Diabetes is on the rise, but making simple lifestyle changes can help prevent it or reduce its effects says Dr Mel Wynne-Jones
Around a million people in the UK are set to develop diabetes in the next few years, adding to the three million or so diagnosed, and around 590,000 who don’t yet realise they have it.
Diabetes means the pancreas gland can’t produce enough insulin, a hormone that regulates blood-sugar levels and stores surplus glucose in body cells; these may also develop ‘insulin resistance’.
Why it matters
There’s no such thing as ‘mild’ diabetes – you can develop complications, even if you don’t need medication. A raised blood-sugar level can trigger chemical disturbances or dehydration (see box, right) and, longer-term, diabetes damages vital arteries, so you’re more likely to develop heart disease, strokes, kidney damage, blindness or poor circulation that can lead to limb amputation.
One in 10 people with diabetes have type 1, which may be an immune disorder and usually develops in childhood or early adulthood; it’s treated with lifelong insulin injections.
But most cases are type 2 (see ‘Risk factors’) which now even affects primary-school children.
With diabetes, your blood sugar (glucose) level becomes raised. It’s diagnosed by blood tests showing that your fasting glucose level, glycated haemoglobin level (HbA1c) or oral glucose tolerance test (OGTT – glucose injection, then blood tests) are high.
But if your ‘random’ blood-sugar level or OGTT are borderline, you may have ‘impaired glucose tolerance’ or pre-diabetes – a sign that you need to take urgent action.
These can alert you to look out for symptoms, although they don’t guarantee you will develop diabetes. They include being overweight (especially apple-shaped), not being physically active enough, having impaired glucose tolerance, metabolic syndrome or polycystic ovary syndrome, having diabetes in pregnancy, or taking certain drugs for raised blood pressure.
You’re more at risk if you’re older, are of South Asian, African, African-Caribbean, Polynesian, Middle-Eastern or American-Indian descent, or you have relative(s) with it. You can assess your personal risk on the type 2 diabetes page at nhs.uk.
How to lower your risk
If you suspect you already have diabetes, or have several risk factors, ask your GP about having a blood test.
But you can start making changes straight away. Lose weight if necessary; UK researchers recently said losing enough to ‘drain’ your pancreas of fat could even reverse diabetes. Your waist should be less than half your height, and your body mass index (BMI) less than 25.
Your BMI is your weight in kilograms, divided by your height in metres multiplied by itself. Try smaller portions and a Mediterranean diet (which is also protective) – more multi-coloured fruit and vegetables, pulses, nuts, oily fish and wholegrains, and less meat, saturated/trans fats and salt.
Regular exercise also cuts your risk; aim to get pink and puffed for the equivalent of 30 minutes, five times a week. You may need to stop smoking and/or lower your alcohol consumption to below recommended limits, too, as these also damage arteries.