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Emerald Group Publishing Limited
Copyright © 2010, Emerald Group Publishing Limited
Article Type: Editorial From: Nutrition & Food Science, Volume 40, Issue 3.
There are 200 million people in the world with diabetes and this figure is expected to increase to 300 million by 2025. In the UK over 2 million people have diabetes and others have the condition but do not realise it.
In diabetes the control of blood glucose levels are impaired due to problems with insulin production.
There are two types of diabetes:
(1) Type 1 – which was previously called insulin-dependent diabetes (IDD) or juvenile diabetes. It affects those mainly under 40 years and is due to insulin production ceasing. It requires the injection of insulin for its long-term control. The onset of the disorder is rapid and symptoms include excessive thirst, frequent urination, blurred vision, rapid weight loss and tiredness.
(2) Type 2 – which was previously called non-insulin-dependent diabetes (NIDD) or maturity-onset diabetes, affects about 85 per cent of people with diabetes is due to insulin resistance or ineffective insulin being produced by the pancreas. It mainly affects people over 40 years of age. The condition is strongly associated with obesity and indeed it is seen in teenagers who are obese. Onset of type 2 diabetes is usually very slow and some may complain of complications rather than the disorder itself. Symptoms include itching, slow healing of wounds, mouth and gum infections, poor vision, cramps, tingling of toes and often tiredness. Control of type 2 diabetes is normally by lifestyle changes, tablets and possibly by insulin.
Diabetes is costly to health care and indeed costs about 10 per cent of the NHS budget due to the associated complications. These include:
coronary heart disease;
high blood pressure;
deterioration of the eyes;
peripheral nerve problems.
Complications are due to variations in blood glucose levels. Therefore regular monitoring of blood glucose levels, weight, blood pressure, cholesterol levels as well as retinal screening and checking of the feet are vital to reduce any deterioration.
The impact of the diagnosis of diabetes can be extremely concerning to individuals who are unaware of the causes of the condition and what they can do to minimise the impact it can heave on health.
Lifestyle changes include:
eating a healthy diet with regular meals, at least five portions of fruit and vegetables plus carbohydrate foods with a lower GI;
maintaining a healthy weight;
avoiding cigarette smoking;
taking regular exercise; and
having regular monitoring of the condition.
Such changes need to be explained fully to enable stepped modification to be made and also to allow sufferers to ask questions about the condition.
The main charity for people with diabetes is Diabetes UK which has not just a website but also a useful telephone help-line.
There are various programmes of education for people with diabetes one of them called the Xpert programme is primarily for those with type 2 diabetes and takes people through a six-week course on the subject of what diabetes is and what they can do to improve their diet, the importance of exercise, monitoring at the GP, tablets and types of insulin used, complications and also factors such as insurance and driving. More recently an Xpert course for those with type 2 diabetes who are controlled on insulin has been launched.
For anyone involved in the management of people with diabetes such courses could be invaluable. Having been involved in such course the impact of a greater understanding of diet and other lifestyle factors was shown to have an important benefit by way of improved diabetic control as shown by various clinical measurements.