What is diabetes?
Diabetes is a condition where the body has difficulty controlling the amount of sugar in the blood. This happens because you are either not producing enough insulin or the insulin you are producing doesn’t produce the response it should – known as becoming insulin resistant.
What is insulin, and why is it important?
Insulin is a hormone or a ‘messenger chemical’. It’s produced by your pancreas (an organ just underneath your stomach) and it helps to lower the level of sugar in your blood.
When we eat food containing carbohydrates, your digestive system turns this into sugar (glucose) which is absorbed into the blood. This sugar is used as fuel by your cells, providing you with energy. Insulin acts to move sugar from the blood into your cells. It may be helpful to think of insulin as the “key” unlocking the door to the cells.
The body is constantly working to keep the level of sugar in your blood within a certain range, as too high or too low can be harmful. The body uses insulin and other hormones to keep your sugar levels in this range.
When blood sugar levels go up, your body produces insulin to move sugar into cells and prevent the blood levels getting too high. When the body cannot produce insulin, or when cells do not respond to insulin, blood sugar levels get too high. Over time this high sugar level can cause harm, and this is the condition known as diabetes.
What’s the difference between type 1 and type 2 diabetes?
There are two main types of diabetes (type 1 and type 2) and they are very different conditions.
Type 1 diabetes is not common, and makes up about 10% of total cases of diabetes in the UK. With type 1 diabetes the body is not able to make insulin because the cells of the pancreas that normally produce insulin have been destroyed by the body’s own immune system. We don’t entirely know why this happens in some people and not others, but it typically occurs in younger people.
Type 2 diabetes is more common and makes up about 90% of total cases of diabetes in the UK. It is usually developed later in life, although it can affect people of any age. In type 2 diabetes the pancreas still has the ability to produce insulin, but it may not be producing enough or the body may have stopped responding well to the insulin that is being produced.
Again we don’t entirely know why this happens in some people and not in others, though the strongest risk factors are family history and obesity, and it is more common in certain ethnic groups such as South Asians.
The information in this Live Well with Diabetes program is for people with type 2 diabetes, and from now on we will use the term diabetes to refer to type 2 diabetes only.
What you can do to improve your health if you have diabetes
Early in type 2 diabetes the body still produces some insulin. With lifestyle changes such as losing weight with healthy eating habits and taking part in regular physical activity, the body can respond better to this insulin, and your blood sugar levels can improve.
Unfortunately over the course of time in diabetes the ability of the body to produce insulin decreases and blood sugar levels can get too high again. Because of this your doctor will often add medications to help increase your levels of insulin, or your body’s response to the insulin you already produce. Keep in mind this can happen even if you make significant changes to your lifestyle, so it doesn’t mean you have failed at improving your diabetes. Also even if you are on medications remember maintaining a healthy weight and regular physical activity is still very important to help the body respond to insulin, and it can help reduce the amount of medication you need even when you have had diabetes for many years.
When you are first diagnosed and every year afterwards your GP and diabetes nurse will work with you to develop a care plan, a clear guide on how best to look after your diabetes that will include goals such losing weight or stopping smoking. Your GP and diabetes nurse are there to support you and answer any questions you may have, though it is important to remember seeing the medical team is only a small part of managing your diabetes, and learning to self-manage your condition can avoid the complications that can occur in diabetes.
Debunking diabetes myths
1. You can only eat “diabetic” foods
MYTH. You can eat a wide variety of foods. Special “diabetic” foods are not necessarily better for you. In fact, they can often be sweet foods, like biscuits and chocolates and are high in fat and calories. If you want to occasionally treat yourself, go for the real thing!
2. Fruit is off-limits because it contains too much sugar
MYTH. You can enjoy Fruit! Since it is a carbohydrate, though, remember to choose moderate portions and spread your servings throughout the day.
3. If your doctor prescribes you insulin, you now have type 1 diabetes
MYTH. Type 1 and type 2 diabetes are very different diseases. Many people with Type 2 diabetes use insulin to control their blood sugar. One type of diabetes cannot turn into another!
4. All diabetes medications cause weight gain
MYTH. Each class of diabetes medications works differently in the body. Some can actually help in losing weight, though others can cause weight gain. Talk to your doctor or diabetes nurse about any concerns you might have.
5. You won’t be able to play sport
MYTH. Keeping active is an important part of a healthy lifestyle and can help to reduce the risk of diabetes complications such as heart disease. However, there may be some considerations to take into account before taking up a new exercise regime, so please talk to your doctor or diabetes nurse if you are unsure.
6. Type 2 diabetes is a mild form of diabetes
MYTH: There is no such thing as mild diabetes. Diabetes is a medical condition that can lead to serious and even life threatening complications. Managing your diabetes in partnership with your medical team can help avoid these complications.
7. People with diabetes are more likely to get colds and other illnesses
MYTH. While there is some medical research that may suggest people with diabetes are at higher risk of developing illnesses, there’s nothing to prove this conclusively. The key thing to remember is that being unwell can affect your blood sugar levels and require changes in your medications. Please ensure you have a plan from your GP or diabetes nurse if you do become unwell, and get in contact with them early if you are unsure of what to do.