Are you ignoring deadly signs of diabetes?

Each year diabetes is responsible for 24,000 premature deaths in England and Wales yet many of those at risk of developing the condition are in denial. Even when they have one or more of the recognisable symptoms, they do not take these seriously and fail to mention them to their doctor.

People’s inaction puts their long term health in jeopardy, because if left untreated diabetes can dramatically increase their chances of developing heart disease, suffering a stroke or going blind. It is also the primary trigger for lower limb amputation, warns Dr Gill Jenkins.

Gill Jenkins“If you have pre-diabetes it’s silent, there are no symptoms and a shocking number of people are in this position and are sleep-walking towards serious health problems. It is particularly important to be aware of your risk of developing type 2 diabetes especially if you’re overweight or you have a family history of diabetes,” says Jenkins from the Simplyhealth Advisory Research Panel (ShARP).

New research commissioned by ShARP, among 2,000 Britons, aged 18-70, found that more than 60% of the respondents were unconcerned about the possibility of developing blood sugar problems such as Type 2 diabetes with 40% admitting they knew very little about the condition. Worryingly almost half – 49% – were already displaying one or more of the symptoms and one in three had a waist measurement that put them at increased risk.

“This level of denial could be deadly,” warns Dr Gill Jenkins from ShARP. “If you ignore diabetes it doesn’t go away. It damages blood vessels, destroys sight and undermines almost every aspect of your health until one day there is a crisis and it becomes impossible to ignore.”

This refusal to face reality may explain why experts believe there are more than 630,000 people in the UK who don’t realise they have Type 2 diabetes.

Ignorance is NOT bliss
Over time, diabetes increases the risk of atherosclerosis – the narrowing of blood vessels that reduces blood flow to the heart. This means that people with diabetes are five times more likely to have a heart attack or stroke.

One in four hospital admissions for heart failure is due to diabetes but 36% in the ShARP poll had no knowledge of this link between the condition and heart disease.

Diabetes also damages nerves, which is why people with the condition are more likely to suffer from foot ulcers and are at higher risk of amputation. Every week in the UK there are more than 100 lower limb amputations due to the condition. Yet 40% of those in the ShARP survey were unaware that people with diabetes are 20 times more likely to lose a limb than those who do not have it.

“Every day lives and limbs are being lost to diabetes, but what is heartbreaking is that in so many cases these personal tragedies can be prevented,” says ShARP advisor, Dr Gill Jenkins.

While almost half of those surveyed, 49%, had one or more symptoms of the condition – excessive thirst, frequent urination, tiredness, dry mouth – 38% of them wrongly believed these early warning signs were not serious and in many cases had failed to mention them to their doctor.

“These statistics show that far too many people are heading for problems by refusing to face the facts. When it comes to diabetes, ignorance is not bliss. It is potentially deadly,” Dr Gill Jenkins, ShARP adviser says.

Diabetes shrinks the brain
Scans of the brain at the Mayo Clinic in the US confirm that blood sugar problems can literally shrink the brain. On average those with diabetes had 2.9% less brain volume than those without the condition. The difference was most marked in the hippocampus – the region of the brain that holds long-term memory and the ability to recall recent events.

Getting Type 2 diabetes in middle age therefore increases the chances of developing a form of brain damage that is linked with dementia.
Cash strapped NHS
There are around 3.8 million people in the UK with diabetes and this figure is expected to rise to 5 million by 2025. Already the condition is pushing the cash-strapped NHS to crisis point. It spends £13.8 billion a year treating people with the condition – the equivalent of £25,000 a minute – and 10% of its drugs bill goes on diabetes medicines.

It costs between £300 and £370 a year per patient to treat and monitor diabetes but when a patient is admitted to hospital with complications this figure jumps to between £1,800 and £2,500.

Regular health checks and treating minor problems before they become major issues can reduce hospital admissions and serious complications for the patients.

“We need all our clinicians, GPs, practice nurses, community nurses and hospital teams, to focus on the risks of pre-diabetes‎ and enable patients to reduce their risk of heading into diabetes itself, the costs of such focus are well worth it in long term outcomes” warns Dr Gill Jenkins from ShARP.

According to a study by the Medical Research Council, more than a third of the UK adult population is overweight and at increased risk of diabetes but they are not being systematically monitored for the condition.

Four out of five interviewed for the ShARP survey claimed their GP or practice nurse had never discussed the risk of developing diabetes with them.

Weighty matters
A study in the Journal of Epidemiology and Community Health calculated that over a decade every kilogram of added weight increases the risk of developing diabetes in the subsequent 10 years by 49%. In the ShARP survey two out of five respondents admitted they were overweight.

