What is diabetes ?

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In very simple terms, as food is digested, the hormone insulin is released by the pancreas (in the upper abdomen) to process and metabolise carbohydrates and sugars to convert into energy.  

Diabetes develops when the pancreas fails to produce enough insulin. The risk is then of raised blood sugar (glucose) levels which can be very harmful to health.

What are the most common types of diabetes?

Type 1 diabetes

This is an auto-immune condition which develops rapidly, usually affecting children, teenagers and young adults below the age of 30 years.

Type 1 diabetes cannot be prevented. Often there is a family history of the condition.

Treatment is with insulin straight away and until further treatments are researched and developed, will continue on a life-long basis.  

All type 1 diabetics will be under the care of the specialist diabetic clinics.  

Type 2 diabetes

This developswhen there is not enough insulin being produced or where the body’s cells react less well to insulin. 

It is often referred to as a lifestyle-related condition and accounts for over 90% of cases of diabetes.

There was a 4-fold increase in diagnosis of type 2 diabetes world wide between 1980 and 2014 to 422 million people with the disease.  

In the UK there are over 4 million people with type 2 diabetes and possibly up to 1 million who have the condition but don’t know it.   

What are the health consequences of type 2 diabetes ?

Raised blood sugar (hyperglycaemia) is known to be very damaging to nerves and blood vessels, particularly if too high over a long period.

This can result in permanent damage particularly to the eyes, kidneys, heart and feet.

As a result there is increased risk of

  • heart disease and heart attack and stroke
  • reduced vision or blindness
  • kidney failure  
  • leg ulcers, loss of sensation to the feet or even amputation.

Who is at increased risk of developing type 2 diabetes ?

  • those who are overweight or obese
  • lack of exercise
  • those with an immediate family member with type 2 diabetes
  • ethnic background – higher prevalence is South Asian and black ethnic groups
  • women who had gestational diabetes (during pregnancy)
  • who have been on high or long term doses of steroids  
  • those with high blood pressure

How can type 2 diabetes be prevented and it’s long-term effects be controlled?

  • a healthy lifestyle is likely to reduce overall risks
  • reduction and good control of weight
  • aim for body mass index (BMI) of 20-25 
  • increase of cardiovascular exercise and physical activity
  • those with ‘pre-diabetes’ – by adopting good self care, development of diabetes requiring treatment can be prevented
  • with self management (diet, weight and exercise), those with early diagnosis can reverse the condition.  
  • take medications as prescribed
  • aim to eat carbohydrates from fresh, natural foods
  • avoid ultra-processed, pre-prepared foods and convenience foods (eg; microwave or ready-made meals)
  • check food labels for hidden sugar and carbohydrate ingredients
  • packet cereals;  sauces and ketchups, bottled pasta sauces, crisps and snacks, biscuits, bread products, ready-made fruit juices, milkshakes and alcohol all have hidden sugars
  • natural grains, potatoes, root vegetables, milk, fruits all have carbohydrates and sugars but a much healthier option
  • attend regularly for routine blood tests, feet and eye checks
  • smoking cessation
  • knowledge is power !  –  ask your diabetic nurse about referral to The Desmond programme (see link below)
  • all of the above are still needed, whatever treatment is prescribed.

How might diabetes affect fitness for work?

  • in uncontrolled diabetes there is likely to be high blood sugar
  • symptoms can include increased thirst, needing to go to the toilet frequently, tiredness and blurred vision
  • increased risk of infections, or infections taking longer to heal
  • infections can temporarily affect normal control of diabetes  
  • increased short term sickness absences, particularly before diagnosis and control with medication  
  • increased risk of long term absences in the event of treatment for chronic or serious complications of diabetes
  • night shift work can potentially impact on medication, insulin and meal routines
  • vehicle drivers may be affected until diabetes is under control
  • drivers treated with insulin must report this to the DVLA
  • drivers on other types of medication may need to report this to the DVLA- ask your doctor or diabetic nurse
  • risk assessment of working at heights, with dangerous machinery or in isolation if there is a risk of low blood sugar ( type 1 diabetes)
  • in event of vision changes, assessment may be needed for adaptations or adjustments
  • refer to occupational health if further advice is needed

Useful links