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Focus on: Diabetes

 There are 1.4 million people in the UK with diabetes, a figure which is expected to double in the next eight years.

Here, we look at what sufferers can do to control this disease.

• What is it?
  

  Diabetes is a common condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly.

  Normally, a hormone called insulin controls blood sugar levels by stimulating the transport of glucose into cells where it is used as fuel by the body.

  When blood sugar levels are high (say, after a meal), insulin levels in the blood rise. When blood-sugar levels are low (eg, during physical activity) insulin levels fall.

  In diabetics, abnormally low levels of insulin mean blood sugar levels are poorly controlled. As glucose in the blood cannot enter cells, it cannot be broken down to make energy, which leads to mental and physical fatigue and blackouts.

• There are two main types of diabetes. Type I diabetes (insulin-dependent diabetes), which affects young people, is an auto-immune condition in which insulin-producing cells in the pancreas are destroyed.

  Type II diabetes strikes between the ages of 40 and 70 and develops when the body can still produce insulin, but not enough for its needs.

• The symptoms
  

  The main symptoms are increased thirst, extreme tiredness, weight loss, blurred vision and going to the loo excessively, especially at night.

  People with Type II diabetes may have it for several years without obvious symptoms. Diagnosis is often made incidentally or when a complication of the disease, such as visual impairment or nerve damage, becomes apparent.

  Telltale signs include fatigue, dizziness, irritability, difficulty concentrating and cravings for sweet foods.

• Who is most a risk?
  

  Genetic predisposition plays a key role. Obesity, having a baby of over 4kg (81/2lb) or being of Asian or Afro-Caribbean origin increase the chances of developing Type II diabetes.

• What causes it?
  

  Type I diabetes develops when insulin-producing cells in the pancreas have been destroyed. It may be triggered by a viral or other infection.

  In Type II diabetes, the body either develops an insensitivity to its own insulin or stops producing enough.

  Doctors claim a close association with obesity and heredity. Nutritionists argue that sugarrich diets and stress are major causative factors to Type II diabetes. They suggest that excessive sugar intake forces the body to produce abnormally high quantities of insulin to control it. Eventually, the body's ability to produce insulin 'wears out', or we become insulin insensitive.

• How is it treated?
  

  People with Type I diabetes rely on injections of insulin and a healthy diet.

  Missing a dose of insulin can be life-threatening.

  Your doctor or diabetes nurse will explain how to give yourself insulin injections.

  They will also show you how you can do a simple blood or urine test at home to measure your glucose levels. This will enable you to adjust your insulin and diet accordingly.

  Type II diabetics may rely on diet alone to control blood sugar, but frequently need additional medication.

  Your doctor will explain how controlling blood glucose and blood pressure levels, regular health checks, healthy eating and fitness can reduce the risk of long-term complications of diabetes, such as heart disease, stroke, high blood pressure, circulation problems, nerve, kidney and eye damage.

• Can nutrition help?
  

  Keeping blood sugar levels within healthy limits is essential - diabetics are advised to avoid sugary foods such as confectionery, cakes and fizzy drinks.

  They should target foods with a low glycaemic index (this means they raise blood sugar levels slowly over time, not suddenly): unrefined brown rice and bread, and oats and grains rather than refined bread, white rice or potatoes.

  Diabetics are also advised to eat fresh fruit and vegetables rich in antioxidant vitamins.

  Patrick Holford, nutritionist and founder of the Institute for Optimum Nutrition, advises eating adequate amounts of Vitamin B6 and zinc found in cereals, yeast, meat and shellfish, which are needed for the formation of insulin.

  The mineral chromium, found in wholefoods, nuts and grains, increases the efficiency of insulin. Studies have found that adult diabetics have lower chromium levels than nondiabetics: if given chromium supplements, they show improved glucose tolerance.

  The charity Diabetes UK warns that diabetic versions of sugary foods still raise blood glucose levels, cost more and can have a laxative effect.