Waist measurements also indicate whether someone is at risk. One in three had a waist measurement putting them in the danger zone – 31.5 inches or more for women and 37 inches or more for men.

The good news
Moderate intensive aerobic activity such as brisk walking or cycling every week cuts the risk. A recent study that tracked 100,000 women for eight years reported that this level of activity reduced their chances of developing diabetes by 40%.

Evidence is also emerging that following a very low calorie diet can cure Type 2 diabetes. A small study at Newcastle University found that seven out of 11 patients with the condition were cured after cutting their food intake to 600 calories a day for eight weeks.

Dr Gill Jenkins from ShARP says: “Diabetes can be a dreadful disorder but it doesn’t have to be. When patients take control of their condition it can make an enormous difference. Something as simple as a regular appointment with a podiatrist could prevent an amputation and eye examinations can spot the early signs of vascular damage and perhaps head off a heart attack or blindness.”

“Hundreds of thousands of Brits have been diagnosed with blood sugar problems or are in the diabetes danger zone. It is vital they head off problems with a proactive approach to their health.”

Myth busting
Two out of five respondents believed they were not at risk of developing diabetes because they avoided sugar not realising it is total calories consumed that count. While sugar consumption has fallen by 6% in the past decade, in that period the number of people with diabetes has increased by 61%.

And 13% in the ShARP poll were sceptical that diet and exercise can reduce the risk but studies show that over a ten year period every kilogram of weight lost cuts the risk by a third.

A widely-held misconception is that only old people develop Type 2 diabetes but it can occur at any age. Around 500 children in the UK have it and another 2,000 children and young people are estimated to be suffering from Type 2 diabetes but have yet to be diagnosed.

About Diabetes

TYPE 1 DIABETES occurs when the cells which make insulin are destroyed and the pancreas is unable to make insulin. It is the most common form in childhood and is rarely diagnosed after the age of 40. It is sometimes called insulin-dependent diabetes. People with Type 1 diabetes have to rely on regular insulin injections. Around 10% of people with diabetes have Type 1 diabetes.

TYPE 2 DIABETES was once known as late-onset diabetes because it usually occurs after the age of 40. However, because of rising obesity it is becoming increasingly common in children, teens and young adults. People with Type 2 diabetes still make some insulin, but not enough. Treatment varies depending on the severity of
the diabetes. In some cases diet and exercise alone will resolve the issue, in others insulin is required. Between 85% and 95% of all diabetes is Type 2.

Extreme grapefruit diet may interfere with the pill


New York: A woman who went on an intense grapefruit-based diet developed a blood clot in her leg and risked losing the limb, US doctors have reported.

The unusual case, written up in the Lancet medical journal, occurred in Washington state in November last year.

Medics concluded grapefruit had affected the way the 42-year-old’s body processed her contraceptive pill.

In November 2008, the woman came to the casualty department of the Providence St Peter Hospital in Olympia, Washington state.

The day before, she had gone on a long car journey, after which she felt pain radiating from her lower back down to her left ankle.

When she arrived at the hospital she was experiencing difficulty walking, shortness of breath, and light-headedness.By the next day her left leg had turned purple.

The woman was generally in good health but was slightly overweight and had decided to diet.

Three days before falling ill, she had begun a crash diet which included eating 225g of grapefruit each morning, after rarely eating the fruit in the past.

When doctors examined her, an ultrasound scan confirmed the woman had a large blood clot within the veins of her left leg, which stretched from her hip down to her calf and she was deemed to be at risk of losing her leg because of gangrene.

The woman was given clot-busting treatment and had a stent, a kind of tube, fitted in order to widen her vein.

The doctors treating her said a number of risk factors had contributed to the woman developing the clot.

She had an inherited disorder which increased her risk, as did being on the combined Pill. Being immobile in a car probably also contributed to the clot forming.

Writing in the Lancet, the authors led by Dr Lucinda Grande, called it a “constellation of potential risk factors”.

But they added: “The increased [oestrogen] serum concentration due to her three days of grapefruit for breakfast may well have tipped the balance.”

They suggest the fruit blocked the action of a key enzyme that normally breaks down the form of oestrogen in her contraceptive.

A spokesman for the Florida Department of Citrus – an executive agency of Florida government which markets, researches and regulates the state’s citrus industry, said: “The Lancet report looks to be inconsistent with published scientific studies which indicate grapefruit does not cause a clinically significant interaction with oral contraceptives.

“We are aware of no validated evidence that grapefruit affects oral contraceptives, and they are generally considered to be safe to consume with grapefruit.”