This
week and next (as it’s such a large topic) I wanted to talk about the facts
behind the alarming headline that was splashed all over the news and media on
Monday – it was reported that Diabetes in the UK had increased by 60% in the
last decade and treating this increase would basically destroy and bankrupt our
entire NHS…..so I figured we should look a little more at diabetes – its types,
its symptoms, those at risk, the correlations between health/weight and
diabetes, worse-case scenario outcomes and then prevention vs end stage
medication (and NHS spending) and of course take a look and what we can do to
help ourselves avoid diabetes.
“60% rise in diabetes cases in the
last decade”
As this is no nonsense let’s start
with the initial report from diabetes.org.uk:
And here are how a couple of the
papers reported the new statistics:
The
Guardian (http://www.theguardian.com/society/2015/aug/17/diabetes-bring-down-nhs-charity)
have quoted a lot of the initial report, whereas the Independent (http://www.independent.co.uk/life-style/health-and-families/health-news/diabetes-could-bankrupt-the-nhs-after-60-rise-in-number-of-cases-charity-warns-10458353.html)
has lead with the cost factor and used words and phrases such as “bankrupt”, “amputations”,
“stroke”…. Using shock language and looking at worse-case scenarios on all
counts for the health system and for people with diabetes. Both are great reports and both give the
facts and figures. Maybe it takes
sensationalism to make it to our conscious and get us talking about it, maybe
with all repots just giving the facts and figures this would have passed the
general population without issue, so I’m grateful for a little doom and gloom
and the splashing of disaster headlines sometimes to raise awareness.
In
any case and via any reporting what we can see is that there has been a 60%
increase in those diagnosed with diabetes in the last 10 years in the UK. I imagine this could be due to a number of
factors including for example
1) the
rate of diagnoses has increased due to better methods of diagnoses
2) the
rate of awareness has increased leading to more people being tested and therefore
more diagnosed 3) even with 1 and 2, we can see the disease is on the increase
Looking
more closely at number 3 I wanted to look at why diabetes is on the rise, what’s
causing this rise and the correlation therefore between risk factors such as health,
weight, obesity and diabetes.
Next week we will look
further into these risk factors (as well at those at a higher risk due to age,
ethnicity, gender), then into symptoms, outcomes, treatments and prevention and
what we can do.
This
week to start with I wanted to just give an overview of diabetes.
Types of diabetes:
For a
start let’s break it down – there are 3 types of diabetes – TYPE 1 and TYPE 2
and Gestational Diabetes. Here is
a handy video from www.diabetes.org.uk that helps explain what happens when you have diabetes in no nonsense
terms that we love:
The
following info is from www.nhs.uk and simply identifies each type.
Firstly: “Diabetes is a lifelong condition that causes a person's blood
sugar (glucose) level to become too high. The hormone insulin – produced
by the pancreas – is
responsible for controlling the amount of glucose in the blood”.
Type 1 Diabetes
– where the pancreas doesn't produce any
insulin
Type 2 Diabetes
– where the pancreas doesn't
produce enough insulin or the body’s cells don't react to insulin
Gestational Diabetes - occurs in
some pregnant women and tends to disappear following birth
For the purpose of this blog (and next weeks) we
will only be focusing mainly on type 2 diabetes as this is on the increase,
this is the type the NHS is spending the most amount of money on and this is
type we may well be able to help ourselves prevent.
Type 1:
“In type 1 diabetes, the body's immune system
attacks and destroys the cells that produce insulin. As no insulin is produced,
your glucose levels increase, which can seriously damage the body's
organs. Type 1 diabetes is often
known as insulin-dependent diabetes. It's also sometimes known
as juvenile diabetes or early-onset diabetes because it usually develops
before the age of 40, often during the teenage years. Type 1 diabetes is
less common than type 2 diabetes. In the UK, it affects about 10% of all adults
with diabetes. If you're diagnosed with type 1 diabetes, you'll
need insulin injections for the rest of your life”.
It's
important that type 1 diabetes is diagnosed as early as possible, so that
treatment can be started as quickly as possible. Type 1 diabetes can't be
cured, but treatment can blood glucose levels as normal as possible and control
symptoms, to prevent more health problems developing later in life. With type 1, your body can't produce insulin
so you will need regular insulin injections to keep your glucose levels normal.
With treatment, you will be shown how to do this and how to match the insulin
you inject to the food you eat, taking into account your blood glucose level
and how much exercise you do.
Type 2:
“Type 2
diabetes is where the body doesn't produce enough insulin, or the body's cells
don't react to insulin. This is known as insulin resistance. If you're diagnosed with type 2 diabetes,
you may be able to control
your symptoms simply by eating a healthy diet, exercising regularly, and
monitoring your blood glucose levels. However,
as type 2 diabetes is a progressive condition, you may eventually
need medication, usually in the form of tablets. Type 2 diabetes is often
associated with obesity. Obesity-related diabetes is sometimes referred to as
maturity-onset diabetes because it's more common in older people”.
As with type 1, there is no cure for type 2 diabetes, however if you're
diagnosed, you may be referred to a diabetes care team for specialist
treatment, or your GP surgery may provide first-line diabetes care as in some
cases, it may be possible to control type 2 diabetes symptoms with lifestyle
changes, such as eating a healthy diet and taking regular exercise (which we
will focus more on next week). However, as type 2 diabetes is a progressive
condition, you may eventually need to take medication to keep your blood
glucose at normal levels. This may be in the form of tablets initially, but
move on to injected insulin at a later stage.
This is where the cost factor to the NHS comes in as the disease is both
incurable and degenerative, so preventing and managing symptoms for as long as
possible with a healthy diet and lifestyle will keep us fitter, healthier and
lower our risks at the same time as saving the NHS money.
NICE care
processes:
You will see from the news articles and the initial
report from diabetes.org.uk that there are 8 NICE (The National Institute for Health
and Care Excellence) recommended care processes recommended to the NHS to use
when monitoring patients at risk or
diagnosed with type 2 diabetes. These
tests are completed annually and these functions are what we can try to prevent
increasing with the use of diet, exercise and lifestyle change:
1) Measuring the effectiveness of diabetes treatment
with blood test
2) Measuring cardiovascular risk factors (such as
blood pressure)
3) Monitoring cholesterol
4) Checking your BMI – Body Mass Index
5) Cutting down / out smoking
6) Monitoring early complications: eye screening and
foot health
7) Checking urine serum albumin (a protein made by the
liver, the main protein of blood plasma)
8) Creatinine – testing kidney function
So these are the no nonsense basics – if you are
interested you can find the full audit for care process and treatment targets in the resources section here (downloadable as a PDF): http://www.hscic.gov.uk/catalogue/PUB14970
So, after establishing these basics behind the headlines, next week we will
look at:
- Type 2 diabetes risk factors and those at higher risk
- Type 2 diabetes symptoms
- Treatment and worse case outcomes of type 2 diabetes
- The correlation/link to obesity
- And finally prevention vs end stage medication ie things we can do in relation to our own health, weight loss, exercise and lifestyle factors - things we can change now to prevent type 2 diabetes
I hope that’s been interesting so far and given an overview of the
diabetes basics – if you want more info you can take a look at www.diabetes.org.uk ; www.diabetes.co.uk and www.nhs.uk or of course contact us at info@nitakothari.com
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