Diabetes 101

Diabetes Week UK 14 – 18th June 2021

Diabetes is a serious medical condition and many people around the world suffer from its effects. This includes a member of our own Fit House team Tom Curtis, who was diagnosed with type 1 diabetes when he was very young.

Tom has kindly put together a “Diabetes 101.” What is diabetes? How do you get it? What symptoms to look out for. How to help a diabetic person who is having hypo or hyper episode. The long term effects. And importantly, how diabetes is affected by food, exercise, illness, stress and other lifestyle factors.

Diabetes. What is it?

There are two main types of diabetes. It is a chronic health condition which causes people to have too much glucose (sugar) in their blood. The pancreas cannot produce enough insulin to help our body absorb the glucose from our blood for use in our cells. Instead the glucose stays in our blood which causes a lot of serious problems.

There are two main types of diabetes.

Type 1

T1 is an autoimmune condition. You are born with type 1 diabetes and it cannot be cured. For me, my immune system fights the insulin cells that come from the pancreas. This causes my blood sugar levels to increase and I have to inject insulin directly in order to absorb the sugar.

Type 2

T2 is the most common type of diabetes. This is caused by unhealthy lifestyle choices. The pancreas has been so overworked byexcess sugar in the body, that it cannot keep up properly. This condition doesn’t have to be lifelong. Those with type 2 diabetes can go into remission, with the right lifestyle changes.

What are the signs of diabetes?

The signs and symptoms for diabetes are similar for T1 and T2.

  • Peeing more than usual, particularly at night
  • Feeling thirsty all the time
  • Feeling incredibly tired
  • Losing weight without trying to
  • Itching around your penis or vagina, or repeatedly getting thrush
  • Cuts or wounds taking longer to heal
  • Blurred vision

If you are experiencing any or all of these symptoms on a regular basis. It’s worth speaking to your doctor.

Type 2 diabetes

This is the most common form of diabetes. Around 90% of diabetic people are T2. It is sadly caused by poor diet and lifestyle. Luckily people with this type of diabetes can put it into remission (unlike T1 diabetic person who will be diabetic for life!).

Around 90% of UK diabetics are T2. It is sadly caused by poor diet and lifestyle.

Type 2 diabetic people can come in all shapes and sizes. Not just “big”. Many can also begin to live with the condition without knowing. Those who are “pre-diabetic” and diagnosed by their GP may also be able to avoid becoming diabetic by improving their diet and exercise. Or those who become T2 diabetic person will most likely be put on medication, a tablet form of insulin, to help regulate their blood sugar. This doesn’t mean they will be free of the long term effects of diabetes. Far from it. They are still at risk of serious health issues in the long term including: heart problems, kidney disease, bad circulation and amputation, blindness and eyesight problems.

The risk factors for type 2 diabetes:

  • Over 40 (or 25 for South Asian people)
  • Have a close relative with diabetes (immediate family member)
  • Overweight or obese
  • Asian, Afro-Caribbean, black African origin (even if you are born in the UK)

Side effects of diabetes medication can include:

  • Bloating and diarrhoea
  • Weight loss or weight gain
  • Nausea
  • Swelling in one or more parts of the body (a build up of fluid)

What is hyperglycaemia or hypoglycaemia?

Hyperglycaemia

This is when there is too much sugar in the blood. This doesn’t mean energy levels spike at all, quite the opposite. Your body and other organs are working a lot harder with more viscous blood. As a result, extremities like hands and feet may not get good blood flow.

Long term effects of hyperglycaemia. The long term damage to the capillaries and blood vessels after the constant thickening of blood are serious. Extreme examples are losing hands and feet due to lack of blood flow. Other long term effects can lead to amputations, blindness, kidney and heart disease and even death.

long term effects can lead to amputations, blindness, kidney and heart disease and even death.

In fact according to diabetes.org.uk “People with type 1 diabetes are more likely to get heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage and gum disease.” This is all due to the regular hyperglycaemic episodes!

“People with type 1 diabetes are more likely to get heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage and gum disease.”

What to look out for with a hyperglycaemic episode?

