How to reduce your risk of diabetes

Justin Jones Justin Jones Professional Head of Physiology at Nuffield Health
This World Diabetes Day, Justin Jones, Head of Physiology at Nuffield Health explains the symptoms, the difference between types 1 and 2 diabetes, and what you can do to reduce your chances of developing the condition.

It’s estimated that 4 million people in the UK are living with diabetes, which is expected to rise to 5 million by 2025. This is a huge concern because, in addition to the impact on quality of life, diabetes can cut life short by up to 10 years.

What is diabetes?

When you eat carbohydrates, your body breaks these down into glucose, increasing your blood glucose levels. Your pancreas responds by releasing insulin to transport the glucose from your blood into your cells, so that you can store it and use it for energy later.

Diabetes is an umbrella term for conditions where the body fails to do this efficiently. There are a few different types of diabetes, but almost all result in chronically high blood glucose levels.

If this isn’t managed, it can cause irreversible damage to your eyes, kidneys, heart, brain and nerve endings. The consequences can be very serious and include blindness, cardiovascular disease, dementia and even amputation. Diabetes can also increase the risk of complications associated with COVID-19.

What are the symptoms of diabetes?

The two most common forms of diabetes are type 1 and type 2, which have very similar symptoms:

  • excessive thirst
  • extreme fatigue
  • unexplained weight loss
  • genital itching or thrush
  • blurred vision
  • slow healing wounds
  • increased urination, particularly at night.

What’s the difference between type 1 and type 2 diabetes?

Type 1 and type 2 are often referred to simply as ‘diabetes’, but while they share symptoms, there are some distinct differences. For example, type 2 diabetes symptoms can develop much slower and it can be more difficult to recognise. Other differences include:

  • Prevalence: About 10% of diabetics have type 1 diabetes, while type 2 diabetes is the most common form, making up about 90% of diabetic cases.
  • Cause: Type 1 diabetes has no known cause, whereas type 2 diabetes is linked to lifestyle factors.
  • Role of insulin: Type 1 diabetes affects the body’s ability to produce insulin, so it must be injected instead. Type 2 diabetics can still produce insulin, but the body’s cells become resistant to the effects – this can be managed with medication, diet and exercise, as well as insulin.
  • Diabetic ketoacidosis (DKA): Those with type 1 are more at risk of DKA – a serious and potentially life-threatening condition. If blood glucose levels are too high, the body uses fat as an energy source and produces an excess of ketones. Symptoms include vomiting, dehydration, high heart rate, confusion and a distinctive smell on the breath, sometimes compared to nail varnish remover or pear drops.

What is pre-diabetes?

There is a grey area, where your blood glucose levels are higher than the recommended range, but not high enough for a diabetes diagnosis.

This is a crucial opportunity to prevent diabetes from fully developing, by taking control of your modifiable risk factors.

Risk factors you can’t change

It’s important to be aware of the things you can’t control in your chances of developing diabetes.

Age

Your risk increases with age and tends to be higher for those above 40. Our health assessment data from 2020 revealed that 2% of under 40s had an abnormal blood glucose, which doubles to 4% for those in their 40s and doubles again to 9% for those over 50. Also, although type 1 diabetes can occur at any age, it’s more commonly diagnosed in children.

Gender

Men are at a slightly increased risk than women. However, giving birth to a baby over 10lbs, gestational diabetes and polycystic ovarian syndrome (PCOS) all increase the future risk of diabetes for women.

Family history

If you have a family history of diabetes, then your risk may be higher.

Ethnicity

Some ethnic groups are a greater risk of diabetes – the risk for South Asian, Chinese and Japanese populations is up to 6 times higher, while for African populations it is 3 times higher.

Reducing your risk of diabetes

Although we don’t know what causes type 1 diabetes yet, type 2 diabetes is largely preventable.

Manage your weight

Being overweight is a significant risk factor for type 2 diabetes. Caucasians are considered to be at an increased risk once their body mass index (BMI) goes above 25 kg/m2, while for Asians the risk increases at a BMI of above 23 kg/m2.

The majority of our health assessment clients in 2020 were at an increased risk of diabetes, due to being overweight (40%) or obese (17%).

Another way to determine your risk is to measure your waist circumference. This should be less than 80cm for women and less than 94cm for Caucasian men, or less than 90cm for Asian men.

Stay active

Being physically active not only helps to control your weight, blood pressure and cholesterol, but also helps to support the transport of glucose from your blood into your cells.

It’s recommended that you complete at least 150 minutes of moderate exercise a week, however 27% of adults do less than 30 minutes of exercise a week.

If this includes you, as well as aiming to get more exercise in, try sitting down less. Being sedentary is an independent risk factor for diabetes, so try to get up and about for at least a few minutes every hour to stretch your legs.

Eat healthily

Both high blood pressure and high cholesterol increase your risk of developing diabetes, and given their lack of symptoms, they may be more prevalent than you think. According to our health assessment data, 12% of clients presented with high blood pressure, while 19% had suboptimal cholesterol.

Keep these risk factors in check by following a Mediterranean diet. Eating a diet of fruit, vegetables, oily fish and fibre and has been shown to improve cardiometabolic health.

Despite the protective factors associated with a healthy diet, just 28% of adults consume five portions of fruit and vegetables a day.

Avoid smoking and drink less

Both smoking and excessive alcohol consumption are associated with an increased risk of diabetes. Smoking rates in the UK have been dropping for quite some time, however 17% of people still partake in this damaging habit.

Also, try not to drink more than 14 units per week, spread over 2 to 3 days. Almost 30% of men regularly exceed this limit, which is over twice as many as women. Generally speaking, drinking habits get worse as we age, which is when the risk of many conditions increases.

Want to know more about your risk?

To understand your risk in more detail, our health assessments include measurements of BMI, waist circumference, blood glucose, blood pressure, cholesterol, urinalysis (to check for glucose and ketones) and your lifetime risk of diabetes.

Our expert Health and Wellbeing Physiologists will work with you to help you truly understand the risk factors you can control and support you in making an action plan to address them.

Have a look at our range of health assessments to help you decide on the right one for you.

References

Diabetes UK, (2010). Key Statistics on Diabetes [WWW]. Available from: https://www.diabetes.org.uk/resources-s3/2017-11/diabetes_in_the_uk_2010.pdf [Accessed on 12th November 2020]

Diabetes.co.uk, (2019). Diabetes prevalence [WWW]. Available from: https://www.diabetes.co.uk/diabetes-prevalence.html [Accessed on 12th November 2020]

Diabetes UK, (2019). What are the signs and symptoms of diabetes? [WWW]. Available from: https://www.diabetes.org.uk/diabetes-the-basics/diabetes-symptoms [Accessed on 12th November 2020]

Diabetes UK, (2019). Diabetes Risk Factors [WWW]. Available from: https://www.diabetes.org.uk/preventing-type-2-diabetes/diabetes-risk-factors [Accessed on 12th November 2020]

Last updated Friday 13 November 2020