Doctor Joshua Smith offers his advice on spotting the signs of diabetes and how to best manage the condition.
Did you know that more people than ever have diabetes? It’s true. In the UK, close to 5 million people are affected. Perhaps even more surprising is that 13.6 million people in the UK are at risk of developing diabetes – and many aren’t even aware (1).
The good news is that, if caught early enough, you may be able to reverse pre-diabetes through a healthy diet and lifestyle changes. But how do you know you’re at risk? Well, complications of diabetes often develop long before it’s diagnosed, which is why spotting the signs and an early diagnosis are crucial.
In this article, we look at the early warning signs of diabetes and how you can best look after your health with the condition.
- What is diabetes?
- What is pre-diabetes?
- Am I at risk of diabetes?
- How to spot diabetes
- Managing diabetes
What is diabetes?
Diabetes is a serious and often lifelong condition that occurs when your body struggles to maintain normal blood sugar levels. Usually, this is because the pancreas doesn’t produce enough insulin or the tissues can’t effectively use insulin. As a result, sugar remains in your bloodstream rather than being taken up by the tissues. Persistently raised blood sugar levels (hyperglycaemia) leads to symptoms and complications.
About 90% of people with diabetes have type 2. The remaining 10% of people have either type 1 diabetes or other rarer types, like gestational diabetes.
What’s the difference between type 1 and type 2 diabetes?
Type 1 diabetes is a genetic condition that often, but not always, shows up early in life. It’s an autoimmune condition, meaning the body attacks itself (the pancreas) and fails to make insulin. It usually develops very quickly and the only treatment currently available is insulin injections.
Type 2 diabetes, on the other hand, often shows up later in life. The body either does not produce enough insulin or the body’s cells don’t react to insulin. Genetics plays a strong role, but there are risk factors that can predispose you to the condition, such as being overweight and living a sedentary lifestyle. Symptoms typically develop more slowly than type 1, and there are also more ways to manage the condition, including lifestyle changes and medication.
Diabetes is not reversible but it’s possible to reach a stage of remission, where your symptoms reduce or disappear, with the right treatment.
What is pre-diabetes?
Some people have raised blood sugar levels but they are not quite high enough to be categorised as having diabetes. This is known as pre-diabetes. Fortunately, pre-diabetes is completely reversible with the right lifestyle changes, but it can very easily get worse and develop into full-blown diabetes if you don’t take action.
How do I know if I’m pre-diabetic?
Pre-diabetes doesn’t cause symptoms, so the only way to find out if you’re at risk is with a blood test. HbA1c is a blood marker that tells you how much sugar is attached to the blood cells, and it can be tested by your GP or at home with a finger-prick blood test, like the Diabetes (HbA1c) Blood Test from Medichecks.
Am I at risk of diabetes?
You may be more at risk of diabetes based on genetic factors (which you can’t change) and lifestyle factors (which you can change).
You’re at greater risk of type 2 diabetes if you:
- Are over 45
- Are of Black African, African Caribbean, or South Asian descent
- Have a relative with diabetes
- Have pre-diabetes
- Are overweight
- Lead a sedentary lifestyle
You can calculate your risk of diabetes using the Know Your Risk tool from Diabetes UK.
Knowing your risk can help you work out whether you need to pay special attention to your lifestyle choices and blood sugar levels. If you’re deemed high risk, you may also be eligible for a free place on the NHS Diabetes Prevention Programme.
How to spot diabetes
In its early stages, type 2 diabetes tends to cause mild, non-specific symptoms which might go unnoticed. As a result, it’s possible to have the condition for years without realising it.
As blood sugar levels rise over time, symptoms may become more obvious or severe.
Signs and symptoms of diabetes include:
- Feeling very thirsty
- Peeing more frequently, especially at night
- Feeling more tired than usual
- Cuts or wounds that heal slowly
- Blurred vision (late sign)
- Bouts of thrush
- Losing weight unintentionally (more likely in type 1 diabetes)
To help you remember the symptoms, it might help to call them the five Ts: tiredness, thirst, toilet, thrush, and thinner.
If you have any of these symptoms, it’s best to see your GP. It might be nothing, but if it is diabetes, it’s best to start treating it sooner rather than later before complications develop. Untreated diabetes can damage your heart, blood vessels, nerves, eyes, and kidneys.
Diabetes is sometimes picked up as part of an NHS Health Check, which is carried out every five years for people aged 40–74. You can also check your blood sugar levels at home with a finger-prick blood test from an accredited provider, like Medichecks, such as their Diabetes (HbA1c) Blood Test.
Living with diabetes shouldn’t mean you need to put your life on hold. There are many treatment options to help you manage your condition. Everyone is different, so it will depend on your individual needs.
