Diabetes

Caring for your Type 2 Diabetes

Type 2 Diabetes is increasing rapidly and is a major public health concern. It accounts for around 9% of the NHS budget and currently affects up to 1 in 8 people in this part of London. (Type 1 is a rather different condition, often starting from a young age and developing rapidly with the need for insulin from the start).

It is important to get a good understanding of what Type 2 diabetes is so you know what to watch for and how to manage it. Good care will slow progression and minimise any adverse effects.

Good care revolves around weight reduction, a good diet and regular exercise and it is vital to stop smoking.

Monitoring requires annual checks of your weight, lifestyle, blood tests (for HbA1c, kidney function and cholesterol), blood pressure, foot checks, retinal (eye) screening and a flu jab each September.

Complications can be reduced or avoided with good care – heart disease, kidney failure, visual deterioration, skin conditions, neuropathy (damaged nerves).

You may require tablets or, for some people, injections. Here you can look-up the different treatments.

Useful information for drivers with Type 2 Diabetes

Detecting diabetes

If you are much more tired than usual, passing urine more frequently, feeling thirsty, itchy skin with more infections, especially thrush, recent blurred vision – please do ask for a blood test; it can be quickly arranged.

Non Diabetic Hyperglycaemia (“Pre-diabetes”)

Hyperglycaemia means high blood glucose levels. Non Diabetic Hyperglycaemia (also known as ‘NDH’, ‘Pre-diabetes’, ‘At Risk of Diabetes’, ‘Glucose intolerance’) is detected by a blood test – HbA1c – a level in the high-normal range indicates an increased risk of developing diabetes in the future. It is a useful test for those with family members who have diabetes or are at high risk due to ethnicity (Chinese or South Asian, Black African or African-Caribbean), excessive weight and abdominal girth, high blood pressure, history of heart attack or stroke, chronic severe mental health illness, polycystic ovaries, history of gestational diabetes).

You can check your own risk of developing Type 2 Diabetes here

For those with NDH as detected through the HbA1c blood test we can offer referral to the National Diabetes Prevention Programme , a 9 month course of learning, lifestyle modification and monitoring, dealing with diet, exercise, stress, habits, mindfulness and so on , all proven to help change behaviours towards a healthier lifestyle and avoiding or delaying the onset of diabetes. This page details the timetable.

Excellent though it is, the programme is a big commitment and you may want to look up the information. Diabetes-UK (founded by HG Wells!) has a wealth of information on preventing diabetes.

Type 2 Diabetes reversal

With weight reduction and careful dietary management, it is even possible to reverse diabetes – ‘diabetes in remission’.

It is not a cure and may come back but it is a dramatic new understanding of the condition (there is a good book by Prof Roy Taylor, who pioneered this approach, ‘Life without Diabetes’ and there are details and good information on the Diabetes-UK website

There are also local programmes being developed and some videos and information on the Know Diabetes site .

We can refer suitable patients in this area to the REWIND programme for reversal of your diabetes.

Excercise for Diabetes

Excerise is very important to help control diabetes. You should be physically active each day – anything is better than nothing.

Aged 19 – 64 it is recommended do at least 150 min moderate exercise each week or 75 min vigorous activity exercise each week.

• Moderate means raising your heart rate and making you breathe faster and feel warm – eg brisk walking, dancing, riding a bike.
• Vigorous means breathing hard and fast and can include swimming fast, running or jogging, walking up the stairs, cycling fast or up hills etc.
• Very vigorous exercise HIIT – High Intensity Interval Training) is short bursts of intense activity such as circuits, running up stairs, interval running, lifting heavy weights. Read about the scientific evidence for this.

Muscle-strengthening exercises on at least 2 days a week

• Muscle-strengthening exercises include: carrying heavy shopping, yoga, Pilates, Tai Chi, lifting weights, working with resistance bands, heavy gardening, push-up and sit-downs.

NHS resources include some good aerobic exercise videos from the NHS Fitness Studio and the famous and excellent (and importantly, fun!) Couch to 5K programme

You can start looking for something which might appeal here

If you need to begin improving fitness, this Strength and Flexibility programme can be an easy, equipment-free start.

No time for exercise – try these 10 minute workouts.

The BBC site also has an overview of all the types of exercise and sport

Older age group recommendations and suggestions:

Older people Sitting exercises Other exercises for older people

There is a wide range of good articles on exercise for health on Patient.Info

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