  • Needing to pee almost every 10/20 minutes.
  • Dramatic fatigue (may need to sit down)
  • I personally feel like someone has tied up my body and is squeezing me tighter and tighter until I get my blood sugar levels to drop

Hypoglycaemia

Hypoglycaemia means there isn’t enough sugar in the blood. Hypoglycaemia can be FATAL if not dealt with properly. The sugars in the body have been totally used up or someone may have over-injected insulin.

Hypoglycaemia can be FATAL if not dealt with properly.

What to look out for with hypoglycaemia?

Different diabetic people present symptoms in different ways, but there are key things to look out for:

  • Shaking or trembling
  • Blurred vision
  • Elevated heart rate
  • Insomnia
  • Inability to do basic maths
  • Short temper
  • Confusion or looking “spaced out”
  • Sudden seizures
  • Sweating profusely (can be hard to tell during exercise)
  • Clumsiness
  • Nausea
  • Nervousness
  • Trouble speaking / slurred speech
  • Agitation
  • Loss of consciousness
  • Death (the only one I haven’t yet experienced myself!)

I often experience sweating and confusion. I’ll try to carry on but I get more and more confused. So if you see me during a session looking like I’ve had 10 beers, it would be helpful to offer a sugary drink!

What to do if someone is “HYPO-ing”

Remember this…your actions in this situation can save a life. So listen up. If you have a diabetic person who is experiencing a hypo and:

They are conscious – get some liquid sugar down their neck and fast. Things such as: Lucozade, full sugar Coca Cola, orange juice. This will help them to perk up and the sugar will kick in within 5-10 minutes. Carbohydrate rich foods are also helpful such as a banana or toast.

They are unconscious – rub sugar or glucose gel (e.g. energy gel) into their gums.

If there is no response, call an ambulance and ask for assistance.

What lifestyle factors affect blood sugar/diabetes?

  • Food
  • Exercise
  • Stress & illness
  • Sun
  • Medicine e.g. betablockers (blood pressure medication)
  • Pregnancy & menstrual cycle
  • Irregular insulin injections

Food

Carbohydrates are the primary focus for diabetic people. But protein and all sugars affect our blood sugar too. I personally inject 1 unit of insulin for every 7g of carbohydrates I eat. This is variable for different people. The type and timing of food consumption plays a big role in diabetes management.

Exercise

Physical activity can affect the blood sugar for up to 48 hours. It tends to lower blood sugar levels. The type of training, intensity, duration and energy system used all affect diabetes.

If you stop exercising after having been in a regular routine, blood sugar can rise due to a lack of energy expenditure. Energy is found in the form of glucagon in the muscle, which comes from the sugars in carbohydrates. The use of this glucagon then demands that more glucose be absorbed from the blood. If we don’t then use it through exercise, that glucose (sugar) stays in the bloodstream.

Injecting insulin directly into a muscle that has recently been used for exercise, can cause it to be absorbed faster than usual. This may also affect a diabetic athlete.

Alcohol

I get a lot of questions about this! Beer contains more carbs than most other alcohol. So consuming beer leads to an increase in blood sugar levels. It’s important as a diabetic person to know what you are doing in advance. Plan your night and your appropriate insulin intake. Getting it wrong, especially when drunk can have very serious consequences.

Stress & illness

Stress can increase chances of hypoglycaemia due to an increase in cortisol (stress hormone) which raises the heart rate and blood pressure. Illness can also be caused by poor management of diabetes. Vice versa, illness can also make it very hard to manage blood sugar. It’s a catch 22!

Sun

Temperature and environmental factors can have a big impact on blood sugar control. For example, in the heat your body works harder to cool you down which increases blood flow. This can lead to a drop in blood sugar. The same situation goes for being cold, your body has to work extra hard to warm up. All these changes in blood flow and blood pressure affect diabetes management.

 

What next?

If you have questions about diabetes, I’m always happy to chat and tell you more. If you are concerned that you or someone you know may have diabetes you should speak to your doctor. Early diagnosis is really important. For more information you can go to https://www.diabetes.org.uk/

 

Thank you

Tom

Resources:

https://www.diabetes.org.uk/

https://www.diabetes.org.uk/resources-s3/2019-02/1362B_Facts%20and%20stats%20Update%20Jan%202019_LOW%20RES_EXTERNAL.pdf