Everyone with diabetes benefits from leading a healthier lifestyle. It not only helps to stabilise your blood sugar levels but can also benefit your mental health and prevent other conditions.
One of the best things you can do to manage your diabetes is to lose weight if you’re overweight.
A large study called the DiRECT trial showed the effects of a weight loss programme on diabetes. By reducing calorie intake and losing weight, over a third of the participants were in remission at two years. This meant that they were able to reduce or stop their diabetes medications. It also led to other benefits like lower blood pressure, improved cholesterol levels, and a better quality of life.
Losing weight can be a challenge, so here are a few tips:
- Don’t go at it alone — If you find it hard to stay motivated, start your weight loss journey with a friend or join a local weight loss group to keep you accountable.
- Exercise regularly — The NHS recommends getting at least 150 minutes of moderate-intensity exercise a week. This could be walking the dog, swimming, cycling, running, a session at the gym, or even a hobby that’s physically active.
- Reduce your portion sizes — Even if you’re exercising regularly, eating too many calories can lead to weight gain. Sometimes using a smaller plate to help you watch your portion size can help or keep a food diary.
Nutrition plays an extremely important role in managing diabetes. Making the right food choices can help you stabilise your blood sugar levels as well as reduce your risk of complications, like heart disease and stroke.
There are three main areas of your diet to focus on with diabetes:
- Minimise blood sugar spikes — Common culprits like fizzy drinks, sweets, honey, fruit juice, cakes, and biscuits should be kept to a minimum. If you have a sweet tooth, substitute these for healthier snacks, like yoghurts, fruits, and unsalted nuts. Carbohydrates also contain sugar but switching to foods with a lower glycaemic index (GI) such as wholegrain foods, can avoid spikes in your blood sugar levels. Linwoods has a range of foods to target blood sugar levels that you can have a look at and consider making any swaps.
- Reduce your lipid levels — Diabetes puts you at greater risk of cardiovascular disease, so to reduce this risk, it’s important to keep an eye on your cholesterol levels. Bad cholesterol can be found in foods like pastries, butter, pies, cream, bacon, and cheese — sadly some of the tastier things in life! You can still enjoy these foods now and again, but switching to more of a Mediterranean diet with healthier fats is much better for your heart health.
- Watching your calorie intake — Even if you feel like you’re eating all the right foods, you can still gain weight if you eat too much. Calories hide in all sorts of food and drink like alcohol, pastries and pies, takeaway meals, and sweets.
If you’re planning on making any drastic changes to your diet, it’s best to speak to your GP first.
Looking after your mental health
Having a chronic condition can take its toll on your mental well-being, so it’s important to take some time to check in now and again and ask yourself how you’re feeling. If you’re not doing so well, speak to a friend or your GP. Some people also find that joining a diabetes local support group is helpful — sometimes it’s easier to open up to someone who is going through a similar situation.
Being stressed also has an impact on your blood sugar levels. The body reverts to its fight-or-flight response and releases stress hormones like cortisol, which can cause blood sugar levels to surge. Stress management techniques like mindfulness or meditation are simple and effective ways to combat this.
Medications and monitoring
For some people, medications are required in addition to healthy lifestyle changes. Just because you are established on treatment doesn’t necessarily mean you’ll need it lifelong, especially if you’ve only just been diagnosed.
There are many different types of diabetes medications. Most of them work by stimulating the pancreas to release more insulin or by improving insulin sensitivity. Some people with type 2 diabetes may need to take insulin injections if their pancreas is no longer able to produce it.
It’s important you take your medications as prescribed and attend your check-up appointments. Most people with diabetes are asked to monitor blood sugar levels and you’ll usually be given a target range. You should keep a record of your blood sugar readings and share it with your healthcare provider or diabetes team.
Awareness is key
Diabetes can be a scary diagnosis to receive. The good news is, there are many ways to manage the condition to minimise the impact it has on your life. For some people, it’s a prompt to help them turn their lifestyle around to one that’s much healthier.
If you have symptoms, or you’re worried you may be at high risk of diabetes, speak to your GP. An early diagnosis means you can make the right changes early to reduce complications.
- Diabetes statistics [Internet]. Diabetes UK. [cited 2022 Sep 21]. Available from: https://www.diabetes.org.uk/professionals/position-statements-reports/statistics
About the author
Dr Joshua Smith is a research scientist for Medichecks, the UK’s leading online blood-testing company. He combines clinical knowledge from his background as a doctor and educator with the latest research to give an evidence-backed, real-world outlook on health. His holistic approach focuses on the value of a well-balanced lifestyle, including nutrition, fitness, and mental wellness.