There are 3.8 million people in the UK living with diabetes. Diabetes is a serious, lifelong condition that can cause significant health problems unless it’s properly managed. We all know it’s got something to do with blood sugar, insulin, and needles - but do you really know what? What symptoms you should be aware of? What to do if someone you know with diabetes needs your help?
So here’s every question you’ve ever had about diabetes, but were too afraid to ask.
What is diabetes?
When we eat, food is broken down into glucose (sugar) and released into our blood. When our blood sugar goes up, it triggers the pancreas to release a hormone called insulin. Insulin allows the glucose to enter our cells and be turned into energy we can use.
People who have diabetes don’t produce enough insulin, or can’t use the insulin they do produce. Without enough insulin, too much blood sugar stays in the bloodstream. Over time, that can cause serious health problems, such as heart disease, sight loss, and kidney problems.
There are two main types of diabetes, type 1 and type 2.
What is type 1 diabetes?
Type 1 diabetes happens when your body starts attacking the cells in your pancreas that make the insulin. That means that although your body can break down the carbohydrates you eat into glucose, there’s no way of actually getting it into your cells. Glucose builds up in your bloodstream causing high blood sugar levels.
Around 8% of diabetics in the UK have type 1 diabetes.
What are the symptoms of type 1 diabetes?
Symptoms can develop quickly, and it’s usually diagnosed in children and teenagers. One of the first things your body will do is to try and get rid of the extra glucose in your system through your kidneys. So weeing a lot, and being very thirsty are two of the main signs to look out for.
Other symptoms include losing weight without trying to, blurred vision, fatigue, general itching or thrush, and your body taking longer to heal cuts.
These symptoms can come on fast – particularly in children – sometimes over a matter of weeks. It’s important to get to a Dr quickly if you recognise any of them.
How is type 1 diabetes managed?
People with type 1 diabetes will need to learn to manage their blood sugar and insulin. That usually means injecting insulin every day, and regularly checking your own blood sugar levels.
The problem is that different things in your day will affect your blood sugar – and therefore how much insulin you need. It’s not just about what you eat. A stressful day at work can make your blood sugar rise with your adrenaline, as can illness and exercise. A late night, a late lunch, or extreme hot or cold can all make blood sugar fall.
Other treatments for type 1 diabetes include insulin pumps, small electronic devices which deliver insulin throughout the day through a tiny tube just under your skin. You may also be able to get an islet transplant, which replaces the insulin-producing islet cells in your pancreas with donor islet cells.
What is type 2 diabetes?
When you have type 2 diabetes the insulin your body makes stops being effective. Around 90% of diabetics in the UK have type 2 diabetes.
Isn’t type 2 diabetes the one you get when you’re too fat?
Lifestyle can be a factor, but it’s not the only one at play. Age can play a part, ethnicity, high blood pressure, genetics (so diabetes in the family), and things like economic status.
Isn’t type 2 milder than type 1?
No, both types of diabetes are serious, lifelong conditions.
What are the symptoms of type 2 diabetes?
The symptoms of type 2 diabetes are the same as for type 1, but often come on a lot more slowly, making them harder to spot. It’s also worth noting that 6 out of 10 people diagnosed with type 2 diabetes didn’t have any symptoms at all.
How is type 2 diabetes managed?
Unlike type 1 diabetes, type 2 diabetes can sometimes be managed through healthier eating, being more active or losing weight. But eventually most people will need medication to bring the blood sugar down to the right levels. Sometimes this can be in the form of tablets rather than injections.
What happens if diabetes isn’t managed properly?
There are lots of long term implications of not having diabetes recognised, treated, or managed correctly, including eye problems, foot problems, nerve damage, heart attack and strokes, gum disease and kidney disease.
All diabetics can suffer from hypos, when their blood sugars are too low, and hypers, when their blood sugars are too high.
One other thing that can also happen is something called diabetic ketoacidosis or DKA, which occurs when your body doesn’t have enough insulin. It’s often how people first find out they’re diabetic.
For people with type 2 diabetics, there is also a danger of Hyperosmolar Hyperglycaemic State (HHS), which is when someone gets very dehydrated and has very high blood sugar levels.
What is a hypo?
Diabetics can experience a hypo – technically known as hypoglycaemia if their blood glucose level is too low.
