What is diabetes?

Diabetes is a chronic condition as a result of too much glucose in the blood also known as diabetes mellitus. There are different types of diabetes that can affect people of different ages and one of them is type 1 diabetes where the body does not form any insulin, it often occurs in children/teenagers before the age of 40. Type 2 diabetes occurs when the body does not produce enough insulin (insulin resistance) and it tends to be more common than type 1 diabetes (1).
Pre diabetes occurs when blood glucose levels are too high but do not meet the criteria for diabetes and one is therefore considered at risk of diabetes and cardiovascular disease. Pre diabetes is a risk factor. The clinical diagnostic tests for diabetes/prediabetes include the measurement of glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) or the 2-hour glucose concentration after a 75-g oral glucose tolerance test (OGTT) (2).
Gestational diabetes occurs during pregnancy and results in increased blood sugar levels and tends to diminish after birth, if it is detected early risks can be managed and reduced (3).
Insulin is the hormone made in the pancreas responsible for controlling blood sugar (glucose) levels. Those with diabetes require treatment to control their blood sugar levels. In type 1 diabetes treatment involves insulin injection and diet modification. In Type 2 diabetes treatment includes diet, weight control and exercise and tablets will be considered if blood sugar levels remain high. Type 2 diabetes is also becoming apparent in younger adults and in children (4).
Some of the symptoms of diabetes include feeling very thirsty, extreme tiredness, weight loss, blurred vision and peeing more than usual especially at night. It is advised to see your GP if you experience any of these symptoms (5).

Statistics

Diabetes is a major cause of blindness, heart attacks, stroke, kidney failure and lower limb amputation and if not treated can be life threatening. More than 95% of people have type 2 diabetes and in 2019 an estimated of 1.5 million deaths were directly cause by diabetes and it was the 9th leading cause of death (6).
On a positive note, consuming a healthy balanced diet, regular exercise, avoiding smoking and maintaining a healthy body weight are ways to prevent or reduce the onset of type 2 diabetes along with medication, regular screening and treatment.
According to Diabetes UK more than 4.9 million people in the UK have diabetes, 13.6 million people are now at risk of type 2 diabetes and modifying lifestyle with sustainable interventions is an effective way to reduce type 2 diabetes by 50%. Diabetes also costs the NHS billions with spendings of at least 10 billion a year by the NHS on treating diabetes alone (7).

What are the risk factors?

People suffering with diabetes are at a larger risk of chronic health conditions some of which include depression, blindness and cardiovascular disease.
Being overweight or obese is a changeable risk factor for type 2 diabetes and at present 90% of adults with type 2 diabetes are obese, deprivation and those from black, Asian and minority ethnic groups tend to be at risk of type 2 diabetes in comparison to white European populations (8).
According to Public Health England Obesity is fuelling a rise in type 2 diabetes, along with deprivation, family history of type 2 diabetes, age and certain ethnicities impacting quality of life and social contact (9).

Diet & Nutrition

There is no specific diet for diabetes but the main factor is to consider having a varied balanced diet incorporating a variety of foods from the main food groups including fruit and vegetables, starchy foods, protein foods, dairy and alternatives and oils and spreads (10).
A report from the Scientific Advisory Committee on Nutrition (SACN) shows that a diet in lower carbohydrates can be a good option in treating type 2 diabetes and obesity for a short-term period of up to 6 months. However, health professionals should support any evidence-based dietary approach that helps achieve long-term weight loss, and this can include a lower carbohydrate diet. It is essential that people get the support of their healthcare team, so that any impact on diabetes management or medications can be closely assessed (11).
With type 1 diabetes carb counting is essential to maintain blood glucose levels in accordance with insulin management. Overall, when it comes to diabetes it is important to make healthier food choices and focus on lifestyle changes (12).
Opting for complex carbohydrates high in fibre, reduce salt and processed red meat, opt for a variety of fruit and vegetables, include unsaturated fats such as olive oil, oily fish and avocados, cut down on added sugar and saturated fats, healthier snacks and portion size control, reduce alcohol consumption and keep physically active are some ways to help manage glucose control and improve overall health12).
Certain dietary patterns linked with reduced risk of type 2 diabetes include the Mediterranean diet, DASH diet, vegetarian and vegan diets, the Nordic healthy diet and moderate carbohydrate restriction (13).

Prevention & Treatment

Structured diabetes education programmes are recommended to be clinically effective for those with type 1 and type 2 diabetes and nutrition management is suggested as part of an inclusive package including clinical care and education for those with diabetes and those at risk of type 2 diabetes. Nutritional advice by a registered dietitian, structured education and a person-centred approach are recommended (14).
Whilst type 1 diabetes cannot be prevented, typed 2 diabetes can be through lifestyle changes. The NHS diabetes prevention programme is an evidence-based programme for those at risk of type 2 diabetes delivered in a group setting and can be done virtually (15).
Type 1 diabetes includes insulin via injection or pump and with type 2 diabetes you may require insulin or tablets such as metformin however lifestyle changes are recommended for type 2 diabetes (16)
There are several courses for those with diabetes these include DESMOND, X-PERT and DAFNE and can be done face to face or online, always speak to your GP regarding any issues you are facing with diabetes and ask about free diabetes education (17).

Support

Diabetes UK is a charity to support those affected by diabetes- https://www.diabetes.org.uk/about_us
Diabetes UK have a dedicated helpline for those with diabetes - 03451232399

NHS provides information for those with Diabetes - https://www.nhs.uk/conditions/type-2-diabetes/finding-help-and-support/
BDA provides resources on Diabetes - www.bda.uk.com/resource/diabetes-type-2.html
Always consult your GP for further support/resources available

With pioneering research diabetes treatment has become advanced, whilst there is no cure small changes in lifestyle can make a difference to your health and diabetes can be managed through appropriate treatment and management.

To learn more - check out this list of diabetes resources we have produced!

Article written by: Gopika Chandratheva (RNutr) @gopis_nourishingrecipes

References

1 https://view-health-screening-recommendations.service.gov.uk/diabetes/

2https://academic.oup.com/jcem/article/101/7/2628/2810090?gclid=CjwKCAjw14uVBhBEEiwAaufYx_kIy8fjemlwlUVYgaRxFnzod81h6qnNVeBRFNJssNVj1Z1EWXEz-BoCaQgQAvD_BwE

3 https://www.nhs.uk/conditions/gestational-diabetes/

4 https://patient.info/diabetes/type-1-diabetes/insulins

5 https://www.nhs.uk/conditions/diabetes/

6 https://www.who.int/news-room/fact-sheets/detail/diabetes

7 https://www.diabetes.org.uk/professionals/position-statements-reports/statistics

8https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/338934/Adult_obesity_and_type_2_diabetes_.pdf

9 https://www.gov.uk/government/publications/health-matters-preventing-type-2-diabetes/health-matters-preventing-type-2-diabetes