The sugar rush is on to diabetes
Type 2 diabetes, a preventable disease caused mainly by obesity and poor diet, has become the 21st century's first real pandemic.
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People underestimate how easy it is to slip into the danger-zone weight where diabetes becomes much more likely.
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From cholera to TB, humanity has known many fearsome epidemics and pandemics.
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And while medicine and hygiene have been hugely effective in fighting disease, one of the best weapons has always been education.
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From practising safe sex to avoiding contaminated water, improving public health often demands nothing more than a simple message.
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The first modern pandemic of the 21st century is no different, and the message is already well-known.
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Yet around the world no government, scientist, doctor or public advocate has been able to stem the rise in numbers.
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Type 2 diabetes now affects more than 220 million people worldwide, according to the World Health Organisation (WHO)
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In 2004 an estimated 3.4 million people with type 2 died from consequences of high blood sugar, and the WHO projects that diabetes deaths will double between 2005 and 2030.The charity Diabetes UK says that there are 2.8 million people diagnosed with diabetes in Britain and an estimated 850,000 people who have the condition but don't know it.
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If trends continue, 60 per cent of men and 50 per cent of women will be obese by 2050
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And the majority will either have type 2 diabetes or be at high risk,' Professor Sir George Alberti, the chairman of Diabetes UK, says.
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This frightening escalation will result in an estimated cost of £50 billion to the NHS.
Type 1 diabetes is a condition in which the immune system attacks cells in the pancreas that produce insulin, the hormone that regulates blood sugar.
It occurs in childhood, is unpredictable and irreversible (cases make up no more than 10 per cent of overall sufferers).
Type 2, on the other hand, ought to be completely preventable.
.It is caused principally by obesity and poor diet, with internal organs taking a battering from large quantities of sugar and fat, preventing the pancreas from producing enough insulin, or the body using it effectively.
Those with the condition may become infertile, lose limbs, their sight, even their lives because of it.
This is not a mild or benign condition
You never get a "touch" of diabetes, as some patients seem to describe it.
Yes, you can control it – with scrupulous care of your blood pressure, cholesterol levels and insulin.
But within 10 years of diagnosis, most people will end up self-injecting insulin daily.
And the disease will probably be inflicting damage on the minor blood vessels in their eyes and kidneys, and in the large vessels around the heart and in the legs.
Though clearly linked with obesity, another concern for doctors is that most people underestimate how easy it is to slip into the danger zone of weight where diabetes becomes much more likely.
You don't have to be obese to be at risk,' Simon O'Neill, the director of care, information and advocacy at Diabetes UK, and a qualified nurse, says.
Much depends on where you store your fat.
Women whose waists measure more than 31½ inches, and men whose waists are greater than 37 inches [35 inches for men of south-east Asian descent] are in the at-risk category.
As we age, we all find it harder to control our weight, so that means we all become more at risk of diabetes simply with the passing of time.
Already we are spending 10 per cent of the health budget on five per cent of the population simply trying to control and manage the problem, and soon one in five hospital beds will contain a diabetes patient.
And we are not alone. India and China are both seeing huge rises in numbers.
The brakes are simply not going on.
What really concerns doctors is that growing levels of obesity in children have led to cases of type 2 being diagnosed among the under-18s.
Twenty years ago it was unheard of,' O'Neill says.
Now, obesity-led onset of diabetes is a completely new paediatric disease.
There are parts of the world where 10 per cent of children have type 2.
If you have diabetes at 50, and you control it well, even with some damage to blood vessels, you may shorten your life a little, or be more incapacitated at 70 than you might have been, but what happens to someone diagnosed at 20?
The consequences for them will be huge.
They will spend their lives on medication, at increased risk of stroke and heart disease, never knowing a normal life.
He gives a warning:
We are at risk of seeing the first generation of humans who will have shorter lives than their parents.
Smoking is a common factor in developing type 2; it raises blood glucose levels, probably due to the nicotine and other ingredients in cigarettes causing insulin resistance.
Type 2 sufferers who smoke risk developing neuropathy (nerve damage), nephropathy (kidney damage) and retinopathy (eye damage)
It occurs in childhood, is unpredictable and irreversible (cases make up no more than 10 per cent of overall sufferers).
Type 2, on the other hand, ought to be completely preventable.
.It is caused principally by obesity and poor diet, with internal organs taking a battering from large quantities of sugar and fat, preventing the pancreas from producing enough insulin, or the body using it effectively.
Those with the condition may become infertile, lose limbs, their sight, even their lives because of it.
This is not a mild or benign condition
You never get a "touch" of diabetes, as some patients seem to describe it.
Yes, you can control it – with scrupulous care of your blood pressure, cholesterol levels and insulin.
But within 10 years of diagnosis, most people will end up self-injecting insulin daily.
And the disease will probably be inflicting damage on the minor blood vessels in their eyes and kidneys, and in the large vessels around the heart and in the legs.
Though clearly linked with obesity, another concern for doctors is that most people underestimate how easy it is to slip into the danger zone of weight where diabetes becomes much more likely.
