A bit overwhelming – that’s how being newly diagnosed with type 2 diabetes can feel sometimes. Worries about regular finger pricking and blood glucose checking and what to eat and what not to eat – these can all seem like an emotional and practical mountain to climb at first so what’s the advice?

Jenny Dunbar is a diabetes nurse and also regional development officer with Diabetes Ireland. She agrees that diagnosis can seem a bit daunting for some.

“Initially people can feel at sea when they get the diagnosis of type 2 diabetes, particularly if they have not had the opportunity yet to have a discussion with their GP or practice nurse, or to attend a group meeting,” Jenny says.

This is the type of diabetes that can be related to lifestyle

“The first port of call is to speak with either your GP or practice nurse – someone you know well and who can put your mind at rest.”

Type 2 diabetes occurs generally in the older age group, over the age of 40.

“It’s when you have some secretion of insulin, but not enough,” she says. “This is the type of diabetes that can be related to lifestyle. We also encourage people, particularly those over the age of 45 and with a family history of type 2 diabetes to have regular check-ups with GPs because the concern is that a person may have it for many years and not know about it.”

The total number of people living with diabetes in Ireland is estimated to be 225,840. About 20,000 of these have type 1 diabetes.

Insulin acts like a key to open the doors into our cells, letting glucose in

Type 1 is different than type 2. It is an auto-immune condition in that it usually occurs in a young child or early adulthood. It is not related to lifestyle and is not preventable. People with type 1 diabetes require the hormone insulin by injection for life.

Jenny highlights the importance of this hormone made by the pancreas.

“Insulin acts like a key to open the doors into our cells, letting glucose in. In type 2 diabetes, the pancreas makes too little insulin to enable all the sugar in your blood to get into your muscle and other cells to produce energy. If glucose can’t get into the cells to be used, it builds up in the bloodstream.”

Why people don’t disclose they have diabetes

While there are no statistics to show how many people keep their diagnosis of type 2 diabetes private, it can happen.

“Some people like to keep it to themselves and you have to respect that. It may be that they don’t share the information because they feel it may be linked negatively to them not being very active and carrying some extra weight, but we would encourage people to be positive if they have been diagnosed with type 2 diabetes, to learn a bit about it, and discover how to manage it well. In that way they won’t feel at sea. If you are having regular assessments and you are on a healthy lifestyle plan you are on the right track to staying healthy.”

Lots of help for the newly diagnosed

Diabetes Ireland encourages those newly diagnosed to learn about the condition and to share what they learn with their families so that they can be supportive.

In Ireland, there is lots of help available for those who are newly diagnosed. Apart from GP and practice nurse support there are diabetes information courses that you can attend. One such course, the CODE programme, is run by Diabetes Ireland.

It is a structured education programme that involves three two-hour group education sessions in an informal setting with up to 16 people. The meeting includes a break for tea which provides an opportunity to chat to other people who have type 2 diabetes and learn from them as well as get guidance from the professional who is facilitating the programme.

Often it’s the little questions and concerns people have but that they’ve never had the opportunity to voice

This CODE course, supported and partially funded by the HSE, was developed initially because of the number of calls to Diabetes Ireland’s freephone line from people attempting to access information regarding diabetes.

“We put this programme together so people could access this information in a local setting,” Jenny says. “Often it’s the little questions and concerns people have but that they’ve never had the opportunity to voice, but it’s important that you have a health professional available to answer those questions. We encourage people to self-manage their own diabetes care every day. Unless they have the knowledge to do that then it’s difficult to know how to get started. CODE allows people to talk, in a supportive atmosphere about what diabetes is, about treatment management and lifestyle change.”

Diabetes smart

As well as its helpline and the leaflets it has available by post, Diabetes Ireland also has lots of literature available for download online and also an online module called Diabetes Smart.

This module explains what diabetes is, healthy eating and the importance of regular physical activity, medications and complications.

“It is an interactive session that you can dip in and out of, learning a bit more about diabetes as you go.”

