How to learn and live with diabetes
The testing kit
Shortly after he turned 50, Jozef Janiga was visiting his diabetic father when, on the spur of the moment, he decided to test his own blood sugar level with his father’s glucose metering kit. He pricked his finger, and to his astonishment the result placed him well on the road to becoming a Type-2 diabetic himself.
The Warsaw optician visited his family doctor, who prescribed metformin, an oral anti-diabetes drug, and soon his blood sugar dropped to an acceptable range. However, the physician didn’t follow up with dietary guidelines, additional testing or provide any other information on self-care, but simply continued to prescribe the drug for the next seven years.
What is diabetes?
But diabetes is a slow-moving disease that needs daily monitoring and management. Last year, Jozef began feeling poorly. He was dizzy, had muscle spasms and vision problems, and his heart beat like a hammer. In desperation, he went to a diabetes specialist, who ordered additional testing, put him on a strict diet and gave him full information about his disease.
Jozef, now 58, is more tired than he ever has been. He fears blindness. His kidneys have been damaged and he faces dialysis or a transplant.
Not having the full information
He’s not alone. According to a startling November 2013 report, hundreds of thousands of European diabetics don’t have access to the information and professional help they need—putting them at significant risk for serious health consequences such as skin disorders and high blood pressure, blindness and even loss of limb.
Further to this, Elodie Besnier, lead researcher for this first-of-its-kind study by the International Diabetes Federation Europe (IDF), which covers 47 countries, emphasises that “hundreds of thousands” is a “rather conservative estimate”.
Diabetes has reached epidemic proportions in Europe, according to the World Health Organisation, which estimates that one in every ten Europeans over the age of 24—some 60 million people in all—is living with diabetes. This total is rising steadily as life expectancy increases and the proportion of elderly people in the general population rises.
Type 1 and Type 2
Diabetes is a chronic disease that occurs when the pancreas doesn’t produce enough insulin (Type 1 diabetes) or when the body cannot effectively use the insulin it produces (Type 2). Insulin regulates blood sugar levels. Hyperglycemia, or raised blood sugar, over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
Although Type 1 diabetics—and some Type 2—require daily insulin injections, basic treatment for both types is otherwise the same: healthy eating, physical activity, weight control and regular testing of blood glucose levels. Thus, successful management of the disease depends on the knowledge and active involvement of the individual person.
But the IDF Europe report found that there’s an “alarming” lack of continuous diabetes education for people with diabetes, their families and healthcare professionals. And without it, many European diabetics are unable to manage their disease and are in a downward spiral that, if unchecked, can lead to health complications and even premature death.
Duncan Venables, who lives in Dorset...
Was diagnosed with Type 1 diabetes when he was seven years old, and began receiving daily insulin injections. But his parents were not sufficiently educated about the gravity of his disease and they took no other steps to manage it. “As a teenager and in my early 20s, I didn’t pay much attention because I thought I was invincible,” he says. As an adult, he ran a successful executive chauffeur business. “In my 30s, I realised I had problems with vision and I had to take charge. I began checking my own blood sugar, eating better and getting more exercise.”
But ongoing daily vigilance is critical from the first signs of diabetes, and for Duncan it was too late. Last year, when he was 40, he experienced extreme fatigue and was hospitalised.
“They amputated my right leg below the knee. Then the upper leg got infected and they had to remove that too. Then I lost sight in one eye and I developed heart problems.” He was in hospital for five months.
Rune Gjertsen, from Stavanager, Norway
The IDF Europe also found that many general practitioners are insufficiently educated about diabetes and sometimes fail to provide adequate care. Rune Gjertsen, a 40-year-old computer programmer from Stavanger, Norway, was in his late 20s when he noticed that he was frequently thirsty, often tired and had periods of blurred vision. For about ten years he reported these classic diabetes symptoms to his doctor at annual checkups, but she failed to suggest that he might have the disease.
Gradually but steadily these symptoms worsened until finally, about five years ago, his vision became dangerously blurred and he decided to go and see a diabetes specialist, who diagnosed him with Type 2 diabetes. But because of the late diagnosis, he experienced bleeding in his left eye and had to have corrective surgery. His vision is back to normal and he now manages his disease with medication, insulin and daily glucose testing. But he says, “I only wish my doctor had told me those many years ago that I had diabetes and I’d been able to avoid all those years of discomfort and uncertainty.”
Tony Hatcher, a 62-year-old resident of Erith, Kent...
Offers a lesson in the value of diabetics taking personal responsibility for the illness. Hatcher, who now drives a medical transportation vehicle, was diagnosed in 2000. He went to a physician, who gave him a diet plan and exercise advice. But at that time he had a job that entailed a lot of travel, and he found it difficult to stick to the meal plan. Despite taking prescribed metformin and gliclazide, his sugar levels kept rising.
In 2007 he got a jolt. A fellow worker, who also was diabetic, died from the disease. “It was tragic. He was only about 50 years old. But he did nothing to take care of himself—smoked, drank, no exercise, bad diet. I decided it was time for me to take personal responsibility for my health and my disease. I didn’t want to die, or even lose a leg or my eyesight.”
He went to a diabetes clinic where a doctor gave him a detailed agenda for managing his disease. He also started his own research and came across the website of Diabetes UK, the charitable group. “I keep up with all the latest information through Diabetes UK. They send me weekly emails and they have a 24-hour helpline that enables me to talk to an expert if I have any questions. They’ve helped me keep my diabetes under control.” He’s also joined a local diabetes self-help group that holds monthly meetings.
Tony gives himself four insulin injections a day—one with each meal and one in the evening, and as a professional driver, he’s required to test his sugar level every two hours. He sees his physician every six months, “and if I have a problem I can see him or a diabetic nurse immediately”.
He makes sure he exercises as often as possible. “There’s a lovely footpath along the Thames near my home, and I walk it a lot. Usually an hour out and an hour back.” He avoids puddings, except as a treat. “More importantly, I read food labels religiously because there’s sugar in a lot of processed foods, especially the low-fat foods.”
The results are impressive. “My insulin levels are lower, my feet are in good shape and my blood pressure is down. I’m going to do my damndest to keep this thing under control.