Special Report: You have constant decisions to make on your medication and you never have a day off'
November is diabetes awareness month... so since sufferers make up more than one in 20 of the UK population, here's some awareness about the condition
My fingers are full of holes. This is an unofficial way of checking if someone you know is a type one diabetic.
A friend of mine, who is also a ‘person living with type one diabetes’ (PC terminology henceforth discarded for brevity) has a stark message to people who might not grasp the unique nature of the condition.
“You are faced 6,7 or more times day with a number which tells you what you need to do,” she says.
“You have constant decisions to make on your medication, and you never have a day off. It’s 24/7 for the rest of your life.”
Yet because many have very poor understanding of diabetes, when you tell people you can sometimes see them thinking: “Well, I’ve heard about diabetes, and it’s your own fault.”
November is diabetes awareness month, so since we make up more than one in twenty of the UK population, here’s some awareness.
One in ten diabetics are type one, an auto-immune condition where the body’s insulin-producing cells are destroyed, for as yet unclear reasons.
Type ones control our diabetes by insulin injections or pumps, and by checking blood glucose several times a day, hence the finger holes.
Type two is caused by the body struggling to make or use insulin.
It used to be brought on mainly by becoming older, or for genetic reasons, but the main risk factor nowadays is obesity.
It’s usually controlled by a variety of drugs, alongside lifestyle and dietary interventions.
New drugs are appearing to help people with type two lose weight as well as manage their diabetes, but health professionals warn never to underestimate the seriousness of type two diabetes, as potential complications are always a risk.
Sheffield has been a pioneer of life-changing diabetes management courses for type ones (DAFNE), type twos (DESMOND) and young type ones (WICKED), which pass on advice from fellow diabetics along with good practice guidance from health professionals.
Insulin, you learn on the DAFNE course, is like a key to allow the body’s cells to absorb sugar for energy, and you have to do the maths to configure your insulin injections around how the food you eat and the exercise you do works in your own body.
More maths is required to cope with confounding factors like viruses, stress and heat. If you get it right, your long term blood glucose level will stay reasonably close to that of a non-diabetic, and you’ll be less at risk of complications.
Get it wrong, and low blood sugars can plunge you into a ‘hypo’ where your brain (and often your limbs) can stop working properly until someone gives you glucose tablets or jelly babies (both of which work quicker than standard sugar).
The cost of diabetes to the NHS is phenomenal: over £250 million a week is spent primarily on complications (including kidney, heart, circulation and eye disease), which cost the country several times more than the drugs, insulin and monitoring equipment we use to try and avoid those complications.
Veteran diabetics like me also bang on about the zero cost drugs of exercise like running, walking and cycling which help insulin work more efficiently to keep all those heart, eye and kidney issues at bay.
There was national type one excitement earlier this month when the NHS announced a willingness to allow ‘flash glucose monitors’ on prescription, finally bringing Star Trek technology to our health services.
You attach a small round sensor to your arm then, like Dr McCoy, wave your monitor at it to reveal your glucose reading (and crucially, whether it’s going up or down) without spilling blood.
Type ones say this is as big a deal as the change 35 years ago when we could stop urinating in a test tube and instead learn how we are by use of those finger pricking blood tests. A local decision is yet to be made.
Flash glucose monitors will give more of us the confidence to exercise more often, help us keep blood sugars normal, stave off complications and thus save the NHS a fortune.
I’m keeping my holy fingers crossed.
THE FACTS ABOUT DIABETES
More than 3 million people in the UK are diagnosed with diabetes - of these about 270,000 have type 2 diabetes and around 300,000 are suffering from type 1 diabetes
China has the largest diabetes population, with 90 million diabetes sufferers
There are three types of diabetes - type 1, type 2 and gestational diabetes
World Diabetes Day is on November 14th every year
Famous people with diabetes include the actor Tom Hanks and Prime Minister Theresa May