Today is World Diabetes Day. The theme is The Family and Diabetes .

The Brussels-based International Diabetes Federation ( www.idf.org ) leads the World Diabetes Day campaign. It is the global advocate for the millions of people living with diabetes worldwide. A Non-Governmental Organisation (NGO), it represents more than 230 diabetes associations in 170 countries and territories. Its mission is to promote diabetes care, prevention and a cure worldwide.

Diabetes concerns every family

According to IDF:

More than 425 million people are currently living with diabetes . It is estimated this figure will rise to 640 million by 2040. Most of these cases are type 2 diabetes, which is largely preventable through regular physical activity, a healthy and balanced diet, and the promotion of healthy living environments. Families have a key role to play in addressing the modifiable risk factors for type 2 diabetes and must be provided with the education, resources and environments to live a healthy lifestyle.

One in two people currently living with diabetes is undiagnosed . Most cases are type 2 diabetes. Early diagnosis and treatment are key to prevent the complications of diabetes and achieve healthy outcomes. All families are potentially affected by diabetes and so awareness of the signs, symptoms and risk factors for all types of diabetes are vital to help detect it early.

Diabetes can be expensive for the individual and family . In many countries, the cost of insulin injection and daily monitoring alone can consume half of a family’s average disposable income, and regular and affordable access to essential diabetes medicines are out of reach for too many. Improving access to affordable diabetes medicines and care is therefore urgent to avoid increased costs for the individual and family, which impact on health outcomes.

Less than one in four family members have access to diabetes education programmes . Family support in diabetes care has been shown to have a substantial effect in improving health outcomes for people with diabetes. It is therefore important that ongoing diabetes self-management education and support be accessible to all people with diabetes and their families to reduce the emotional impact of the disease that can result in a negative quality of life.

What is the difference between type 1 and type 2 diabetes?

Put simply, there are two main types of diabetes: type 1 and type 2. Both types of diabetes are chronic diseases that affect the way the body regulates blood sugar, or glucose. Glucose is the fuel that feeds a body’s cells, but to enter the cells it needs a key. Insulin is that key.

·People with type 1 diabetes don’t produce insulin. You can think of it as not having a key.

·People with type 2 diabetes don’t respond to insulin as well as they should and later in the disease often don’t make enough insulin. You can think of this as having a broken key.

Both types of diabetes can lead to chronically high blood sugar levels. That increases the risk of diabetes complications.

Diabetes in the UK

In the UK, poor diet, obesity, inactivity and other unhealthy lifestyle choices are key triggers for diabetes, particularly type 2.

The Diabetes Research & Wellness Foundation in Hampshire ( www.drwf.org.uk ) reports that there are currently more than 3.8 million people with diabetes in the UK. It is estimated that around a further 500,000 adults have type 2 and don't know it. For every 10 people with diabetes, 1 (10%) has type 1 which is unpreventable. The remaining 9 (90%) people have type 2 which in many cases can be prevented.

There are a number of other leading UK charities focused on diabetes research, advocacy, advice and raising funds. A search on the internet for ‘Diabetes’ will reveal a wealth of information too numerous to list here. The NHS and other healthcare providers also offer useful advice.

Diabetes and Podiatric Care

Every week 170 people will lose a limb to diabetes, the majority with type 2 diabetes.

Betafeet Podiatry ( www.betafeetpodiatry.co.uk ) with clinics in Hemel Hempstead and Tring takes diabetes very seriously. Clients established and new are asked to update or provide their medical history, where diabetes is a key question. Despite the effect the condition can have on the feet, podiatry for people with diabetes is one of the most overlooked aspects of diabetes management (see www.betafeetpodiatry.co.uk/diabetic-feet-arthritis ).

Diabetics who visit Betafeet will be assessed once or twice yearly to check for any nerve damage (neuropathy) and other potential diabetic-related foot health issues, even if diabetes hasn’t been formally diagnosed.

Diabetes break-throughs in research and treatments

Diabetes is oft in the news these days. Again, these are too numerous to list, but here are a few:

·Wearable glucose monitors will be available to tens of thousands of type 1 diabetes sufferers from April 2019 through the NHS. It reduces the need for finger-prick tests and helps type 1 diabetics personally manage their condition. Prime Minister Theresa May, a well-known type 1 diabetic was spotted wearing such a monitor at a dinner with President Donald Trump in July.

·Doctors in Edinburgh believe a simple blood test ‘could mean the end to daily insulin jabs’ for Type 1 diabetics.

·Type 2 diabetes signs may be ‘detectable 20 years before diagnosis’. A Japanese research study carried out between 2005 and 2016 looked at Body Mass Index (BMI) levels for 27,000 non-diabetics. A higher BMI is a well-known risk factor for type 2 diabetes.

·Diabetes UK has published the following article on how a low carbohydrate diet has allowed a man to stop taking insulin. See www.diabetes.co.uk/diabetes-news- ‘Diabetes Awareness Month: David no longer takes insulin thanks to Low Carb Program’ (12 November 2018).