How to beats DIABETES

YOUR VITAL PULLOUT GUIDE

DIABeTeS is now one of Britain’s most common long-term health problems. Over the past 20 years, the number of adults in the UK affected has more than doubled to 3.8 million.

That figure is expected to reach 5 million by 2025. The vast majority have type 2 diabetes, the kind that develops in adulthood and is linked to lifestyle and being overweight.

But experts think a further 14 million could have ‘pre-diabetes’ — high bloodsugar levels that raise the risk of diabetes — without realising it.

Many people assume that it’s type 1 diabetes that’s the serious form because you need insulin injections.

But it’s wrong to think type 2 is nothing to worry about, says Simon O’neill of Diabetes UK. If it’s uncontrolled, type 2 diabetes can lead to a host of painful and debilitating complications, ranging from impotence to blindness and amputation as a result of nerve damage.

Currently, one hospital bed in seven is occupied by a patient with diabetes — rising to one in three in some areas.

Type 2 is also known to increase the risk of heart disease — 80 per cent of people with diabetes die of cardiovascular disease and type 2 can shorten life expectancy by up to six years.

The good news is that in many cases type 2 diabetes can be controlled, thereby minimising complications and extending life expectancy — and in some cases, it can even be reversed.

In this fourth part of our unique How To Beat series, we help you identify if you could be at risk — and how to protect yourself.

And if you’re one of the millions who already has the condition, we’ve drawn on the latest thinking to help you manage it better, and possibly put it into remission.

WHY ARE SO MANY GETTING DIABETES?

THe simple fact is that too many of us are too heavy, and having a Body Mass Index (BMI) above 25 is the singlelargest risk factor for type 2 diabetes. So why is being fat so significant? Diabetes is caused by problems with the hormone insulin, which mops up sugar from the blood. Insulin is made in the pancreas — in a healthy body, cells in the pancreas sense when sugar levels in the blood rise after we’ve eaten.

This triggers the release of insulin, which picks up the sugar. The insulin molecules then attach to ‘receptors’, or docking stations, on cells in our liver, muscles and fat (the fat that’s typically in the abdomen); these cells respond by opening up to let the glucose in. The glucose is then stored in the muscles and liver as glycogen, ready to be released into the blood for energy.

If we eat a carbohydrate-based meal (carbs are broken down into sugar), our insulin levels rise in response; this tells the liver and the muscles to stop releasing their glycogen, as this would trigger a blood-sugar overload.

Conversely, when blood- sugar levels drop, insulin production stops, and glycogen is released from the liver and muscles to provide fuel. However, if you’re over- weight — particularly if you are apple-shaped — this all goes awry.

Men whose waist is more than 40 in (102 cm) are five times more likely to be diagnosed with type 2 diabetes than those with a smaller waist, while women whose waist measures more than 35 in (88 cm) are three times more likely to develop the condition, says Public Health england.

This is partly because when we overeat, fat forms around the organs in the abdomen, including the pancreas, stopping them working properly. As a result, the pancreas doesn’t produce enough insulin.

WHAT IS INSULIN RESISTANCE?

ANOTHER problem is that cells around the body — particularly those in the muscles and liver — stop responding to the insulin the body does produce, which is known as insulin resistance.

As a result, sugar stays in the blood and you end up with constantly high blood-sugar levels.

Why exactly insulin resistance occurs is not clear. Some research suggests that specific fat cells in the abdomen secrete inflammatory chemicals that disrupt the way the body’s cells respond to insulin.

Another theory is that the chemical interactions in fat tissue — particularly belly fat — draw immune cells to the area, triggering lowlevel chronic inflammation.

Age is also a factor — your risk of diabetes increases over the age of 40, partly because we tend to gain weight, but also because the mitochondria (the tiny powerhouses in our cells) start to slow.

When this happens in the muscles, it makes them more prone to insulin resistance. Inactivity is another factor. When we move around, our muscles become more sensitive to insulin, lowering bloodsugar levels. The reverse is also true.

As cells become resistant to insulin, the pancreas responds by trying to produce even more, but your body becomes increasingly unable to use it efficiently.

A diet high in sugary drinks, high-sugar convenience foods and refined carbs (such as biscuits) not only makes you fatter but creates more sugar than the cells can take in, leading to higher blood-sugar levels.

It might not even take that unhealthy a lifestyle to cause problems. A study published in the British Medical Journal in 2013 found that just one can of sweetened drink a day is enough to increase the risk of type 2 by 18 per cent.

Some specialists believe even diet drinks can raise your risk (because the sweeteners mimic the action of sugar in the body).

There’s also a genetic link to type 2 diabetes. If one of your parents has it, your risk increases by 15 per cent; if both parents have it, your risk increases by 75 per cent.

But it’s not just genes: experts believe lifestyle factors such as poor diet and inactivity, ‘inherited’ as family behaviour, are key.

And just because you’re skinny, you are not immune. Family history puts you at greater risk, regardless of your weight, as does polycystic ovarian syndrome (a hormonal disorder where cysts grow on the ovaries) regardless of your weight.