ON THE COVER Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Over 4 million people in the UK are estimated to have diabetes today. Type 2 diabetes can usually be managed with diet, lifestyle and tablets for years. Type 1 diabetes needs insulin from day one.
The rate is rising all the time, but new technologies are helping people to cope.
About 90% of people in the UK with diabetes have type 2, which is largely to do with lifestyle – a combination of being overweight and ageing makes your body more resistant to the hormone insulin, which controls blood sugar.
Type 1 diabetes, however, is an auto-immune disease – your immune system attacks your pancreas, stopping it producing insulin. Most people are diagnosed in childhood or early adulthood. Along with multiple injections of insulin, they need to test their blood sugar several times a day. Until now, that involved several daily finger-prick tests.
One of the most exciting advances in recent years for people with type 1 diabetes has been the development of technology which allows blood sugar levels to be tested either automatically or by swiping a reader over a device strapped to your arm.
There are many potential advantages, not least a drastic reduction in finger-prick tests. They also allow you to check and treat early for potentially fatal low blood sugar readings, and you can adjust treatment if sugars are too high. Some versions alert you if your blood sugar is low – even waking you if you’re asleep.
The first of these has now become available on the NHS. Currently, you’re only eligible
KEEPING YOUR WEIGHT DOWN IN TYPE 2 DIABETES IS KEY. NEW APPS ALLOW YOU TO MONITOR YOUR FOOD AND EXERCISE, CALORIE INTAKE AND ENERGY USED
RESEARCH IS ONGOING INTO A POTENTIAL VACCINE TO PREVENT TYPE 1 DIABETES, WITH CLINICAL TRIALS DUE TO START THIS YEAR
if you have type 1 diabetes and are prone to severe episodes of low blood sugar despite testing regularly. Monitors with alarms aren’t available yet on the NHS – but hopefully it’s only a matter of time.
Currently you need several injections of insulin a day if you have type 1 diabetes. You need to learn to adjust the dose according to your blood sugar, how much you’re eating, exercise levels etc. Insulin pumps with a tiny catheter inserted under the skin provide a continuous baseline supply of insulin and allow a booster dose at meals. First developed in the 1990s, they are already available for some people with type 1 diabetes on the NHS.
But newer pumps, which can “speak to” a monitor that detects your blood sugar levels and adjust the dose of insulin they give automatically, are becoming ever more accurate. The hope is that in the future, they will provide an “artificial pancreas” to keep your blood sugar predictably controlled.
People with type 2 diabetes aren’t left out either. Tight blood sugar control in diabetes hugely reduces the risk of damage to your kidneys, eyes and nerves, as well as protecting against heart disease. The early symptoms of type 2 diabetes – tiredness, thirst, needing to pass water more often, minor infections – can be mild. So many people live with type 2 diabetes for years before being diagnosed. New sensors to detect diabetes early are being developed.
So are new treatments – for instance, an insulin-regulating hormone called GLP1, currently only available as an injection. Researchers are working on newer versions, based on chemicals found in the venom of platypuses!
Older treatments for type 2 diabetes leave you at risk of dangerous episodes of low blood sugar. Newer treatments are widely available on the NHS. Next week: Ask Dr Google