According to the International Diabetes Federation, more than 400 million people around the globe already have diabetes.
Of this figure, around 90 per cent will have Type 2.
If nothing changes, more than five million people will have diabetes in the UK by 2025.
Here in the UK, Type 2 diabetes already soaks up a whopping 10% of the entire annual NHS budget – equivalent to an astonishing £1.5million an HOUR.
But how has a condition which was only properly identified and named little more than a century ago come to be such an enormous threat to our health?
And more importantly, what can you do to protect yourself against this rising epidemic?
Over the next two days, our brilliant new Your Health In Your Hands series will detail what makes Type 2 diabetes so dangerous and how you can adopt lifestyle changes to drastically reduce your chances of falling victim to it.
What exactly is diabetes?
Around 10% of all diabetes cases are due to Type 1, a condition brought on by a malfunctioning immune system, often
in childhood.
Type 1 is largely random, usually striking because a mild infection has sent the immune system haywire, although those with a family history of the illness are more at risk.
Although the numbers affected are rising, the rate of increase is comparatively slow – about 3% a year.
The big problem is Type 2 diabetes, an altogether different form of the illness which is more commonly associated with obesity, poor diet and sedentary lifestyles.
“Type 2 diabetes is now an epidemic and we are extremely concerned at the rate at which it’s increasing,” says Natasha Marsland, senior clinical adviser at the charity Diabetes UK.
“Around 3.8 million people in Britain have been diagnosed, but it’s estimated that another million or so also have it but do not realise it.”
In both types of diabetes, the body loses its ability to make use of glucose, a type
of sugar released when we eat food which is turned into a source of energy for
the muscles.
The F word
To get into the muscles, glucose needs insulin, a hormone produced by the pancreas – a large gland just behind the stomach. Insulin acts a bit like a key that unlocks the door into muscle cells, so that glucose can be taken on as fuel.
Type 2 is caused when excess fat interferes with the mechanism of this lock. The pancreas senses the insulin it is producing is not being used effectively and tries to compensate by making even more of the hormone.
This can go undetected for years until the pancreas becomes exhausted and can no longer produce enough, or any, insulin.
Meanwhile, blood glucose levels rise, which can affect circulation and cause irreversible damage to vital vessels all over the body.
Left untreated, Type 2 can raise the risk of heart attacks, blindness and amputation. In fact, it is the most common reason for limb removal in the UK and the numbers are soaring.
The reason for this is that high glucose levels restrict blood flow to the feet and lower legs – where blood vessels are smaller and narrower.
The tiniest cut or scratch can then turn into a gaping wound that will not heal because insufficient oxygen-rich blood is reaching it to kick-start the repair process.
“A lot of people, including some doctors, have this misperception that Type 2 is not as serious as Type 1, when in fact it’s just as dangerous,” says Marsland.
“The tragedy is many cases could be prevented with the right advice and support on how to live a healthy lifestyle.”
Now studies show that obesity is the main driving force behind the global spread of the disease.
An estimated 80% of Type 2 cases are directly connected to excess weight.
When doctors assess a patient’s risk, they test for impaired glucose tolerance – a sign that blood sugar levels are higher than normal – and measure the body mass index.
This is a calculation that takes account of weight compared to height.
For patients of white or Caucasian origin, a BMI score of 30 (officially obese) indicates you’re at serious risk and in the need for lifestyle changes, such as a healthy diet and more exercise.
An example would be a man who is 5ft 10in and weighs 15st.
But for patients of South Asian origin – who are genetically more susceptible to the effects of diabetes – the BMI warning flag starts to fly at a score of just 23, or a 5ft 8in man weighing 11st. But BMI is not a perfect alarm system as it doesn’t measure actual body fat levels.
This is why, for example, strong, fit rugby players can be classed as obese – they are large, but much of that bulk is muscle, not fat.
Hidden dangers
Instead, a more accurate indication of diabetes risk is what doctors call visceral fat – hidden fat that lies around the heart, liver, kidneys and pancreas.
Visceral fat is thought to be a major factor in the 20% or so of Type 2
cases where patients appear to be relatively slim and don’t consider themselves to be at risk.
One indicator of visceral fat is a spare tyre – or pot belly in men – which points to a build-up of fat in the abdomen.
But if you are slim and your waistline is not necessarily bulging, how would you know if diabetes is setting in?
“There are many patients who are not overweight but have abdominal fat sitting around the pancreas,” says Marsland.
“They need to look out for other symptoms, such as increased thirst, fatigue, urinating more often than usual and genital itching – all these symptoms can be signs of Type 2.
“Some patients end up walking around for 10 years with the disease before they actually get diagnosed.”
Now there is a major push to catch patients before they get to this stage.
Scientists have identified a condition called “pre-diabetes”, where blood sugar levels are high but full-blown Type 2 diabetes has not yet developed.
At this point, experts say, simple lifestyle changes such as a healthier diet, increased physical activity and weight loss can stop diabetes in its tracks.
“Our blood sugar levels tend to creep higher as we age,” says Marsland.
“So it’s very important that this is picked up early enough to do something about it.
“Losing weight, if you are overweight, and doing more exercise are good ways to lower your glucose levels.
“Exercise helps because it makes
the body more sensitive to insulin and this will help to reduce the amount of sugar in your blood.
“But this doesn’t mean you have to run marathons to improve your health.
“Instead, it’s much better to set yourself realistic goals that you know you can achieve, rather than unrealistic ones that are probably out of reach.”