The Prevention and Management of Diabetes

basset on lead

This week I have been learning about diabetes – its symptoms, its management and what can go wrong.  The subject choice was particularly apt, given the huge attention that the topic has currently been raising within the media.

On 4th July, Diabetes UK revealed that 738 people are being diagnosed with Type 2 diabetes and 30 more with Type 1 diabetes, every day within the UK.  This is equivalent to a massive 280,000 people every year, and with a further 18 million people having pre-diabetes symptoms already.

So, you may be wondering, what is the difference between Type 1 and Type 2 diabetes?  From what I have learnt, Type 1 diabetes is usually diagnosed in the very young and is basically an autoimmune disease in which the body attacks itself.  In Type 1 diabetes the pancreas stops producing insulin and replacement insulin needs to be injected every single day to keep the person alive.  In addition to this, the person’s blood glucose level needs to be monitored before every meal, and their dietary needs and insulin amounts must be adapted to balance these needs.

Type 2 diabetes is usually diagnosed as a consequence of bad lifestyle choices, and needs to be managed through adopting a healthy diet, taking regular exercise and effectively managing weight.  People with Type 2 diabetes do not need to take insulin, as their bodies are still producing it, but are not able to utilise it effectively.

fruit and veg

One of my nurse lecturers commented that when she started nursing 30 years ago, Type 2 diabetes was only diagnosed in the over 40s age group, and was typical of individuals who were ‘fat, forty and middle-aged’.  Nowadays however, it is increasingly common in people as young as 20.  The reason for this is our Western diet and sedentary lifestyle.  Many of us do not respect our bodies.  We have too much fat and sugar in our diets, not enough fruit and vegetables, too much alcohol, we might sit down in offices all day, we drive our cars everywhere, we sit down in the evening watching TV, we sit down on the Playstation or chat on social media, and added to all that (if that weren’t enough), we might even be indulging in the smoking of cigarettes.  Considering all this therefore, it is not really surprising that the incidence of diabetes is on the increase.

eat well plate

In order to address this spiralling problem, we clearly need to be doing the opposite of all the habits in the paragraph above.  Prevention is undoubtedly the way we need to be going.  To do this therefore, we need to be adopting the principles of the Eat Well plate, as advocated by the NHS.  We require: at least five daily portions of fruit and vegetables; complex carbohydrates such as wholemeal varieties of bread, rice, pasta and cereals; smaller amounts of dairy products such as cheese, yoghurt, eggs and semi-skimmed milk; proteins such as beans, lentils, soya, nuts, fish and lean meat; and very small amounts of fat (preferably unsaturated) such as polyunsaturated margarine and olive oil; plus sparing amounts of sugary treats, such as cake and biscuits.

Added to this, we should be drinking plenty of water, limited amounts of tea and coffee, and non-sugary drinks.  We need at least 30 minutes of exercise daily, which can easily be achieved through a simple walk.  Furthermore, we need to limit our alcohol intake, perhaps just using it as a weekend treat.  We must adhere to our recommended units sensibly, and should avoid resorting to binge drinking.  The perils of smoking meanwhile, are now widely accepted and acknowledged, and it is up to each individual to get the help they need to help them to give up.

If we can all respect our bodies just a little more, our bodies will hopefully continue to work and serve us in the way in which they were intended.  We do not have to give up everything that we love; moderation is the key to good overall health.

So what if you are wondering whether you might be at risk of diabetes already?  What are the signs?  The common indicators are excessive thirst (polydipsia), excessive urinating (polyuria) and perhaps using the toilet throughout the night (nocturia), increased appetite (polyphagia), loss of weight, frequent fungal infections such as thrush, and extreme tiredness and lethargy.  The presence of diabetes can easily be determined through a simple blood test.  A healthy blood glucose level reading should be between 3.5 to 7 mmol/Litre.   If you have any concerns, you should visit your GP.

glucometer

At university I am really enjoying learning about the physiology of the pancreas and its role in the production and regulation of insulin levels.  It has also been really fascinating finding out about the pathophysiology – about what happens when things go wrong with the body.  Crucial to my nurse training, is the understanding of how to recognise and deal with low glucose levels (hypoglycaemia) and high glucose levels (hyperglycaemia), and furthermore what either extreme can lead to.

To look after my patients who have diabetes effectively, I have also been learning about the types of health problems that may be encountered, and particularly moreover, when patients fail to properly manage their long term condition.  Diabetes puts people at long term risk of neuropathy (nerve damage to the fingers and toes), nephropathy (kidney damage), retinopathy (damage to the eyes) and heart disease; so it is therefore really important that patients with diabetes attend for regular health check-ups with the diabetes nurse, have their eyes checked at the opticians and have their feet checked with the podiatrist.  With good management and a healthy lifestyle, people with diabetes can enjoy a good standard of living; but without this however, the future could be bleak.

For further information, visit http://www.diabetes.org.uk/

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