Managing the risk and living with Type 2 diabetes
There are around 4.7 million people in the UK living with Type 1 and Type 2 diabetes - with that number expected to rise to 5.5 million by 2030. It’s also estimated that there are nearly 1 million people living with Type 2 diabetes, but have not yet been diagnosed and a further 12.3 million people at risk of developing it. If not managed well, diabetes can lead to devastating health complications, so the need to take preventative measures against the condition has never been greater.
Here, Dr Chet Trivedy BDS FDS RCS (Eng) MBBS PhD FRCEM FRGS consultant in Emergency Medicine and founder of Boundaries for Life and the Tulsi Foundation talks about his experience of not only treating patients with Type 2 diabetes but also living with the condition.
It can happen to you!
My brush with Type 2 diabetes came as a bolt from the blue in February 2015 when I was diagnosed with a minor stroke that was secondary to high blood pressure, high cholesterol and underlying Type 2 diabetes. As a medical doctor I thought I would have been able to read the signs better, but I was convinced my fatigue was due the long shifts working in A&E and the constant switch between day and night shifts. Also, I thought the regular trips to the bathroom were down to the excessive tea and coffee I was drinking. Both being important consequences of Type 2 diabetes. The truth was I was caught off my guard as many of us are and if it can happen to a doctor it can happen to anyone.
Knowing and not ignoring the warning signs
Diabetes is a condition which results from poor regulation of sugar levels through the production of the hormone insulin from the pancreas. Raised sugar levels can have a knock-on effect on practically every organ in the body. Excessive urination and excessive thirst are important markers for underlying diabetes. Feeling sleepy after a big meal, blurry vision, having wounds that won’t heal or skin infections or periodontal disease (bleeding gums). These often-innocuous signs are often overlooked and put down to the busy lives we all live. Diabetes is a master of disguise and not like other conditions which result in obvious features that are difficult to ignore. The Diabetes UK UK Diabetes risk score is a useful free online tool that can be used by anyone to predict their risk of diabetes and it is easy to complete yourself (https://riskscore.diabetes.org.uk/start)
- First degree relative of Type 1 or Type 2 diabetes
- Waist circumference
- Body mass index
- Diagnosis of high blood pressure or medications for blood pressure
Simple answers to these questions can help stratify the risk of developing Type 2 diabetes and prompt people to see their doctors for a definitive diagnosis.
Getting yourself checked if you are at high risk of developing Type 2 diabetes
Having a simple finger prick blood test has been the hallmark for assessing blood sugar. This test measures the random blood sugar which can often be misleading through a false positive where the blood sugar may be high without a diagnosis of diabetes. Measurement of the Hb1Ac which is the amount of sugar that is carried by the haemoglobin in the blood cells is a much more reliable way of measuring sugar levels and is now the diagnostic criteria for diabetes as it represents a three months’ worth of sugar control and accounts for the variability of a random blood sugar check. Most health care providers use a blood Hb1ac level to diagnose diabetes. Checks for diabetes are becoming more widely available in the community and one example being the Boundaries For Life (BFL) initiative which I set up 10 years ago and has been sponsored by Simplyhealth for the last 3 years. This initiative has been providing free health checks for cardiovascular disease, diabetes and oral health for fans attending cricket matches across the UK. To date over 5,000 members of the public as well as club staff have benefited from a free health MoT at high profile events such as the Ashes. Making people more aware of diabetes through high profile events can help raise awareness of diabetes and pick up early cases particularly in those individuals (like me) who are less likely to go for preventative health checks with their GP.
A healthy diet and increasing exercise
A healthy diet and plenty of exercise is the key to not only living with Type 3 diabetes but also preventing Type 2 diabetes. This is often harder to achieve in the increasingly busy lives that we live. It is easy to hide behind our hectic lifestyles to avoid healthy eating and exercise. One quote comes to mind “We can either eat food as a medication or eat medications as food”. The choice is entirely ours and even simple things like swapping the lift for stairs, or in my case swapping my car for walking when I can, are small ways of behavioural change that help make that difference.
Living with Type 2 diabetes
There are many challenges living with diabetes such as planning when I should eat, what I should eat and not skipping my medications or my mealtimes in order to keep my sugar levels on an even keel. In a strange way diabetes has allowed me to become more aware of what I eat. But it has not made me change my life.
Currently as I write this I am in India waiting to start a tour of the Indian wilderness working in a lion sanctuary where I will be conducting diabetes checks for forest rangers who live in isolated regions and are at high risk of diabetes.