Article in The Telegraph by Lela London a type 1 for 20 years. Lchf and DCUK get a mention. All good. Also a good article she wrote here on Twitter for info.
https://twitter.com/lelalondon/status/1121036151685636097
There are many cultural misconceptions about diabetes – one of the most common being the dangerous assumption that type 1 and type 2 diabetes are one and the same.
Though it may only seem obvious to diabetics of either type (I write as a type 1 diabetic, having been diagnosed when I was a child over two decades ago), the conditions are 'caused' in very different ways, cared for through largely individual treatment plans, and can become as dangerous as each other if left undiagnosed or untreated.
Knowledge is power in every area of diabetic care and it is especially important to understand the difference between type 1 and type 2. The latter, particularly, because it is sure to affect someone you know (as you'll see, below).
What is the difference between type 1 and type 2 diabetes?
Diabetes (technically, diabetes mellitus) typically comes in two forms: ‘type 1’ and ‘type 2’. No awards for creativity. Both are chronic conditions which affect the way the body processes insulin – the handy little hormone which turns carbohydrates and sugar/glucose into energy, regulating blood sugar levels.
Beyond this, they are largely unrelated.
Type 1 diabetes is an autoimmune disease whereby a person’s immune system targets and kills off insulin-producing beta cells.
Type 2 diabetesis, in short, a condition based on insulin resistance. While the aforementioned beta cells are still alive, they don’t work as well as they should and tend to make less and less insulin as time goes on.
Though type 2 was once only prevalent in adults (earning itself the moniker 'adult-onset' diabetes), it is now increasingly common for the condition to affect children – particularly those who are overweight or obese.
According to Diabetes.co.uk, there are currently over four million people living with diabetes in the UK and type 2 diabetes accounts for roughly 90pc of all diabetic cases. This means roughly one in every 18 people suffer from type 2 diabetes.
Can type 2 diabetes develop into type 1?
Though many people believe type 2 diabetics can ‘become’ type 1 diabetics, this is not true. They are different diseases. At the same time, type 2s can become insulin-dependent and regulate their blood sugar levels through daily blood monitoring and injections, as all type 1 diabetics have to do.
If left untreated, type 2 diabetes can increase the risk of cardiovascular conditions and cause blindness, kidney failure, and limb amputations.
In more severe cases, type 2 diabetics have to inject themselves with insulin to regulate blood sugar levelsCREDIT: ALEX FLYNN/BLOOMBERG
Symptoms of type 2 diabetes
It is very common for symptoms of type 2 diabetes to appear gradually, which means that, without the help of medical tests for unrelated issues, it is rarely diagnosed at an early stage.
Symptoms also vary from type 1 diabetes, which tends to cause extreme fatigue and dehydration when undiagnosed.
For type 2 diabetics, common symptoms include feeling tired after meals, feeling hungry shortly after eating (polyphagia), urinating more often than normal, itchy skin (particularly around the genitals and especially if you have regular yeast infections), blurred vision, slow healing of cuts, and new skin disorders such as psoriasis or acanthosis nigricans (dark, discoloured skin folds).
Causes of type 2 diabetes
Unlike type 1 diabetes, there are many known causes and risk factors associated with type 2 diabetes. Often, a number of contributing factors lead to diagnosis.
Risk factors include having high blood sugar, cholesterol, excess weight, type 2 in the bloodline, and a prior case of gestational diabetes (which typically disappears post-pregnancy).
The most prominent and medically-acknowledged cause of type 2 diabetes is a poor diet (which, coincidentally, leads to many of the risks outlined above).
A number of medications, particularly steroids and statins, have also been linked to an increased risk of type 2 diabetes. The list includes – but is not limited to – corticosteroids (including those which treat Athsma and Crohn’s disease), thiazides and beta-blockers (often used to treat hypertension), and statins (like Lipitor and Lescol).
Actor Tom Hanks, who was diagnosed with type 2 diabetes in 2013, said he was a "total idiot" leading up to his diagnosis by being "part of the lazy American generation that has blindly kept dancing through the party and now finds ourselves with a malady" CREDIT: EDDIE MULHOLLAND
Still, many people find they're diagnosed with type 2 against the odds. Chris Rooney, a type 2 ultra-marathoner from Huddersfield, told me his own diagnosis, discovered during a routine medical check up, came as a huge shock. "The three biggest risk factors did not apply to me," he said. "I was overweight but not obese, active and exercised regularly, and had no family history of diabetes.
"However, there was no doubt; my resting blood glucose was 9.7mmol, HbA1C was 66 – definitely diabetic."
Thankfully, Rooney sent his diabetes "into remission" within three months by committing to the LCHF lifestyle outlined below.
Treatment of type 2 diabetes
There are two primary aims of treating type 2 diabetes. Firstly and most imperatively, to control blood glucose levels. Secondly, to ‘cure’ type 2 diabetes altogether.
Depending on type 2’s personal severity, initial treatment plans range from healthy lifestyle adjustments to tablet medications, injections, and bariatric surgery. When medication is prescribed, yearly diabetic health checks are also put into place to help you avoid long-term complications.
When you are newly diagnosed or feel your treatment plan needs an update, it is routine for GPs to set up diabetes education, courses and specialist referrals.
Though type 2 ‘reversal’ has only become a mainstream idea in the last few years, many of the same lifestyle changes used to control blood glucose levels can be put into permanent practice to eliminate the need for medication.
Often, losing weight is not only a primary goal for those with type 2 diabetes but a choice which improves insulin sensitivity overall. Because of this, balanced low-carbohydrate diets created specifically for type 2 diabetes are regularly touted as a ‘cure’ for the condition.
An LCHF diet plan has recently gained popularity in type 2 communities for not only helping diabetics to lose weight but lowering their HbA1C (a person’s average blood sugar levels over two to three months) to non-diabetic numbers.
The diet plan, which stands for Low Carb High Fat, champions whole foods and limits sugar and starch to a minimum. The keto diet falls under this umbrella and, as a particularly extreme form of LCHF, has been medically proven to reduce the need for type 2 diabetes medications. However, it has its own side effects.
Debra Scott, a type 2 diabetic and activist from Blackpool, said: "I was devastated when I was told I had type 2. I saw it lead to my mum being registered blind, having a stroke, having sores that wouldn't heal and more.
"I declined the offer of medication and asked the nurse if I could try to find a way through diet. I looked into 'reversing diabetes' and found everyone who was doing it was doing it on a low carbohydrate diet.
"I started this way of eating on December 8th and my blood glucose levels were in pre-diabetic range by February. By May I was in non-diabetic range and had lost four stone – reaching my goal weight. I've never felt healthier, happier or more confident about myself. My diagnosis has really been a blessing in disguise."
Many doctors also recommend reducing your alcohol intake and quitting smoking, for obvious reasons, as part of both type 1 and type 2 diabetes treatment.