they couldn’t insure me due to my diabetes. I was beginning to panic, as I couldn’t travel without insurance due to my health problems. Finally Diabetes UK came to the rescue with their own insurance (run by a different company). My quote was very competitive, plus they allowed all five of us on the one insurance (myself, wife, 16 year old, 18 year old, and 21 year old).

I do wonder why the other insurances felt unable to insure me though, providing my diabetes is well controlled and a letter from my GP is produced to confirm it what is the problem?

Another form of discrimination is driving licenses, though I’m not clear about this and am aware of things changing (or changed). Some companies discriminate when they find out their employee have become diabetic.

¤¤ DIABETIC'S GOING OUT GEAR ¤¤

When a diabetic goes out it can be a major task they have a few things to remember to take with them:

1. Blood glucose monitor

2. Test strips for the meter

3. Tissues (for obvious reasons)

4. Finger pricker

5. Blood glucose boosters (i.e. glucose tablets, mars bar, etc.)

6. Medic alert information (i.e. jewellery/card/other) telling medics of your condition(s)

7. Insulin

8. Other medication

Further sources of information can be found at the following web sites:
www.diabetes.org.uk

www.diabetes.org (USA)

www.bbc.co.uk/health/diabetes

http://www.diabetes-insight.info/

Sugar free store
http://www.sugarfreesuperstore.co.uk/

Diabetes UK can also be contacted at:

10 Parkway London NW1 7AA
Tel 020 7424 1000
Fax 020 7424 1001
Email info@diabetes.org.uk

For dietary information please visit:

http://www.diabetes.org.uk/eatwell/index.html

Thanks for reading and please feel free to contact me regarding any aspect of this opinion-Dave

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FACT: 1 million people in the UK know they have diabetes

FACT: 1 million people in the UK DON'T know they have diabetes

Check the signs, get advice, see the doctor: the sooner it's caught the better you feel.

From Mumbai,

The three major types of diabetes are:

Type 1 diabetes (previously known as insulin-dependent diabetes)
Type 1 diabetes is an auto-immune disease where the body's immune system destroys the insulin-producing beta cells in the pancreas. This type of diabetes, also known as juvenile-onset diabetes, accounts for 10-15% of all people with the disease. It can appear at any age, although commonly under 40, and is triggered by environmental factors such as viruses, diet or chemicals in people genetically predisposed. To live, people with type 1 diabetes must inject themselves with insulin several times a day and follow a careful diet and exercise plan.

Type 2 diabetes (previously known as non-insulin dependent diabetes)
Type 2 diabetes is the most common form of diabetes, affecting 85-90% of all people with the disease. This type of diabetes, also known as late-onset diabetes, is characterised by insulin resistance and relative insulin deficiency. The disease is strongly genetic in origin but lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are major risk factors for its development. Symptoms may not show for many years and, by the time they appear, significant problems may have developed. People with type 2 diabetes are twice as likely to suffer cardiovascular disease. Type 2 diabetes may be treated by dietary changes, exercise and/or tablets. Insulin injections may later be required.

Gestational diabetes mellitus (GDM)
GDM, or carbohydrate intolerance, is first diagnosed during pregnancy through an oral glucose tolerance test. Between 5.5 and 8.8% of pregnant women develop GDM in Australia. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity and being a member of a community or ethnic group with a high risk of developing type 2 diabetes. While the carbohydrate intolerance usually returns to normal after the birth, the mother has a significant risk of developing permanent diabetes while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life. Self-care and dietary changes are essential in treatment.