How to | Manage and reduce the risk of type 2 diabetes

Six tips from Dr David Cavan, the UK’s leading expert on diabetes self-management and author of Reverse Your Diabetes: The Step-by-Step Plan to Take Control of Type 2 Diabetes.

1. Do not exceed 14 units of alcohol per week. Choose drinks with a low carbohydrate content such as wines and spirits. If you are overweight, reducing or stopping alcohol altogether can be beneficial as it is high in calories.
2. Drink water, coffee or tea instead of fruit juice, smoothies and fizzy drinks. Caffeine may be beneficial but only as unsweetened tea or coffee – not a latte or cappuccino.
3. Eat at least three servings of green leafy vegetables every day. These contain vitamins, fibre and are very low in calories and carbohydrate. Limit fruit and choose lower-sugar fruit such as berries, a small apple, orange, plum or peach.
4. Avoid sugary snacks such as biscuits, chocolate bars or cakes. Instead, choose natural, low sugar foods such as a piece of cheese, a hard-boiled egg, handful of nuts, unsweetened yoghurt or a small piece of fruit.
5. Limit starchy foods such as potatoes, rice, pasta, bread and cereals. They can all cause a rapid rise in blood glucose.
6. Eat good quality poultry, fish and meat and avoid highly-processed products.

7. Two thirds of the type 2 diabetes admissions for the under-40s last year involved female patients and there is evidence they are more susceptible to complications.

   The data only covers those patients with type 2 diabetes, which is strongly linked to being overweight and inactive.

   The figures show there were 4,992 admissions for women aged 20 to 29 in 2018/19, compared with 1,755 for men.

   Similarly, there were 16,707 admissions for women aged 30 to 39 compared with 10,207 for men. Overall women accounted for 65 per cent of the 34,601 admissions among the under-40s last year.

   An estimated 4.7million adults and children in Britain are living with diabetes, and the majority have type 2. This number has doubled since 1998, in line with rising obesity levels and the condition is believed to cost the NHS £14billion annually.

   Those suffering from type 2 diabetes can face further health complications such as heart disease and kidney disease.

   Hospital admissions for patients suffering from heart failure have risen three times faster than all other health conditions, according to British Heart Foundation (BHF) research.

   The difference between type 1 and type 2 diabetes

   Type 1 diabetes cannot produce insulin, whereas people with type 2 cannot produce enough, or their bodies grow resistant to it. Either way, too much glucose accumulates in the blood.

   Nobody knows what causes type 1. People are more likely to develop type 2 if they are overweight or if their family history, age or ethnic background puts them at increased risk. Type 1 usually begins in childhood, starting suddenly and quickly becoming more severe. Type 2 often strikes later in life, and sufferers can be oblivious to it for years.

   Type 1 is treated with daily insulin doses, either via injection or via a pump. To begin with, type 2 is treated with a healthy diet and exercise. Later, tablets and insulin are often required.

   World wide, type 2 affects far more people than type 1. Nine in 10 diabetics have type 2.

   Source: Diabetes UK

   New analysis commissioned by the charity shows admissions for heart failure reached record levels in England last year, up to 86,474.

   The figures have prompted the BHF to call for improvements in detecting heart failure, and for GPs to be given access to specialist blood tests and heart scans to diagnose the condition earlier.

   The steep rise is three times as fast as all other hospital admissions, which have only risen by 11 percent in the same period.

   It’s estimated that around 920,000 people have the condition and the burden of heart failure in the UK is similar to the four most common cancers combined.

   Patients suffering with heart failure stay in hospital for around 10 days, which is double the average wait for all diagnoses, placing further strain on NHS services.

   Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said: “Heart failure poses a growing and increasingly complex challenge, not only for people living with the condition, but for those who care for them too.

   “It’s concerning to see yet another increase in hospital admissions – an indication that how we diagnose, treat and care for these patients needs urgent attention.

   “There is no cure for heart failure, but with access to the right services and support, people can go on to have a good quality of life for many years.

   “We need to find new and improved ways of delivering this care, including in communities rather than hospitals. Doing so will improve thousands of lives and relieve the unsustainable pressure that heart failure is putting on our health service.”

   Several factors contribute to the rise in heart failure, including an ageing population, and high rates of people living with high blood pressure and diabetes.

   Earlier this year a study in the Journal of Epidemiology & Community Health found that almost 10,000 cases or heart disease could have been prevented if control of salt reduction targets had not been handed to the food industry in 2011.

   Male vs female heart attacks

   Women’s symptoms can differ from classic chest pain (but this can also be true for men). We also know women tend to wait longer before discussing symptoms with their GP, or calling 999, which could be due to differences in pain threshold, not wanting to cause a fuss, or simply not being aware they can be at risk of a heart attack. Signs and symptoms of a heart attack in women include:

   • Chest pain or discomfort – the most recognised symptom of a heart attack though not always present.

   • Pain or numbness radiating to the arms (both left and right), neck, jaw, stomach and back -you may experience pain in just one or all of these places; for some people the pain is severe but for others just uncomfortable.

   • A feeling of indigestion or reflux type pain – this is often ignored in the hope it will pass.
   • Feeling sick, sweaty, breathless or lightheaded with associated chest pain or discomfort

   • A general feeling of being unwell or lethargic can also be an indicator of a heart attack when accompanied by chest pain or discomfort.

   If you’re experiencing chest pain, call 999. If you have a family history of heart disease and are concerned, see your GP.

   By Vanessa White, a senior cardiac nurse at the British Heart Foundation

   Before then, the Government’s Food Standards Agency had led the dive to crack down on salt.

   Professor Simon Capewell, Liverpool University commented: “Britons deserve better. These terrible trends are a wake-up call for the government and Health Minister Matt Hancock.

   “Premature heart failure deaths are eminently preventable, by slashing the salt, sugar and animal fats now hidden in junk food.”

   The BHF has also launched a new £1 million Hope for Hearts Fund to test new ways for caring for people with heart failure.

   The charity already funds more than £41 million in heart failure research such as regenerative medicine and work alongside NHS England.

   An NHS England spokesperson said: “Tackling heart disease is a priority in the NHS Long Term Plan and is backed by billions of pounds of extra investment to ensure patients receive earlier detection and diagnosis of heart failure, and better access to specialist care and advice.

   “The NHS is working with the British Heart Foundation and other partners to raise awareness of the symptoms of heart failure and provide more opportunities for the public to check on their heart health, including on the High Street.”