Real Conversations: Diabetes

Debra Hale discusses diabetes – the fastest growing health threat facing our nation, according to Diabetes UK

A spoonful of sugar helps the medicine go down, so the song goes, but these days sugar is considered to be one of our biggest health enemies and some people may even assume that diabetes is a result of consuming too much of the sweet stuff.
Let’s address one of the biggest myths around diabetes: it’s not just about sugar consumption. Diabetes is a complicated condition and there are many contributing factors and causes.
It’s no myth though that diabetes is a global health concern, causing one death every six seconds and being responsible for 14.5% of global deaths in the 20 to 79 age group.
The greatest increased risk of death is in younger ages and in females, but life expectancy is reduced for all types of diabetics so we need to be concerned.

What is diabetes?

Diabetes can be a lifelong condition that causes a person’s blood sugar level to become too high. It presents in two main forms though there are other diabetic conditions to consider.
Type 1 diabetes normally occurs in childhood between the ages of nine and 14 where the body’s immune system attacks and kills the cells that produce insulin. It’s an incurable autoimmune condition and sufferers have to inject insulin daily.
The pancreas produces this hormone, which controls blood sugar levels; we need insulin to move glucose out of our blood and convert it into energy, so if there isn’t enough of it or the body cannot process it then blood sugar levels will either be too low or too high.
Around 345,000 people are living with type 1 diabetes in the UK and although the cause of this unpreventable illness is unknown, it’s got nothing to do with lifestyle or sugar consumption.
The more common type 2 diabetes – 90% of diabetic adults in the UK have this form of diabetes – is caused when the body either can’t produce enough insulin or the body’s cells don’t react to insulin.
Many people wrongly assume that type 2 diabetes is the milder form, but any form of diabetes is serious and needs to be controlled otherwise there can be serious implications.
There are other lesser known types of diabetes such as gestational diabetes, neonatal diabetes, maturity onset diabetes of the young (MODY), Wolfram syndrome and Alström syndrome.
Gestational diabetes occurs in pregnancy. Women with gestational diabetes are seven times more likely to develop type 2 later in life and likewise children born to mothers with gestational diabetes are more at risk having type 2 when they are older.
Neonatal diabetes is a form of diabetes that is diagnosed under the age of six months.
MODY is a rare form that is hereditary and caused by a mutated gene. If passed onto a child, the condition normally develops before the age of 25. Wolfram and Alström syndromes are also both rare genetic disorders.

Who is at risk?

Slightly more men in the UK have diabetes than women and alarmingly it is becoming more common in children and young people of all ethnicities. There are over 31,000 children and young people under the age of 19 living with diabetes, in the main type 1.
Type 2 is usually a lifestyle related condition. No sugar coating here - being overweight, having a large waist, high blood pressure, heart disease, stroke or depression adds to the risk.
Obesity is the main risk factor for type 2, accounting for 80 to 85 % of the overall risk and pertinent to the two-thirds of the UK population deemed overweight or obese. You are also more likely to get type 2 diabetes if you have a family member with diabetes.
Type 2 diabetes usually occurs over the age of 40. If you watch BBC soap opera EastEnders then you will notice that it’s a current health issue for Ian Beale; he’s over 40, has a sedentary lifestyle, enjoys a pint of beer and café food. OK, it’s a TV soap but we probably all know someone who has type 2 with this kind of lifestyle.
Some ethnicities are at greater risk of type 2 than others. In South Asian people it often appears from the age of 25. It is six times more likely in African people and three times more likely in people of African-Caribbean origin. It’s also a big issue in India and China, likewise in the US.
Diabetics can also be at increased risk of other illnesses and ailments. Coeliac disease, another genetic autoimmune condition, is more common in people with type 1.
You are more likely to have muscular problems with an increased risk of joint immobility, retinopathy, frozen shoulder and even carpal tunnel syndrome.
Diabetes can lead to dental problems, blindness, amputated limbs, depression, kidney disease, dementia and cardiovascular disease. The facts around cardiovascular disease are particularly concerning, accounting for 44% of fatalities in those with type 1 and 52% with type 2.

What can you do?

Bearing in mind the prevalence of diabetes, odds are that some of your clients will be living with this condition. It’s never been so important to make sure they can get the protection cover that they and their families will need if they become seriously ill or if the worst happens.
Providers are starting to offer better life cover terms to clients with diabetes and for those with type 2, some even offer terms for critical illness, depending on smoker status, other health issues and management of the condition.
Although there are no lifestyle changes you can make to lower your risk of type 1 diabetes, with both type 1 and type 2 it’s wise to have a healthier lifestyle.
Recent data tells us that 10.7% of the UK population has a higher risk of type 2 diabetes and there is a lot we can do to reduce the risks of having it and to limit the damage if you already have it. Control is the keyword – control your blood pressure, glucose and blood fat levels, control your weight and give up smoking.
Diabetics can have normal lives: Sir Steve Redgrave has achieved great sporting achievements despite suffering with genetically induced type 2 from the age of 35 and having to inject insulin daily.
Having access to support and resources to manage the condition is really important. Some providers can add real value in these areas with focused life and health coaching. Zurich Support Services offers much support in this area and not just to the policyholder but to members of their family too.

Debra Hale is a protection specialist at Zurich