The Increasing Threat of Diabetes Mellitus. What does it mean to our Health, and the NHS?

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A 2016 statistic found that over 3 million people in the UK alone are currently living with Diabetes Mellitus, with England contributing to over 80% of this statistic. Considering Diabetes costs the NHS over £10 billion pound a year, and this figure is expected to rise, isn’t it about time we do something about it?

What is the difference between Type 1 and Type 2 Diabetes?

It is too easy to assume that Diabetes consists of just one disorder that is ‘Diabetes Mellitus’ when in fact there are numerous kinds including Type 1, Type 2, Diabetes Insipidus and Gestational Diabetes. Diabetes Mellitus is characterized by an inability to react or produce the hormone Insulin. Insulin is a hormone released by the Beta Cells contained within the Islet of Langerhans located in the Pancreas. Insulin encourages a transporter named ‘GLUT4’ to move to the cell wall and remove glucose from the blood. A clinical sign of Diabetes in any form is a high blood glucose concentration at all times. Below is a table comparing fasting glucose concentrations of a non-diabetic person and a diabetic person.

Category

Fasting Glucose Blood Concentration (mmol/L)

Average Non-Diabetic Value

4.5 - 6.0

Average Diabetic Value

>7.0

Table 1: Fasting Glucose Values 

TYPE 1

In simple terms the Type 1 form (T1DM) is when the pancreas fails to produce any Insulin. This is thought to be an inherited autoimmune condition. This means that the body’s immune system attacks the Beta Cells so they are no longer able to produce Insulin. There is very little positive evidence answering how or why the body does this but we are making gigantic leaps towards finding the definitive answer. Treatment for TD1M usually focuses on relieving the symptoms of the disease, as we currently have no cure. Additionally, they will undergo Hormone replacement therapy that will replace the Insulin they are unable to produce themselves.

Risk Factors for this form of Diabetes include:

  • A 1st generation relative with Type 1 Diabetes.
  • Pre-existing autoimmune disease 

TYPE 2

Type 2 Diabetes is much more common than Type 1, with over 90% of the population of Diabetic people coping with symptoms of this form. Type 2 Diabetes (T2DM) occurs when pancreatic Beta Cells don’t produce enough Insulin to cope with dietary carbohydrates, or the body doesn’t react to the Insulin made. This can be brought on by Glucose intolerance, caused by the body being bombarded with continuously high levels of sugar. One of the main causes of T2DM is obesity. As obesity in the UK has reached an all time high it is clear to see why prevalence of T2DM has followed suit.

Risk Factors for this form of Diabetes include:

  • Being Obese or Overweight
  • Sugar-laden diet
  • Middle aged (+40 years)
  • Central distribution of fat deposits
  • Family members with Diabetes
  • Ethnicity (South Asian, Chinese and African Caribbean)

Gestational Diabetes

‘Gestation’ refers to a time in which a woman is carrying a foetus, thus Gestational Diabetes occurs during the 9 month gestation period and disappears after this point. It should be made clear that any woman can develop Gestational Diabetes but there are some factors that puts a woman at greater risk.

  • Family members that have also had Gestational Diabetes
  • A BMI indicating Obesity
  • Ethnicity (South Asian, Chinese, African-Caribbean)
  • Birth of previous child weighing more than 10lbs when born.

Gestational Diabetes can have great effect on your pregnancy. If you do suffer from this, be mindful that you are at greater risk of premature birth, pre-eclampsia, excess amniotic fluid and Infant Jaundice [6].

Whether the cause is modifiable or non-modifiable Diabetes is putting a strain on our NHS, demanding more from Healthcare professionals, clinics and funding.

What are the Symptoms of Diabetes?

Typical symptoms of Diabetes Mellitus are:

  • Constant Thirst
  • Easy to Fatigue
  • Frequent Urination
  • Slow Wound Healing
  • Poor Vision etc. 

What are treatments are available?

Drugs

The predominant treatment recommended for Diabetics is lifelong Insulin replacement therapy or drugs. The most common drug is Metformin, however the person may also be prescribed Glitazones, Sulphonylureas or specific peptidase inhibitors.

