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Diabetes

Diabetes is a chronic condition that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. There are two basic forms of diabetes:

• Type 1: people with this type of diabetes produce very little or no insulin.
• Type 2: people with this type of diabetes cannot use insulin effectively. Most people with diabetes have type 2.

A third type of diabetes, gestational diabetes mellitus, develops during some cases of pregnancy.

Who gets it and how serious is it?

The older you are the more likely you are to get diabetes. Pregnant women are also at risk: 2-5% of pregnant women get gestational diabetes and 40% will go on to have diabetes later on. Diabetes is also getting more common. This increase is linked to the rise in obesity levels. 

More than three quarters of people with diabetes have type 2. It is more common in people who are very overweight and for this reason the number of children with type 2 diabetes is increasing.

Symptoms of diabetes include needing to urinate frequently, feeling very thirsty, feeling very hungry or tired, and losing weight without trying.

Type 2 diabetes means that symptoms can appear over several years, but many people don’t actually have symptoms.

People with type 1 diabetes experience the symptoms quite suddenly, over a few days or weeks.

If diabetes is not treated it can lead to many different health problems. This is because large amounts of glucose can damage the blood vessels, nerves and organs.

Even a mildly raised glucose level that does not cause any symptoms in the short-term can affect the blood vessels, nerves and organs in the long-term. This may lead to complications often years after the diabetes was first diagnosed.

Complications include heart disease and stroke, retinopathy (damage to the retina at the back of the eye), kidney disease, foot problems and impotence in men.

In general, the risk of developing complications is greatly reduced if the blood glucose level is well controlled and if other risk factors, particularly high blood pressure and high cholesterol are controlled.

Pregnant women with diabetes are at increased risk of miscarriage and stillbirth. 

Treatment

Diabetes cannot be cured, but it can be controlled. Type 1 diabetes is controlled by taking insulin regularly, exercising regularly, watching what you eat, and checking your blood glucose level throughout the day. 

The best way to control type 2 diabetes is to keep your blood glucose levels as close to normal as possible by watching what you eat and exercising regularly. The doctor should measure your average blood glucose level every couple of months.

Diabetes tablets, such as metformin, sulphonylureas and meglitinides, are also taken to control diabetes. Insulin is another option to the tablets, but may increase the chance of getting hypoglycaemia more often and cause weight gain.

How common is it?

More than 2 million people in the UK have diabetes and another 1 million probably have diabetes but don’t know it. The 2003/5 Welsh Health Survey asked adult respondents if they were currently being treated for diabetes (by injection, tablets or diet).

Analysis of the data by LHB area shows reported prevalence (persons aged 16+) to be lower in the north region and higher in the south, with estimated prevalence ranging from 2.9 per cent to 6.6 per cent with an All-Wales average of 5.3 per cent.

Prevention    

You may be at risk of developing type 2 diabetes if it runs in your family or if you are overweight and don’t get a lot of exercise. The best thing you can do to try and prevent diabetes is to eat a healthy diet and take regular exercise.

A healthy diet is one that is low in saturated fat, salt and sugary snacks and drinks. Try to eat regular meals throughout the day to keep your blood-sugar level constant and eat at least five portions of fruit and vegetables every day. Stop smoking and reduce your alcohol intake. If you have diabetes, you can still eat foods such as chocolate and sweets as long as you keep your overall diet healthy.

Ideally you should take thirty minutes of exercise at least three times a week. However, regular exercise does not have to be a chore; you can make sure you keep active by walking instead of taking the bus and using the stairs instead of the lift.

Minimising impact in Wales

The Health Information Analysis Team of the NPHS collates data on the levels of diabetes in the Welsh population: Health Needs Assessment 2006: Health Status and Key Determinants. Such data allows significant trends and any particular groups of the population affected to be identified, and enables effective delivery of high quality, accessible and appropriate specialist public health services, both in partnership and support of other national and local bodies.

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