We all know that the UK is hurtling headlong into an obesity epidemic, and many experts predict that obesity and its complications will not only soon be the leading cause of premature death in this country, but may also put an impossible demand on the NHS and its limited resources. More than half of the adult population here is either overweight or obese with these figures only predicted to increase in the future, and we face the very real prospect of the next generation being less healthy than our own for the first time in history, largely (forgive the pun) because of our weight. Overweight and obesity are putting the health of the nation at risk in so many ways, but none more so than through diabetes.

Diabetes (more correctly known as diabetes mellitus) is a condition in which the amount of glucose in the blood is too high because the body cannot use it efficiently due to a deficiency of insulin. If it is not diagnosed and treated appropriately it can significantly increase the risk of heart disease, stroke and damage to other vital parts of the body, including the eyes, kidneys and nerves. All of these can be minimised by effective treatment once the diagnosis is known, although it is estimated that there are 750,000 people in the UK who currently have diabetes but who have not yet been diagnosed.

There are different types of diabetes, and most people with the condition either have Type 1 or Type 2. Type 1 occurs when the body is unable to produce any insulin, and the diagnosis is usually made at a young age when the person visits their doctor with fairly obvious symptoms (see later). It tends to be caused by factors that are not related to lifestyle and is usually unavoidable. Type 2 usually occurs later in life when either insufficient insulin is produced, or the insulin becomes less effective (known as insulin resistance). The symptoms are usually less pronounced and could easily be attributed to other causes. Many people assume their tiredness is because of stress, or getting older, and frequent infections are often thought to be caused by ‘being run down’. Of course these things can be true, but may not always be the case. Type 2 diabetes is most often a consequence of being overweight, hence the reason that one of my patients affectionately refers to her husband’s condition as ‘pieabetes’!

The symptoms of diabetes include increased thirst, passing large amounts of urine, tiredness, weight loss, blurred vision, frequent infections including thrush and slow healing of wounds. If you have any of these then it is well worth consulting a health professional as making the diagnosis – or equally reassuring you that you do not have diabetes - is relatively easy.

There are three main ways to check for diabetes. The most reliable is a blood test taken early in the morning before you have had anything except water to eat or drink. The easier, less painful, but also less accurate ways of testing for diabetes are a urine test or a ‘finger prick’ blood test. In our surgery we would not normally give someone a diagnosis of diabetes based on these, but if they were suggestive of diabetes then we would recommend the early morning blood test to confirm it. You can have these tests carried out by your GP, practice nurse or a number of pharmacies.

If you do find yourself being diagnosed with diabetes then it is very important to gain as much information as you can about how best to live with the condition and to follow the advice from your local health professionals. For type 2 diabetes the fundamental advice is to exercise regularly, eat a healthy diet (I will leave Julie, our resident nutritionist, to cover this) and LOSE WEIGHT! During my time as a GP I have had the privilege of seeing some diabetic people make the transition from obesity to a normal weight, and in that time they have seen their blood sugars and cholesterol return to normal and they have been able to stop taking their diabetic medication. 

While you are busy making these necessary lifestyle adjustments your doctor will probably want to prescribe various medications to make whatever insulin you do have more effective and to minimise any damage that your condition may have on other parts of your body.  This would include treatment for any high blood pressure or cholesterol in particular. In general terms I would strongly advise that you follow their guidance until you have succeeded with your fitness and weight loss goals, and then you can meet with your doctor and discuss the possibility of reducing, if not stopping, your treatment. Please be guided by your local expert for individual advice!

If you visit your doctor and receive the happy news that you are not diabetic then it is still possible to determine whether or not you remain at high risk of developing the condition in the future. If you have metabolic syndrome, that is a combination of increased waist circumference (more than 31.5 inches for a woman and 37 for men), high blood pressure and elevated blood cholesterol levels, then you are far more likely than other people to develop diabetes in the near future so it is important to take action now. And the action required? You guessed it – lose weight! Other factors that make diabetes more likely include having close relatives with the condition and a history of diabetes during pregnancy and a personal history of heart disease or stroke. 

Hopefully by now you are getting my basic message that Type 2 diabetes is largely avoidable (although not always), and that the key to avoiding it – or dealing with it if you are diagnosed with it – is to maintain a healthy weight. If you are a Type 2 diabetic, or at risk of diabetes, and you apply the principles of the Fit For Life Forever plan to your own situation, then before long you should be well  on your way back to good health. If diabetes is not an issue for you then maintaining a normal weight is still important for countless other reasons that we will look at over the coming months. I wish you well on your journey!