NHS England blog: Millions of people have diabetes, but how much do you know about it?

By Dr Joan St John

An estimated 5.6 million people in the UK are living with diabetes and rates are rising.

Recent figures showed that 549,000 more people have been identified over the past year as being at risk of developing type 2 diabetes.

Why does this matter? Diabetes is a leading cause of many serious yet preventable health conditions. These include kidney disease, strokes and retinopathy, which affects the eyes and can lead to blindness.

The good news is that we can do something about it. Diabetic eye screening and health checks can help identify people at risk of these conditions early, so that preventative treatment can be offered sooner.

But many people, even some NHS colleagues, tell me they lack confidence when talking about diabetes. Experience tells me that when people discuss it and are supported, it helps them to make positive lifestyle changes. It also means they can share their knowledge with friends and family who may also have the condition.

Here are some of the basics you may not know:

Type matters

Many people think type 2 diabetes is an earlier, milder form of type 1 diabetes, but it isn't – they're separate, serious conditions and both can affect children and adults.

In type 1 diabetes, the pancreas can't produce insulin, a hormone that manages the glucose levels in the blood, what we also call blood sugar. This means the levels become too high and this needs to be treated with insulin. It's a lifelong condition that can't be cured.

With type 2 diabetes, the pancreas isn't making enough insulin, or the insulin isn't working properly, causing blood glucose levels to rise.

About 9 in 10 people living with diabetes in this country have type 2 diabetes but it can often be prevented by maintaining a healthy weight, eating a balanced diet and being active. It may also be possible to put type 2 diabetes into remission, with these same lifestyle changes.

Both types can lead to life-changing complications. They can affect your vision or cause problems like kidney disease. They can even be life threatening, leading to heart attacks or strokes.

Another type of diabetes, called gestational diabetes, is caused when high blood sugar develops during pregnancy. It requires close monitoring and sometimes medication too. It usually disappears after giving birth but people who've had gestational diabetes are more at risk of having it in subsequent pregnancies and of developing type 2 diabetes later in life. This is why they will need to have tests to check if gestational diabetes or type 2 diabetes has developed in the future.

I can't have diabetes because I don't eat much sugar

This is something I often hear when people find out they are at risk of developing type 2 diabetes. However, type 2 diabetes is really about our actual weight levels rather than just being about the sugar we eat. Being overweight is one of the biggest risk factors for type 2 diabetes, and the risk is particularly high if you're living with obesity.

Also try to be more active, whether you already have diabetes or want to prevent it. Adults doing the recommended amount of physical activity each week are up to 40% less likely to develop type 2 diabetes.

Know your risk

Diabetes usually develops slowly and the signs are subtle. People might feel tired, have unexplained weight loss or want to pass urine more often. Sometimes people feel really thirsty and drink a lot more than they used to. Or they might have repeated skin or genital infections, like thrush, or wounds that don't heal as they used to.

Having a relative living with type 2 diabetes can increase your own risk of developing the condition. Ethnicity is important too. If you are of black African, African-Caribbean or south Asian heritage, you're more likely to develop type 2 diabetes, and from a younger age – possibly from as young as 25.

Anyone can find out their risk of developing type 2 diabetes with Diabetes UK's Know Your Risk tool. Finding out your risk means you can start making any changes needed to prevent type 2 diabetes, including accessing help from the NHS.

You may be able to join the free NHS Healthier You NHS Diabetes Prevention Programmefollowing a simple blood test. More than 1.6 million people have been offered this support since it launched.

Or, if you're living with obesity and have diabetes and/or high blood pressure, the NHS Digital Weight Management Programme could help.

Living well with diabetes

Following healthy eating advice and keeping active, while being consistent with taking medication, regular testing and attending diabetic health checks are all essential to keeping people living with diabetes well now. Taking these steps also prevents complications later in life.

Regular checks include blood tests to monitor blood sugar levels and how well your kidneys, liver and other organs are functioning. There will also be checks for blood pressure, height and weight as well as foot health. This is because diabetes can also cause problems with our feet and skin.

Diabetes can also lead to a condition called diabetic retinopathy. If you live with diabetes and are over 12 years old, you're invited for a diabetic eye screening appointment every 1 or 2 years depending on your risk. This looks for early signs that something might be going wrong at the back of your eyes which you may not be aware of. Diabetic eye screening isn't the same as the eye tests at the optician to check your vision or glasses, so it's important to have both.

People living with diabetes are also among the eligible groups for seasonal vaccinations, because having diabetes can make you especially vulnerable to serious illness from flu or Covid-19.

Each one, teach one

Education is critical to improving the health and wellbeing of our communities and you don't need to be a diabetes expert to make a difference. The proverb ‘each one, teach one' means taking the time to learn and spread your knowledge. It's important because when people understand the benefits of looking after themselves, they're more likely to do just that.

Dr Joan St JohnDr Joan St John is a GP and trainer specialising in diabetes who works in London.

She co-authored ‘Carbs & cals world foods: a visual guide to African, Arabic, Caribbean and South Asian foods for diabetes and weight management' and speaks regularly at events.

She also contributed to the Eating Well podcast from Diabetes UK and this NHS England podcast with AffinityXtra.