Diet

Particularly in the case of Type 2 Diabetics it is important to control the diet and weight as majority of the symptoms can subside if properly controlled. For Type 1 diabetics this is also important as careful consideration of sugars and carbohydrates will ensure that the drugs work to the best of their abilities. People with Diabetes should consider the following:

  • Only eat wholegrain, brown or granary carbohydrates instead of white varieties. White varieties are laden with fast release sugars that cause a rapid and large glucose peak which is not well managed in a diabetic body.
  • Increase your fruits and vegetables, ensuring they are low sugar varieties.
  • Avoid high saturated fat foods such as crisps cakes and chocolates.
  • Reduce your alcohol intake as it is rich in refined, fermented sugars
  • Also be mindful of your weight. Being overweight or obese can bring on symptoms of pre-diabetes or worsen symptoms. Eating well and being considerate of healthy living can reduce your risk or symptoms of Diabetes.

Moreover there are excellent supplements that are on the market that are targeted at common symptoms of Diabetes. The most beneficial to Diabetics would be:

Garlic Tablets. Garlic is well known to control and regulate the levels of glucose in the blood. Additionally, it has been shown to reduce the risk of coronary heart disease a comorbidity of Diabetes.

Vision Care Tablets. Any supplement or tablet formulated to promote eye health and prevent eye ageing is beneficial to diabetic health. High blood pressure among other side effects of Diabetes are responsible for the reduction of visual quality. Find a tablet that contains atleast one of the following ingredients, Lutein, or Vitamin A, and an antioxidant such as Bilberry, Grapeseed extract or Vitamin C.

Chromium/White Kidney Bean. Kidney Bean extract is rich in Chromium which is trace mineral responsible for regulating glucose. It does so by helping to form the glucose tolerance factor (GTF) which helps regulate glucose uptake into the cell. Thus controlling blood glucose concentration and providing more energy rich substances in the cell to reduce fatigue.

Exercise

Exercise is also important when avoiding or improving symptoms. You are recommended to do atleast 30 minutes, 5 times a week of moderate exercise (cycling walking or jogging), or 75 minutes per week of vigorous exercise (weight lifting or team sports).

Other Tips

There are other commodities to Diabetes such as:

  • Cardiovascular disease (Atherosclerosis, Stroke)
  • Ulcerations
  • Blindness
  • Yeast Infections
  • Kidney Disease.

Therefore it is important to invest in good healthcare whether that be private or from the NHS. Ensure you get regular eye, blood lipid, blood glucose and blood pressure check ups. Ensure that you take regular courses of medication, and receive your annual flu jab. Finally, seek medical and nutritional advice from your local Nutritionist, Dietitian, or GP.

Having one of the risk factors doesn’t condemn you to getting Diabetes, nor does it have to worsen any symptoms of it, if you already have the disorder. Take steps towards a healthier you, today.

  1. Diabetes UK. (2016). State of the Nation 2016, Time to Take Control of Your Diabetes. Available: https://www.diabetes.org.uk/Documents/Position%20statements/Diabetes%20UK%20State%20of%20the%20Nation%202016.pdf.
  2. NHS. (2016). Diabetes. Available: http://www.nhs.uk/Conditions/Diabetes/Pages/Diabetes.aspx.
  3. Mann,J. (2012). 23: Diabetes Mellitus and the Metabolic Syndrome. In: Mann,J. Truswell,S. Essentials of Human Nutrition. 4th ed. Oxford: Oxford University Press. Pg. 375-393.
  4. NHS. (2015). Type 1 Diabetes. Available: http://www.nhs.uk/Conditions/Diabetes-type1/Pages/Introduction.aspx.
  5. NHS. (2015). Type 2 Diabetes. Available: http://www.nhs.uk/conditions/diabetes-type2/pages/introduction.aspx.
  6. NHS. (2016). Gestational Diabetes. Available: http://www.nhs.uk/Conditions/gestational-diabetes/Pages/Introduction.aspx#close.
  7. Brewer, S. (2002). Diabetes. In: Grapevine Publishing Services The Daily Telegraph Encyclopediaof Vitamins, Minerals and Herbal Supplements. . London: Constable & Robinson. Pg. 407-409.

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