Diabetes is a very common health condition. Currently, over 4.9 million people in the UK have been diagnosed, although it’s estimated an extra 850,000 have it but are unaware. It is usually a lifelong condition which occurs in two forms; type 1 and type 2 diabetes.
Type 1 diabetes
Type 1 diabetes usually starts at a young age, and is considered to be determined by genetics. It occurs as the pancreas becomes unable to produce a hormone called insulin, which is responsible for regulating blood glucose (sugar levels).
This type of diabetes is much more rare than type 2 diabetes. Although some genetic factors are involved in the onset of type 2 diabetes, lifestyle factors such as physical activity and diet play a much larger role, specifically inactivity and unhealthy eating habits.
Type 2 diabetes
Type 2 diabetes is often, but not always, related to obesity. Rather than being unable to produce insulin, the body becomes resistant to its effects and blood glucose dysregulation occurs.
Both type 1 and type 2 diabetes result in chronic high blood sugar which can be dangerous and damaging to bodily systems. If unrecognised or poorly treated, long term effects can include weight gain, eye, kidney or nerve damage, and an increased risk of heart disease.
Diabetes and ethnicity
Black and South Asian ethnic groups in the UK are three to six times more likely to get type 2 diabetes than White ethnic groups, respectively. This has a correlation with higher rates of obesity in these populations, which is a strong predictor of diabetes. Interestingly, individuals in these ethnic groups seem to be at a higher risk of diabetes compared to other ethnic groups – even when body mass index (BMI) is equal. Research is currently ongoing to determine exactly why this is the case.
If you are concerned about your diabetes risk, the best thing to do first is to get tested, regardless of ethnicity.
Diabetes and driving
Most people with diabetes that’s controlled using tablets or diet alone do not need to inform the DVLA and can hold an ordinary driving licence or a vocational licence – provided that their vision meets the required standard. There are certain exceptions to this, such as if specific tablets are taken in combination. If this is the case, the driver should check with their doctor and/or the DVLA guidance. If the diabetes progresses and insulin becomes necessary, the vocational licence will be revoked.
Testing for diabetes
There are many tests used to diagnose diabetes or to alert someone if they are in a stage of pre-diabetes (higher levels of blood glucose than normal, but not diabetic).
The two most common methods of testing for diabetes are fasting blood glucose (measures your blood glucose level at the time of testing) or HbA1c (indicates your average blood glucose over the previous 8-12 weeks). The table below shows how diagnosis is determined, ‘mmol/L’ stands for millimoles per litre:
| Fasting glucose | HbA1c | |
|---|---|---|
| Normal | 4 – 5.5 mmol/L | < 42 mmol/L |
| Pre-diabetes | 5.5 – 6.9 mmol/L | 42 – 47 mmol/L |
| Diabetes | ≤ 7 mmol/L | ≤ 48 mmol/L |
A fasted blood glucose test is done after a period of at least 8-10 hours of fasting (no food or calorie containing drinks, only water). This is usually performed in the morning for this reason. If testing blood glucose at other times in the day, then a normal reading would be anywhere between 4-7mmol/L, or up to 9mmol/L two hours after eating.
Treating diabetes
Type 1 diabetes is treated by injecting insulin throughout the day to control blood glucose, as the body no longer produces its own. This will be accompanied by lifestyle changes (diet and physical activity), and possibly tablet medications.
In contrast, if type 2 diabetes is diagnosed early, it can often be treated with lifestyle changes alone, and sometimes with the aid of tablet medication. If it’s not treated early and successfully, type 2 diabetes can also result in damage to the pancreas, which leads to insulin no longer being produced. At this stage the treatment is similar to type 1 diabetes, where insulin injections are required.
Essentially, type 2 diabetes is reversible if acted on in the early stages, but unfortunately there is no cure for type 1 diabetes currently.
If you have type 1 diabetes, it is important to realise that this does not mean you cannot still do all of the things you want to do and live a long, healthy and happy life. It just means that you will have to take certain precautions and incorporate your insulin therapy into your daily routine.
Tips to prevent or manage diabetes
- Get tested – It is advised that we all get tested for diabetes, especially as we get older. If you currently have diabetes, it is also vitally important to keep track of your blood glucose levels regularly to notice any drastic changes.
- Limit (or eliminate completely) your intake of refined carbohydrates (white starchy foods, cakes, biscuits etc.) and sugar – This has to do with the glycaemic index (GI) of the foods, or the rate at which your blood glucose levels rise after eating. Refined carbohydrates are generally a higher GI than their unrefined (whole) versions, producing an excessive increase in blood glucose. If you currently have diabetes, this can lead to serious health problems if left untreated. If you do not have diabetes, consuming these foods regularly can cause insulin resistance and type 2 diabetes.
- Eat plenty of fibre (30g per day) – A high fibre diet has been shown to regulate blood glucose and appetite, reduce cravings and aid in weight management. Some good sources of fibre are vegetables, fruits (not fruit juice), nuts, seeds, beans and wholegrains.
- Keep active – Being physically active helps with blood glucose control in both the short and long term. After a meal, going for a walk has been shown to significantly reduce the rise in blood glucose compared to just sitting down. Long term, improving physical fitness and increasing muscle mass can help to increase insulin sensitivity (important for reversing type 2 diabetes). This will also help to reduce the risk of other complications associated with diabetes, such as heart disease or damage to the body’s other tissues or organs.
Further support
NHS – General information about diabetes
Diabetes UK – Charity offering information and support
Diabetes.co.uk – Information and support, including an online forum.
Ref: WPW0080 This information was reviewed April 2024.
