Friday 23 February 2018

15 facts about diabetes

People with diabetes can travel the world and climb the highest mountain
People with diabetes can travel the world and climb the highest mountain

Áilín Quinlan

From the difference between type 1 and type 2, to knowing the symptoms and how to control it, our reporter talks to Professor Seamus Sreenan, Consultant Endocrinologist at Connolly Hospital, to bring you all you need to know about diabetes

There are currently almost 226,000 people living with diabetes in Ireland. The incidence of the condition is rising, and the economic burden of the condition on the Irish health care system is a growing challenge for both the government and the HSE.

Research carried out in 1999 showed that the cost of treating type 2 diabetes alone accounted for a staggering 10pc of the national health budget.

However, if predictions about the growing incidence of diabetes in the Irish population prove true, this is a cost which may spiral even higher in the coming years. According to research published last year, the number of people with diabetes in this country is set to rise to nearly 279,000 within 15 years. Knowing as much as possible about your diabetes and its medication regime is key to helping you remain in control.

1 Type One? - Type Two?

There's a significant difference between type 1 and type 2 diabetes, and it can be difficult for people to understand.

Type 1 diabetes, Professor Sreenan explains, is an auto-immune condition in which the body's own immune system attacks and damages beta cells, which are the cells which make insulin in the pancreas. That means patients have little or no insulin themselves, so they have to take it.

Type 1 usually presents in younger people, but can occur in adults. Onset can be rapid, with noticeable symptoms over a number of days. Treatment involves insulin, which is regulated to food intake and physical activity.

Type 2 diabetes, which usually occurs in older people, normally adults but also in younger people with a strong 'at risk' family history, is very different.

"This occurs where the body becomes resistant to insulin, which can happen over years or decades. The pancreas starts to produce more insulin to overcome the resistance, but at some point that compensation mechanism fails and the blood sugar levels start to rise.

"In the early stages it can be controlled by diet and exercise, and may require oral tables or injections of insulin or other treatment. Such people are often overweight, may be older."

2 Type 2 diabetes is preventable - in some cases.

You can reduce your risk of developing type 2 diabetes by eating a healthy diet and staying active. Most importantly, you can reduce your risk by watching the waistline and maintaining a weight appropriate for your height. Calculate your own risk on

3 Yes, people with diabetes can eat sugar.

Sugar is fuel for the body, Professor Sreenan explains. "There is a belief that if you have diabetes you cannot have sugar, but we recommend that approximately 50pc of the calories everyone takes in should come from carbohydrate sources, ie. starchy carbohydrates and with meals rather than on its own.

"Foods such as bread, pasta or rice contain sugars which are broken down by the body and used as fuel."

4 All diabetes is serious!

"There is a perception out there that type 2 diabetes is less severe because you don't necessarily have to take insulin, so people will say they have 'a touch of diabetes'," Professor Sreenan observes.

"However, type 2 diabetes is a serious condition which needs to be controlled."

Yes, people with type 2 diabetes don't necessarily need to take insulin, he says - but if someone with type 2 diabetes doesn't manage their condition properly, they can develop the same complications as someone with type 1 who has to take insulin.

5 Diabetes is the leading cause of blindness in Ireland today

Every person with diabetes should ensure they're registered with Diabetic Retina Screen, the free national programme offering regular screening for people aged 12 and over. The eye-check is not to tell you whether you need glasses for reading - it checks the blood vessels at the back of your eye which can become damaged with no symptoms till too late to treat. The number to check if you are registered is 1800 45 45 55 or visit

6 Control your diabetes - don't let it control you

You can do this by eating healthily, taking regular physical activity and complying with the prescribed regime of medication. Have your annual check-up to ensure sure you're still in control of all aspects of your diabetes.

7 You can't take insulin as a tablet!

Currently insulin must be taken as injection or via a pump as the digestive juices would harm it if it was taken in tablet form, but there are trials of inhaled insulin taking place with limited success.

"When people are diagnosed with type 2 diabetes for the first time, they may need insulin," says Sreenan. "Some think it is possible to have it in tablet form, but this is not possible, although there is ongoing work to develop a non-injectable form."

8 Yes, some people with type 2 diabetes will need insulin injections

But this does NOT mean they have developed type 1 diabetes.

"It's not inevitable but a significant proportion of people with type 2 diabetes will require insulin at some time," explains Professor Sreenan.

When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications, he says.

But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.

9 Low blood sugars are not a symptom of diabetes!

Low blood sugars are actually a side-effect of the treatment (tablets or insulin) which a person needs to maintain good glycaemic control of their diabetes.

"When a patient takes insulin for type 1 or type 2 diabetes, or a patient is taking certain medication for type 2, a potential side-effect can be low blood sugar. Insulin lowers the blood sugar level, so if you take too much or you don't eat enough during exercise, the blood sugar level may drop," Sreenan explains.

10 People with diabetes don't need special "diabetic" foods

Foods marked "diabetic" are neither recommended nor needed according to Professor Sreenan - they generally offer no special benefit, he says.

"Most of them still raise blood glucose levels, are usually more expensive and can also have a laxative effect if they contain sugar alcohols. The diet for a person with diabetes is a healthy meal plan the same as a healthy diet for anyone - low in saturated and trans-fat, moderate in salt and sugar, with meals based on lean protein, non-starchy vegetables, whole grains, healthy fats and fruit."

11 People are not 'diabetic'

People should not be labelled by their condition. "Increasingly there is a perception of stigma around diabetes," he protests. " When you say a person is "diabetic" you are labelling that person by their condition. People with diabetes can travel the world, climb the highest mountain, and partake in any workplace task as long as they have their equipment with them."

12 Learn the ABC of diabetes control

Diabetes requires more than simply managing sugar intake and controlling blood glucose levels, warns Professor Sreenan.

"The complications of diabetes are not just related to blood sugar, but to blood pressure and cholesterol also," he observes. "All of these risk factors should be monitored and controlled."

So use 'ABCs' of diabetes control.

A is for A1C: an estimated average glucose tells you your average blood glucose for the past two to three months.

B is for blood pressure. High blood pressure makes your heart work harder than it should.

C is for cholesterol which tells you about the amount of fat in your blood. Some kinds, like HDL cholesterol, help protect your heart. Others, like LDL cholesterol, can clog your arteries. High triglycerides raise your risk for a heart attack or a stroke.

13 Ask your pharmacist

The pharmacist can help you plan out a schedule for your medication regimen, resolve health issues, and save you time and effort by directing you to additional help. He or she knows the medications you are on, can alert you to potential drug interactions or advise you on over-the-counter medications.

14 Don't go it alone

Never discontinue a medication without first consulting your doctor or other health professional.

"We find that compliance with medication is often far from 100pc," points out Professor Sreenan. "There are various reasons for this but it's always crucial for a patient to discuss any reservations they may have about their medication with their doctor, nurse or pharmacist.

"Be sure to talk to your pharmacist or your nurse if you are experiencing any problems or side-effects from the medications you were prescribed," he adds.

15 Type 2 diabetes can be put into remission

Type 2 diabetes in a person carrying a lot of excess weight can be put into remission by losing the excess weight. However, if the weight is regained, type 2 diabetes will almost certainly re-occur, Professor Sreenan warns.

For further information, please contact the Diabetes Ireland Helpline which is open Monday to Friday 9am to 5pm on 1850 909 or visit:

Head Office: 01 842 8118 or

Southern Regional Office in Cork: 021 4274229 or email

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