The number of people in the UK who suffer from Diabetes is continuing to rise - especially the number of people who suffer from Type 2, which is sometimes due to lifestyle and sometimes to factors beyond your control. Although Type 1 and Type 2 occur for different reasons, both can cause significant medical complications if they are not managed.
Diabetes UK, for whom I am a regular volunteer, is doing everything possible to increase awareness and help people to successfully live with their condition.
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We are all aware of the problems which have occurred during the pandemic and lockdown. But have you considered what the knock-on effect might be?
As a regular contributor to online meetings, I have heard so many people complain that the past year has had a bad effect on their eating habits and that they have put on weight. People have had less opportunity to get out and have had less exercise - again contributing to their weight issues.
Your risk of developing Type 2 Diabetes depends on a number of risk factors. Some of these you cannot change - such as your ethnic origin. Others you can - such as your weight and hence your BMI. The more overweight you are, the higher your risk of developing Type 2.
We are all aware of the effect of lockdown on the mental health of so many people and how levels of depression have risen. Depression can increase your risk of developing Type 2 - in younger adults it is believed that depression can increase the risk by as much as 25%. And it's a vicious circle - developing Type 2 may well cause depression, even if it was not a factor in the onset of the condition. And of course many people admit that eating more is one of the ways they deal with feeling depressed.
Many people think that what you eat, and how much, is what determines whether or not you put on weight, but that is only part of the picture. When you eat it is also significant. Do you sometimes decide to skip lunch and compensate at teatime? After about 5 or 6pm your metabolic rate starts to fall. Also - what do you do about breakfast? You could try eating breakfast within the first hour or so after getting up. And you should try to avoid things which will cause spikes in your blood sugar level.
Another thing you might consider is Glycaemic Index (GI), which applies to food with carbohydrate (i.e. sugars) in them. The higher the GI, the faster the sugar is absorbed. However, it can be misleading - some foods with a high GI are healthy and some with a low GI are not. And because fat lowers GI, chocolate actually has quite a low GI rating. Another point to consider - for example - what about bread? Different types of bread have different GI values - multigrain bread tends to have a lower GI than plain white bread. You might decide to experiment - some people find that eating food with a lower GI leaves them feeling fuller for longer, which of course means they are less likely to snack during the evening.
And finally consider alcohol. You may be surprised by the number of calories in some types of alcohol. For example, a litre of vodka contains about 2,200 calories. Drinking one pint of a 5% beer will give you about the same number of calories as a standard Mars Bar.
It's a complicated subject and if you feel it impacts on your life you might want to seek expert advice. Hopefully though I've given people a few pointers for them to start to consider.
When I was diagnosed, I spent three weeks in hospital. When I was discharged, I went home with the things I needed to both treat and monitor my diabetes.
Like most people with Type 1 Diabetes, I had a glass syringe and a handful of stainless steel needles. I stored these in surgical spirit in a glass butterdish. Once a week I wrapped the syringe in a hankie and boiled it, together with the needles, for 20 minutes. Whilst it was boiling I discarded the surgical spirit, gave the butterdish a real clean and then filled it with new spirit.
In those days, home blood tests simply did not exist - the only way I could monitor my diabetes was to do a urine test twice a day - see the images below. I would collect urine in a sample bottle and then put measured amounts of urine and water into a test tube. Drop in a tablet and the mixture would quickly start to boil. Once it stopped, I had to shake the test tube and compare it to a colour chart. Dark blue meant that my urine contained no glucose, dark green meant it contained a little. The time to worry was if it was yellow or orange, because then there was a lot of glucose present.
Nowadays life is very different.
In 2015 I stopped doing multiple injectons each day and switched to using an insulin pump - up to that point I had done about 60,000 injections. Now, instead of urine tests, I get a drop of blood from my finger and apply it to a test strip inserted into a special meter. Five seconds later it tells me just how much glucose is in my blood. What's more, if my blood glucose level is high, the meter sends this to my insulin pump, which then automatically adjusts my insulin the next time I am giving myself insulin when I have a meal. The test meter stores several months results and every so often I can send them to my diabetes consultant who then has a detailed picture of how my diabetes has been doing. This has been especially useful during the lockdown.
My insulin pump is about 8cm x 5 x 2.5 and weighs about 150 gms. Now and again I think it's a bit inconvenient with it hanging from my belt or pyjamas 24 hours a day. But then, I look at the image below of the first-ever insulin pump, and try to imagine what it would be like spending your life connected to that!