Information is the key

Counselling is also available for those who are struggling with the new diagnosis.

“We do have a limited counselling service at our Cork and Dublin care centres,” Jenny says. “Information is the key, if people are given time and information, hopefully they will come to terms with how to manage their diabetes.”

Care now in community

Jenny also points out that diabetes care is now within the community.

“Some GPs have signed up to the HSE’s Diabetes Cycle of Care which means that people can access regular type 2 diabetes care through their GP in the community, including a dietitian or group education service, rather than having to travel long distances to hospitals for review.

If you take time to talk to people about why they have diabetes or why it is in their family, it does allay their anxiety and either of these programmes are a good place to go

“This makes access to continued care much easier than in the past for some people.”

Similar to CODE courses, the HSE also runs a diabetes programme called Discover Diabetes (formerly called the X-pert programme).

“If you take time to talk to people about why they have diabetes or why it is in their family, it does allay their anxiety and either of these programmes are a good place to go,” Jenny adds.

Don't put symptoms down to busy lifestyle

People may put the symptoms they are experiencing down to a busy lifestyle or to other reasons, she states, but it’s important, if you have any of the symptoms in the above panel, to have a check-up.

“It’s a simple blood test that your GP would do (to check blood glucose levels). Type 2 diabetes can go unrecognised and unfortunately it may be when you develop a complication of diabetes that it will be discovered. This could be when your optician finds a bleed at the back of your eye, for example. That could be before you know you have diabetes yourself.”

Complications

If the blood sugar level is high over a long period you are more likely to develop diabetes complications which can affect many of the organs in the body.

These can include retinopathy (damage to the retina in the eye), as well as issues with kidneys and feet. People with diabetes have an increased risk of heart attack and stroke and are advised not to smoke.

“The better your care and (blood sugar) readings over the years then the less likely you are to develop these complications,” she adds.

Preventing diabetes

Prevention of type 2 diabetes is also part of the educational remit of Diabetes Ireland.

“With respect to prevention we would encourage people to stay as slim and trim and active as possible in order to reduce their risk of getting type 2 diabetes,” Jenny says.

So what are the general risk factors for type 2 diabetes?

  • Being older (over 45).
  • A family history of type 2 diabetes. If diagnosed, siblings should also be checked.
  • Those who have had gestational diabetes during pregnancy.
  • Those who are not very active and/or carrying extra weight. This is because the insulin you are secreting may not be able to work as well if excess weight is being carried.
  • Those with hypertension (high blood pressure) and high cholesterol.
  • Symptoms

    If you develop type 1 diabetes the symptoms come on very quickly and dramatically, but with type 2 you may not have any symptoms. However, if you have, the following may be experienced:

  • Thirst.
  • Fatigue or lack or energy.
  • Going to the toilet a lot more than usual.
  • Blurring eyes (may be because of high glucose levels).
  • Tingling or burning in the feet.
  • Infections that keep recurring.
  • Slow healing sores or cuts.
  • Top tips for managing diabetes

  • Eat a healthy balanced diet, be aware of carbohydrate foods and portion sizes.
  • Aim to achieve a healthy weight and waistline.
  • Include regular physical activity in your daily routine.
  • Don’t smoke.
  • Take medication as prescribed.
  • Check your feet daily and ensure you have a foot assessment by a health professional at least once a year.
  • Attend your eye screening appointment yearly or as advised.
  • Have a good relationship with your doctor and understand what the targets of your treatment are.
  • Be aware

    Jenny Dunbar’s overall advice is to be aware of risk factors, have your blood sugar levels checked from the age of 45, particularly if you have a family history or the risk factors mentioned.

    Understand why your diabetes needs to be managed well (to avoid the medical complications mentioned above) and don’t be afraid to ask questions or seek support.

    For further information or to register for a CODE programme click here.

    The helpline for Diabetes Ireland is open Monday-Friday, 9am-5pm at 01-842 8118.

    Email: info@diabetes.ie