terry gault
on diabetes

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Terry Gault is a proud paid-up, card-carrying type-one diabetic, who has experienced the general public and medical profession's ignorance first-hand.

For those who are interested, here are a few basics:

Oh, diabetes... my auntie has that...

Diabetes, generally speaking, is actually several conditions that share similar symptoms and sometimes common treatments.

The most common variety is type-two, in which the body can't use the insulin it produces efficiently. The treatment ranges from more exercise and a modified diet through medication to insulin injections in severe cases.

Although poor control of the high blood sugars involved can lead to very serious long-term damage, people choosing to pretty much ignore the dangers may continue to overindulge in carbohydrate-rich foods and not follow an exercise regime without obvious short-term problems. A bad move in the long term, but lots of people do it.

Equally, by getting the right diet and exercise programme and possibly medication, many people are able to reduce their blood sugars to normal levels. Some describe it as " a cure". It's not. But keeping up a healthy regimen can mean elimination of the symptoms more or less permanently.

This is the diabetes that we hear about on TV ads and programmes pointing to the risk for obese children and adults, though it's worth pointing out that type-two is not inextricably linked with being overweight.

Type-one diabetes is less common and means the pancreas has simply stopped producing insulin, the hormone we all need use the blood sugars - from the carbohydrate we eat - as energy.

Sometimes described as juvenile diabetes or insulin-dependent diabetes, it isn't caused by lifestyle factors and is often believed to happen to young people only. In fact, many older people are now getting it.

As with type-two, there is no cure. Any type-one must immediately take over the job of the pancreas and start injecting insulin so it is available at the times and in the amounts the pancreas would have done. Most type-ones, therefore, will inject insulin up to six times a day.

Unlike type-two, the onset of type-one is usually quick, as the insulin-producing cells of the pancreas pack up, and failure to use insulin would mean blood sugars soar very fast, causing the body's organs very serious problems which, if left untreated, are likely to be fatal in a short space of time.


Falling over in the supermarket...

Type-ones, and some type-twos on certain treatments, can face situations where their blood glucose levels fall too low (hypoglycaemia, or hypo for short). They may have had too much insulin, too little carbohydrate or have used up too much blood glucose doing something energetic. The results, if no action is taken,will range from feeling sweaty to woozy, disoriented and slightly drunken to becoming unconscious and even going into a coma.

The good news is, diabetics can usually spot the early symptoms and reverse the situation: the treatment is ALWAYS to take something sugary such as Lucozade or fruit juice. The bad news is the drop in blood sugars can be very fast– a matter of minutes – if untreated.

If you ever find someone with the symptoms of a hypo, look for a medical alert bracelet, pendant or card that says they have diabetes. If they're conscious, get them to eat or drink something sugary – they may carry glucose tablets or similar, but they may not thank you at the time as their glucose-deprived brain may make them pretty disoriented! If they're unconscious, possibly with fits, do nothing other than call an ambulance. Never be tempted to find the insulin they carry and inject them. That could have very serious consequences.

A few random things to know about type-one diabetes

1 Foods labelled "suitable for diabetics" should be avoided like the plague. They're often overpriced, high in fat and other ingredients that may be somewhat undesirable. So don't waste your money on diabetic chocolate... I'll happily take Green & Black's instead!

2 Eating lots of sugar doesn't cause diabetes.

3 The insulin most diabetics use is synthetic, though some animal insulins are still available.

4 Most type-one diabetics I know are not the slightest bit interested in an insulin inhaler, because injecting is much more precise.

5 They're generally not interested in transplants either – the lifetime of anti-rejection drugs seems a far worse option than using insulin.

6 Generally it's far better for type-one diabetics to be on a regime with five or six injections a day rather than just two. It makes blood glucose control easier and more precise.

7. Diabetics don't have to avoid sugar per se. It's the total carbohydrates in food that they need to watch, and eat in a measured way. Potatoes, cereals, bread, rice and pasta all need to be controlled carefully.

8. There is a staggering amount of ignorance in the general medical community about diabetes. GPs are notoriously hit-and-miss, with many using outdated thinking, using partially understood guidelines, misunderstanding the differences in treating the different types of diabetes and obstructing modern patient self-management.

9 Long-term diabetes is a leading cause of blindness. Poor blood glucose control is the main culprit. Other nasty consequences can include limb amputation and organ failure.

10 There is no cure. Type-twos may keep their blood glucose within the normal range by lifestyle and dietary means, but they're not 'cured'. One thing that seriously hacks off most diabetics is claims for herbal, or other, cures.

If you are diabetic...

The best education I've had has come from the internet. Support groups can be particularly useful and the best I know is

www.diabetes-support.org.uk/diabetes_forum