Diabetes is vastly prevalent around the globe. It is a complicated condition currently affecting more than 4.9 million people in the UK. In other words, one in 15 people in the UK have diabetes, including one million people who have type 2, but not been diagnosed (ref; Diabetes UK, 2019a). Working in Health & Nutrition arena, I came across people who need support with managing Diabetes, behavioural aspects towards daily lifestyle and most importantly clearing their understanding about what exactly it means being diagnosed with Type 2 Diabetes.
So, to start with, let’s firstly know what the different types of Diabetes are and will also talk you through the most common types. Here are the common types of Diabetes Type 1, Type 2 and Gestational Diabetes. There are other types as well, but those ones are the rare types which affects 2% of people. We might not go through the details of all rare types of Diabetes, but it is important to understand the most common and main type of Diabetes. The three major symptoms of diabetes are 3 Ps:
- Polyuria - the need to urinate frequently
- Polydipsia - increased thirst and fluid intake
- Polyphagia - increased appetite
I always receive a question about a confusion between Prediabetes and Type 2 Diabetes. To understand both terms, I’ll try to explain this in a very easy terms/way. Prediabetes is an alarming stage that tells you that your blood sugar or in other words blood glucose levels are higher than the normal levels, but not yet crossing or reached the edge to form a diabetes diagnosis. This also means once you are at this stage, you are most likely to be at a risk of developing Type 2 Diabetes. However, at this point, there is a humongous support available that helps you to reduce your risk of going to the next stage.
I supported many people who worked towards makings changes to their lifestyle and were successful in managing their blood sugar levels at the optimum range. Behavioural modification and small, yet sustainable changes to your lifestyle would make a huge difference to your wellbeing.
Now, a little bit about Type 2 Diabetes- Although this type of Diabetes can occur in all ages but in the past, it was only predominant in adults. The recent data reflects that it is now affecting in young children as well. The number of children who have diabetes under the age of 19 is about 36,000, of which about 10% have type 2 diabetes (or other rarer types of diabetes) [Diabetes UK, 2019a]. Type 2 diabetes is a condition in which your body can’t control the amount of glucose (sugar) in your blood. As a result, your blood glucose level becomes too high. This happens when your body doesn’t respond to insulin (pancreas makes this hormone) properly, and pancreas may not produce enough insulin.
Insulin is a vital hormone and plays a very important role in our body. In a normal process, insulin helps glucose to enter the blood stream that is needed for energy/fuel. Here is my favourite and easy to memorise example e.g. by visualising insulin as a car and glucose being the passenger. Passenger needs to reach at the destination and the only way is that car. Regarding our body, Insulin is a car which means, the transporter of glucose (a passenger) who needs to reach into the body cells. Therefore, insulin is an important hormone to live and helps to balance blood glucose levels. Both glucose and insulin must be in a set proportion for normal metabolism.
Where do we get energy from and how it converts in the form of glucose in our body?
After consuming carbohydrates, blood glucose levels rise and why is that?
The answer is- When you eat carbohydrates, it breaks down into sugar and enter the bloodstream in the form of glucose. As explained above, the pancreas acts by producing insulin that allows glucose to enter the cells/tissues. In case of where insulin production isn’t working well, your blood glucose keep rises and if insulin is not available, the extra glucose remains in the blood and affects the organs it comes in contact with.
Target blood glucose level ranges: Image taken from Diabetes UK
| Target levels by type | Upon waking | Before meals | At least 90 mins after meals |
|---|---|---|---|
| Non-diabetic | 4.0 to 5.9 mmol/L | under 7.8 mmol/L | |
| Type 2 diabetes | 4 to 7 mmol/L | under 8.5 mmol/L | |
| Type 1 diabetes | 5 to 7 mmol/L | 4 to 7 mmol/L | 5 to 9 mmol/L |
| Children w/ type 1 diabetes | 4 to 7 mmol/L | 4 to 7 mmol/L | 5 to 9 mmol/L |
Blood sugar levels in diagnosing diabetes: Image taken from Diabetes UK
| Plasma Glucose Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Random | Below 11.1 mmol/l.Below 200 mg/dl | N/A | 11.1 mmol/l or more.200 mg/dl or more |
| Fasting | Below 5.5 mmol/l.Below 100 mg/dl | 5.5 to 6.9 mmol/l.100 to 125 mg/dl | 7.0 mmol/l or more.126 mg/dl or more |
| 2 hour post-prandial | Below 7.8 mmol/l.Below 140 mg/dl | 7.8 to 11.0 mmol/l.140 to 199 mg/dl | 11.1 mmol/l or more.200 mg/dl or more |
The other common question I receive is about a lack of understanding regarding the HbA1c. This term refers to glycated haemoglobin. HbA1c tells your average blood glucose levels over the last 3 months. The target range of HbA1c for people with diabates is 48mmol/mol. Please see the table below to know more about the HbA1c levels (Image taken from Diabetes UK):
| HbA1c | mmol/mol | % |
|---|---|---|
| Normal | Below 42 mmol/mol | Below 6.0% |
| Prediabetes | 42 to 47 mmol/mol | 6.0% to 6.4% |
| Diabetes | 48 mmol/mol or over | 6.5% or over |
I would suggest seeking support if you are newly diagnosed with Diabetes and not sure where to start. Please find the appropriate health professional for more support or ask your GP for any help. Happy to support with healthy eating, nutrition and better lifestyle with Diabetes.