This article is written to support World Diabetes Day on November 14th and raise people’s understanding about diabetes. To advocate for improved care and diabetes prevention whilst also supporting those affected by the condition, World Diabetes Day is the world’s largest awareness campaign for diabetes reaching over 160 countries.
Diabetes UK estimates more than 5.6 million people in the UK are living with diabetes, and that around 90% of those people have type 2 diabetes. We look at the types of diabetes and their impact, spotting the signs, tips for prevention and how employers can support employees.
Types of Diabetes
There’s more than one type of diabetes and it’s helpful to understand the differences.
Type 1 diabetes is a lifelong condition where the body’s immune system attacks and destroys cells that make insulin. Type 2 diabetes is also a lifelong condition and occurs when the body either doesn’t produce enough insulin or the insulin it does produce doesn’t work properly (called insulin resistance). Or it can be a combination of both. There are also some rarer types of diabetes that affect 2% of people with diabetes in the UK.
Do I have diabetes? Spotting the symptoms
Many people have diabetes without realising. This is because symptoms do not necessarily make you feel unwell. The following are all symptoms of diabetes – although they may not necessarily be diabetes. That’s why anyone experiencing the following should visit their GP practice as soon as possible.
- Feeling excessively thirsty.
- Urinating more often than normal.
- Feeling tired.
- Weight loss and loss of muscle.
- Itching around the genitals or frequent bouts of thrush.
- Blurred vision.
Type 1 can develop quickly within weeks or possibly even days. Weight loss is more common for type 1, but less so with type 2.
Your doctor may recommend a HbA1c blood test. This is used to help diagnose diabetes and monitor blood glucose control in people who have diabetes. No preparation is needed for this test.
Diabetes and complications
There are many complications and impacts that diabetes and high blood sugar can have on our bodies. However, there are steps we can take that can help to prevent or delay many of these.
These complications are usually described as either chronic, which are serious complications that build up over time, or acute – which can happen at any time.
Chronic complications:
These can lead to serious bodily damage if left untreated and unchecked.
Eye problems: Some people develop retinopathy which are changes to the inside of the back of the eye and which can affect eyesight. This can be picked up through eye screenings and can be treated to prevent vision loss.
Feet problems: For a diabetic, foot issues can be very serious and can lead to amputation if untreated. Cuts and sores are slower to heal due to damaged circulation; and diabetic patients are often unaware of these because of nerve damage.
High blood sugar: If experienced for long periods can lead to problems with blood vessels. These blood vessel problems can make heart attacks, strokes and other organ issues more common.
Kidney issues: Damage caused by high blood sugar levels and high blood pressure for a long time then affects how easily your body can clear fluids and waste from your body. In severe cases this can result in chronic kidney disease or even kidney failure.
Nerve damage: Occurs due to high blood sugar levels and can make it harder for messages to be carried along nerves to the peripheries of the body and can affect how you see, feel and move.
Mouth issues: Such as gum disease or others due to the effects of diabetes on blood vessels.
Sexual problems: The damage to nerves and blood vessels can mean either a loss of sensation or difficulty getting aroused. This can affect all genders.
Increased infections: High blood sugar levels have an impact on the immune system, which can make it more difficult to fight some types of infections. This means that diabetic patients can experience an increased number of infections compared to the general population, and they can take longer to heal.
Acute complications:
These can happen at any time and could lead to chronic or long-term complications.
Hypos: This is when your blood sugar is too low.
Hypers: Are when your blood sugars are too high.
Hyperosmolar hyperglycaemic state: Is a life-threatening emergency that only happens to those with type 2 and is brought on due to dehydration and very high blood sugar levels.
Diabetic ketoacidosis: Is a life threatening emergency where the lack of insulin and high sugar leads to a buildup of ketones.
How to prevent, delay and manage diabetes
The good news is that there is strong evidence that the onset of Type 2 diabetes can be prevented or delayed in those at risk. This is achieved through a nutritious diet and increased physical activity, both of which will help obtain a healthy weight.
You can do this by:
Stopping smoking: Smoking makes it harder for blood to flow around your body such as to your feet and heart. Stopping is a key part in reducing your chances of complications.
Eat healthier: This can be simply making healthier choices in food you eat, or you can try a mediterranean diet consisting of whole grains, lean protein and healthy fats.
Physical activity helps reduce your chance of complications.
Going to all your medical appointments: Anyone with diabetes in the UK, will be invited for a range of tests and checks each year to monitor their diabetes, look out for any problems and seek further support if needed.
NHS – Healthier You NHS Diabetes Prevention Programme
For those at risk of Type 2 diabetes, the NHS have a free programme called Healthier You NHS Diabetes Prevention Programme, or Healthier You programme for short, which can help to support you. It offers a range of personalised support options, and you’ll have access to trained health coaches.
For more information: https://www.england.nhs.uk/diabetes/diabetes-prevention/
You may be eligible for the programme if you are aged over 18, not pregnant and score moderate or high on the Diabetes UK Know Your Risk tool.
For more information: https://riskscore.diabetes.org.uk/start
How can employers support employees with diabetes?
Reasonable adjustments
This can simply be making sure they have breaks at set times to be able to check their blood sugar levels or providing special equipment if they have eye issues. Sometimes just asking what support is needed reminds people that the organisation cares and that they can discuss their diabetes or attend medical appointments.
Time off work for illness and checkups.
People with diabetes are likely to require several appointments a year to help monitor their condition and to reduce their risk of developing complications. They also have an annual review which is essential for them to continue managing their diabetes. When managing someone with diabetes it is imperative for them to be able to take time off for these checkups, thus check your policies for those with long term health conditions and approving time off for medical appointments.
Also, when someone with diabetes gets a cold or stomach bug they may need to do extra checks, whether that be with their team, checking their blood sugar levels, staying hydrated or managing what they eat. Therefore, provide them with flexible working options if appropriate as they return.
Time off for a diabetes educational course
There are educational courses, such as DAFNE (for type 1) and DESMOND (for type 2), your employees can take to help them understand and manage their condition. You as an employer could encourage them to go to one as they can make a large difference in how well they can manage their condition and improve their health in the long run, reducing their time off for complications.
Awareness and support for healthier eating
Your workplace restaurant (if you have one) is the ideal platform to serve food that contains more whole grains, fruit and vegetables with more protein, less sugar and the right balance of fats. Promotion of good nutrition should go in hand with eliminating bad food habits. Common offenders are eating at desks (preventing exercise) and the vending machines that dispense processed food such as snacks high in sugar and saturated fat. For more information, please see our article ‘A healthier approach to processed foods at work’.
In conclusion
To echo the positive message behind World Diabetes Day, with appropriate access to diabetes care and support for wellbeing and healthier dietary options at work, everyone with diabetes has the chance to live well.
Useful sources of further information
https://www.diabetes.org.uk/living-with-diabetes/life-with-diabetes/employment/employers
https://www.nhs.uk/conditions/diabetes/
https://www.diabetes.org.uk/about-diabetes/complications