They will usually feel shaky or disorientated, may look pale or complain of hunger or headaches, and could be anxious, irritable or teary. Lots of people report tingly lips, too.
If you recognise the symptoms in yourself or someone else, it’s important to get a sugary drink or snack quickly to get blood sugar up.
What is a hyper?
A hyper, or hyperglycaemia, is the opposite of a hypo, and can occur when your blood sugar level gets too high. It can happen if someone misses their insulin medication, has eaten too many carbohydrates, is stressed, or even otherwise unwell.
People will usually experience headaches, tiredness, thirst, and may wee more frequently.
It’s really important to keep checking your blood sugar levels so you can make sure you’re getting the right amount of insulin.
What is diabetic ketoacidosis?
If your body can’t use sugar for energy it starts to store fat instead, which releases chemicals called ketones. These can build up and make your blood acidic - and that can be serious if it’s not treated. It can cause people to go into a coma.
Look out for the usual diabetes symptoms, stomach pain, sickness, passing out, and sweet or fruity-smelling breath.
What is Hyperosmolar Hyperglycaemic State?
This is when a type 2 diabetic gets very dehydrated, and has very high blood sugar levels, and it is also a life-threatening emergency.
It can sometimes happen if someone is otherwise ill or fighting an infection, and symptoms include thirst, weeing a lot, dry skin, disorientation, drowsiness and eventually passing out.
How do you help someone with diabetes who is feeling unwell?
If you know someone who is diabetic, it’s well worth talking to them about their condition, what they need from you, and it’s well worth knowing the symptoms of a hypo or hyper.
If someone diabetic passes out, it’s an emergency, and you should call an ambulance, telling them the person is diabetic. It is most likely to be the result of a hypo, and the call handler may direct you to give the person a sugary drink or glucose gel.
Put the person in the recovery position, and stay with them until paramedics arrive.
What do businesses have to do for diabetic people?
If you work in an organisation with 20 or more people, the likelihood is one of them is diabetic.
Under UK employment law, diabetes counts as a disability, because is has a ‘substantial and long-term negative effect’. That means workplaces have to make reasonable adjustments to make sure the environment is safe and the diabetic person can carry out their job.
That might mean letting someone have snack breaks whenever they need them, or letting them eat at their desk. It could mean keeping glucose gel and sugary snacks on hand. It could also mean providing a space (that isn’t the toilet) for someone to do their injections or check their blood sugar levels, or providing a sharps box for the safe disposal of needles.
Almost certainly it will mean employers will have to give a diabetic person more time off for the regular medical appointments they will need to keep on top of their condition.
Employers should also be aware that living with diabetes is hard. And that means it can also cause stress, anxiety and depression. 3 in 5 diabetics in the UK suffer from mental health problems.
Are there other types of diabetes?
Yes. For instance you can get gestational diabetes when you’re pregnant that will need treating for the course of your pregnancy.
How can I check if I’ve got diabetes?
If you have any of the symptoms above, you need to go to your GP, or make an appointment with Equipsme’s 24/7 remote GP under your Equipsme plan.
However, sometimes symptoms can creep up, or like 60% of people you may not have clear symptoms at all. Equipsme members with Level 1 cover or on Solo or Solo Plus plans can get an annual diabetic finger-prick test to do at home, through our health check partner Thriva.
What is a Thriva diabetes test?
The Thriva HbA1c test shows how well your sugar levels have been controlled over the last 3 months. It measures the amount of glucose bound to haemoglobin in the red blood cells, known as HBA1c.
Haemoglobin is the protein essential for transporting oxygen around your body. The amount of HbA1c formed is proportional to the average glucose concentration in your blood. As blood cells live for up to 3 months, the amount of HBA1c can be averaged.
It indicates your risk of diabetes and prediabetes – where the glucose in your blood is high, but still below the level of diabetes diagnosis.
How does a Thriva test work?
Thriva will send you your pack through the post, with full instructions to help you do your finger-prick test from the comfort of your own home. You then pack it up, send it back through the post - and wait about a week for your results to come back.
It’s also worth noting that diabetes is linked to other autoimmune conditions, including coeliac disease and thyroid disease. These can also be checked with a Thriva finger-prick test.
How do I find out more?
There’s lots of support out there for diabetic people and their families. Visit the Diabetes UK website at www.diabetes.org, or the NHS website at www.nhs.uk/conditions/diabetes.