One of the reasons I have tried to remain in control of my diabetes is because, right from the start, I saw what might happen if you don't, and I did not want to go in that direction.
I was diagnosed a few weeks after my fifteenth birthday. I had a cousin who was a year older than me and he had been diagnosed even earlier - aged nine - and he never paid any attention to the advice given to him by healthcare specialists. It is easy to understand why a chld of nine might rebel - "Why me?" - but it is a real problem if they are still doing it fifteen or twenty years later. He would totally ignore any guidelines about diet - someone with diabetes putting three spoonfuls of sugar into a cup of tea is not a good idea. At regular intervals, he would just decide to stop doing his insulin injections. I lost count of how many times he was admitted to hospital by ambulance, in what at that time was called a "diabetic coma".
Eventually this took it's toll. Whilst in his twenties he suffered two of the most common problems which can occur - with his eyesight and his legs. Before he was thirty he had had one leg amputated near the knee and had had laser surgery on both eyes. The problems with both eyes and legs continued into his thirties and he also developed both heart and kidney problems. He died in his early forties, a few days after refusing the option to have his other leg amputated.
Someone I did not know personally, but know her story well, was a girl who was diagnosed with type 1 when aged eighteen. She totally refused to accept the situation. At one point she said "I don't do needles." She died from complications due to diabetes when aged twenty. Just two years from diagnosis until the day she died.
But enough of the gloom!
In the previous blog I talked about having a long and active life with diabetes. With modern treatment and testing, it is possible to still enjoy the odd naughty treat - it simply needs to be balanced against your insulin. And it is still possible to do most things - I would never have got a pilot's licence, but I still drive an SUV and I tow a caravan. My 25th anniversary of living with diabetes saw me walk from Robin Hood's Bay in North Yorkshire to St Bees Head in Cumbria - Wainwright's famous Coast-To-Coast Walk - 200 miles in two weeks. I've climbed some big mountains across Europe. I've skied in Norway. If you want an example of how the sky really is the limit, look at Henry Slade, a regular in the England Rugby Union team - he too has type 1 diabetes.
People develop the complications if they ignore their diabetes. Do not make that mistake.
2021 sees a double anniversary, one personal to me and the other of global significance.
In March I reach the milestone of having lived with Type 1 Diabetes for 50 years. 2021 is also the centenary of the first successful use of insulin to treat diabetes, although this was in dogs, and it was not successfully used with humans until January 1922. In-between these two anniversaries, there is also national Diabetes Awareness Week, which is always in June and this year runs from the 8th to the 15th.
Although I do not claim to be a saint, I have always tried to draw a sensible line in managing my diabetes. As a result, I have avoided the major complications which can result from diabetes and still lead a very full and active life. Sadly, many people do suffer serious complications, despite having it had it for far less time in many cases.
Over the course of this year, I want to document some of my experiences and also some of the experiences of others I have met. My aim is to try and help other people better manage their diabetes, and to help them avoid the complications which can seriously impact on their lives and can become life-threatening.
At the moment, there are more than 4 million people in the UK who have some form of diabetes – so it is highly likely that you know at least one person who has some form of diabetes. Probably about half a million are not yet aware that they have it. Over the past twenty years the number of people with diabetes has increased significantly, mostly in terms of the number of people who have type 2 – obesity is a common cause of type 2. Moreover, the age at which it is being diagnosed is getting ever lower. It is estimated that about 25,000 people die prematurely each year because of diabetes.
Diabetes UK invests around £30 Million each year in research, towards two goals: to reduce the number of people being diagnosed with type 2 diabetes, and ultimately to find a cure for diabetes. If this sounds a lot, bear in mind that the NHS spends more than this in treating diabetes-related problems every day of the year – each year this amounts to about £14 Billion. On top of this, workdays lost due to diabetes-related problems cost the UK economy a further £15 Billion each year Of the NHS amount, about 60% is spent treating avoidable, type-2-related problems.
Advances made from research will improve the health of people suffering these problems, will reduce the pressure on NHS budgets, and ultimately will reduce the financial burden on every tax-payer in the country. So, if you are able, please consider making a donation to help this cause. You can find out much more by clicking on https://www.diabetes.org.uk/and can also donate via the website.