Diabetes is a common long-term condition that is caused by too much glucose (a type of sugar) in the blood. In the UK, diabetes affects approximately 3.7 million people, and more than 7 million people are thought to be at high risk of developing type 2.

The main thing to remember is that both are as serious as each other. Having high blood glucose (or sugar) levels can lead to serious health complications, no matter whether you have Type 1 or Type 2 diabetes. So if you have either condition, you need to take the right steps to manage it.

The main symptoms are:

• feeling very thirsty;
• going to the toilet a lot, especially at night;
• extreme tiredness;
• weight loss and muscle wasting (loss of muscle bulk).

There are two main types of diabetes:

Type 1 – often referred to as “insulin dependent”, it occurs when the body cannot produce insulin. It is far less common than type 2 diabetes and people with type 1 make up only 10% of all people with diabetes. Symptoms of type 1 can develop quickly, over weeks or even days.

Type 2 – often referred to as “insulin resistant”, it occurs when not enough insulin is produced by the body. Type 2 diabetes is often associated with obesity.

Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it is more common in older people.

If you have type 2 diabetes you may be able to control your symptoms by following a healthy diet and monitoring your blood glucose level. Many people have type 2 for years without knowing it because early symptoms can be general. Although there isn’t a cure for diabetes, the condition can be treated very successfully, especially if diagnosed early. Living a healthy lifestyle and keeping your weight under control can also prevent type 2 diabetes.

If you are overweight, losing weight can help reduce the risk of developing type 2.

If you have type 2 diabetes you do not need a special diet. Eating a healthy, varied diet and being active will enable you to manage your blood glucose levels and your weight. Incorporating physical activity is good for all of us but is especially important for people with diabetes.

Eating well and being active, along with any medication that you might be taking, will help you to manage your diabetes and help prevent long–term complications.

Remember – before you start any new activity or weight-loss programme, talk to your doctor or health care team.

The NHS and Diabetes UK recommend a healthy, balanced diet that is low in fat, sugar and salt and contains a high level of fresh fruit and vegetables.
The following tips sum up their approach to controlling type 2 diabetes with diet:

Choose high-fibre, starchy carbohydrates and take care with portion sizes. Eat carbohydrate foods with a lower Glycaemic index (Gi) and include some at each meal. Examples of lower-Gi carbohydrate foods include wholegrain bread, porridge oats, pulses, most fruit and low-fat yogurt.

• Avoid high-Gi foods (eg white bread, short grain white rice, dates) especially between meals.
• Eat regular meals and healthy snacks and don’t skip meals or miss breakfast.
• Choose fruit in moderation. Eating large quantities, for example several portions at once, will raise blood glucose.
      1 portion =
      1 piece of ordinary-sized fruit, eg apple, orange, small or ½ a banana, 80 grams of vegetables
      2 fruits, eg plums or satsumas
      a handful of grapes or a slice of a large fruit, eg melon
      ½-1 tbsp of dried fruit, eg sultanas
      a small glass of pure fruit juice (150ml)
      2-3 tbsps of cooked vegetables or a small bowl of mixed salad.
• Avoid hydrogenated fats, fried and fast food.
• Choose low-fat plant-based dairy-free products.
• Check food labels for fat, added sugar and salt content.
• Choose low in saturated fat options - cutting back on coconut and palm oil.
• Eat B12 rich foods regularly
• Keep hydrated, with water as the best choice or well-diluted sugar-free/diet drinks.
• Stick to the safe limits for alcohol and avoid binge drinking.

Hypoglycaemic attacks
As a general rule, these occur when meals are missed and blood sugar drops too low, or when the calories taken in are less than the body needs. To avoid hypoglycaemic attacks make sure that you don’t miss any meals and have low-calorie snacks in between.
To treat a hypoglycaemic attack, 10g of rapidly absorbed carbohydrate is required and this can obtained from:

• 3 glucose tablets;
• ½ cup (100ml-150ml) fruit juice or regular, non-diet squash;
• 2 tsps of sugar, plain or dissolved in water;
• 50ml Lucozade.
Wait about 15 minutes before eating any more. Be careful not to over-treat by eating too much. This can cause high blood sugar and weight gain.

If regular hypo attacks occur only after you start your diet, it’s possible that you may be eating too little, or not managing your eating properly. Make sure that you are matching your recommended calorie allowance and keep a full record of what and when you eat (and drink) for a week. If symptoms appear following a meal or snack, note them and look for patterns and then check with your diabetes nurse next time you see him/her, as he/she knows your full history and medication details.

Exercise advice

Physical activity lowers your blood glucose level, so it is particularly important to exercise regularly if you have diabetes. You should be aiming to build up gradually, with your eventual goal being:

F – FREQUENCY = Working towards building activity into your daily routine on 5 days of the week.

I – INTENSITY = Working at a moderate level where you feel mildly breathless, warm but comfortable.

T – TIME = Work towards performing your chosen activity for a total of 30 minutes. This can be broken down and accumulated. You may begin with as little as 3-5 minutes each session and build gradually.

T – TYPE = any activity that fits well into your daily life. For example: walking, vigorous housework, cleaning the car, dancing to music at home, structured exercise (gym sessions, classes etc) sporting activities (swimming etc), yoga/Pilates, exercise DVDs.

With regard to activity, firstly we would advise you to be assessed by your GP or diabetic team prior to increasing your activity levels.
The key considerations are:
• Your diabetes is well controlled.
• Wearing the correct footwear and looking after your feet.
• Your GP will advise you on the effect of activity on blood glucose levels.
• You are able to self-monitor blood glucose levels.
• You may need to adjust your carbohydrate intake prior to exercise and for 24 hours after – again, discuss this with your GP.
• Remember to drink plenty of water before, during and after exercise.

Options you could discuss with your GP are:
Cycling, as it has many benefits
Doing the housework a little more vigorously and maybe more frequently.
Washing the car with vigour!
Taking up an active hobby such as gardening or DIY.
Swimming and exercise in water offer support to the body and the increased buoyancy minimises stress on the joints. Water also adds resistance to your movements, which can help increase muscle strength.
Walking is a great way to improve your fitness levels and help you lose weight, but take care not to overdo it. Exercising to music such as following exercise DVDs is a great way to get fitter..

Finally, taking up gentle yoga or Pilates may help with your flexibility. You should be working towards positions where you feel mild tension, not discomfort. You should also check that your instructor is properly qualified.

The emotional impact of Type 1 and Type 2 diabetes

Living with Type 1 or Type 2 diabetes can sometimes feel overwhelming.
Both types are different but feeling down or anxious because of your diabetes can affect anyone. It is important to understand that a long-term condition can come with an emotional impact, no matter how it has been caused or how you treat it.

If you’re struggling with your diabetes, remember that you’re not alone.

There is lots of support available to you, for example the Diabetes UK helpline:  
Call: 0345 123 2399*, Monday to Friday, 9am to 6pm
Email: helpline@diabetes.org.uk

If you're in Scotland:
Call: 0141 212 8710*, Monday to Friday, 9am to 6pm.
Email: helpline.scotland@diabetes.org.uk

There you can speak to their highly trained advisors about how you're feeling.  It can be frustrating to explain the differences between Type 1 and Type 2.
Both types face confusion over what causes the condition and how it can be treated. This will be slightly different whether you're Type 1 or the more common Type 2. Just because something is more common, doesn't mean it is understood.