You don't have to be obese to be at risk,' Simon O'Neill, the director of care, information and advocacy at Diabetes UK, and a qualified nurse, says.
Much depends on where you store your fat.
Women whose waists measure more than 31½ inches, and men whose waists are greater than 37 inches [35 inches for men of south-east Asian descent] are in the at-risk category.
As we age, we all find it harder to control our weight, so that means we all become more at risk of diabetes simply with the passing of time.
Already we are spending 10 per cent of the health budget on five per cent of the population simply trying to control and manage the problem, and soon one in five hospital beds will contain a diabetes patient.
And we are not alone. India and China are both seeing huge rises in numbers.
The brakes are simply not going on.
What really concerns doctors is that growing levels of obesity in children have led to cases of type 2 being diagnosed among the under-18s.
Twenty years ago it was unheard of,' O'Neill says.
Now, obesity-led onset of diabetes is a completely new paediatric disease.
There are parts of the world where 10 per cent of children have type 2.
If you have diabetes at 50, and you control it well, even with some damage to blood vessels, you may shorten your life a little, or be more incapacitated at 70 than you might have been, but what happens to someone diagnosed at 20?
The consequences for them will be huge.
They will spend their lives on medication, at increased risk of stroke and heart disease, never knowing a normal life.
He gives a warning:
We are at risk of seeing the first generation of humans who will have shorter lives than their parents.
Smoking is a common factor in developing type 2; it raises blood glucose levels, probably due to the nicotine and other ingredients in cigarettes causing insulin resistance.
Type 2 sufferers who smoke risk developing neuropathy (nerve damage), nephropathy (kidney damage) and retinopathy (eye damage)
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Smoking also decreases the amount of oxygen reaching the tissues of the body, which can lead to a heart attack or stroke.
And it can make blood cells stick together, which attracts cholesterol and causes fats to stick to the artery walls, making it difficult for blood to circulate.
The end result is damaged and constricted blood vessels (known as atherosclerosis), or the formation of a clot which can break away to travel round the body, leading to a heart attack, stroke, peripheral vascular disease and worsening of foot and leg ulcers.
It is a classic symptom of type 2, caused when the body responds to the need to excrete toxic amounts of sugar circulating in the blood, which would normally be managed via insulin and burnt off or stored; instead the kidneys flush it out – leading to intense thirst, and constant trips to the lavatory.
Sufferers of type 2 don't automatically need to begin injecting insulin, which is naturally produced whenever we eat, with the stomach sending a message to the brain that food is present, and the brain sending a message along the spinal cord (the neurotransmitter superhighway) to the pancreas to warn that insulin is needed to deal with the sugar that will be produced when food is digested, and be transported by the blood.Insulin acts as a key, unlocking the cells, so if there is not enough insulin, or it is not working properly, the cells are only partially unlocked (or not at all) and glucose builds up in the blood.
And it can make blood cells stick together, which attracts cholesterol and causes fats to stick to the artery walls, making it difficult for blood to circulate.
The end result is damaged and constricted blood vessels (known as atherosclerosis), or the formation of a clot which can break away to travel round the body, leading to a heart attack, stroke, peripheral vascular disease and worsening of foot and leg ulcers.
It is a classic symptom of type 2, caused when the body responds to the need to excrete toxic amounts of sugar circulating in the blood, which would normally be managed via insulin and burnt off or stored; instead the kidneys flush it out – leading to intense thirst, and constant trips to the lavatory.
Sufferers of type 2 don't automatically need to begin injecting insulin, which is naturally produced whenever we eat, with the stomach sending a message to the brain that food is present, and the brain sending a message along the spinal cord (the neurotransmitter superhighway) to the pancreas to warn that insulin is needed to deal with the sugar that will be produced when food is digested, and be transported by the blood.Insulin acts as a key, unlocking the cells, so if there is not enough insulin, or it is not working properly, the cells are only partially unlocked (or not at all) and glucose builds up in the blood.
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If you eat constantly (the modern passion for grazing), or consume a lot of high-sugar foods (such as sweetened drinks, cakes and sweets), or super-calorific food such as pizzas and chips, your pancreas is bombarded with demands for insulin.
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Eventually the pancreas stops responding and either floods the body with insulin that no longer works properly or packs up altogether..
And this is becoming an almost insoluble problem because every food manufacturer on the planet knows that you just need to add sugar and salt to everything in order to hook your consumers
Today without realising it most are hooked on sugar and salt
Where we go from here is anyone's guess
What is clear though is that increasing numbers of our young are dysfunctional
Dysfunctional in the sense that they are not fit and are not capable of leading a full healthy life
Today without realising it most are hooked on sugar and salt
Where we go from here is anyone's guess
What is clear though is that increasing numbers of our young are dysfunctional
Dysfunctional in the sense that they are not fit and are not capable of leading a full healthy life
Societies faced with higher bills for health care and ageing populations face difficult choices.
These choices are coming at us at the same time as other major issues confronting society demand our attention.
We do indeed live in interesting times.
These choices are coming at us at the same time as other major issues confronting society demand our attention.
We do indeed live in interesting times.
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