Diabetes – so what are Type 1, Type 2, Type 3, Type 1.5 and gestational diabetes? (and pre-diabetes as well)

Doctor Max Pemberton
Doctor Max Pemberton

One of the big confusions, for a lot of people, is what are the different types of diabetes. In fact a lot of people have never heard of type 1.5 and type 3 diabetes. So we though we would ask Dr Max Pemberton who is an expert in this field!

He told us “I think this causes people a lot of confusion. There’s three main ones – Type 1, Type 2 and gestational diabetes and they’re all quite different. Type 1 diabetes is caused by an immune response whereby the body creates antibodies to the cells that make insulin in the pancreas, and it destroys those cells. So people with Type 1 diabetes no longer have the cells that make insulin, and so therefore they have low or no insulin in their blood.

Type 2 is quite different and that’s where the cells in the body have become resistant to the effects of insulin, so their body still makes insulin but the cells aren’t responding to it in the way that they should.

Now, gestational diabetes, that refers to a condition where women who are pregnant can sometimes develop diabetes and it’s just for the time that they are carrying a baby. So when they then give birth the majority of them, the diabetes then sort of passes. It’s really a response to being pregnant and the physical and hormonal changes that take place. People with gestational diabetes are at risk in the future of possibility developing diabetes but it is one of those things at the time, it then does go.

Now there’s these other terms that you mention, 1.5 and Type 3 and to be honest these complicate matters a bit. So all that 1.5 means really, it used to be thought that Type 1 diabetes affected people when they were very, very young and that’s when they first got diagnosed with it, and Type 2 was a result of lifestyle like being obese and so on, and that tended to happen when people were much older. Actually what they realised, that there is a group of people who despite might be relatively normal weight, they don’t have high cholesterol and so on and so on, so relatively physically healthy and yet still it’s often in their 40s or so they develop diabetes. So it’s not clear if it’s because of lifestyle changes, and it’s got a component probably of auto immune to it but it’s just presented much later, so it sits in-between Type 1 and Type 2 so they call it Type 1.2. To be honest I don’t think it is particularly helpful, I think it just confuses people.

Type 3 again I find it a slightly confusing term. It’s used by researchers just to talk about the evidence that shows that in some types of Alzheimer’s, the brain has become resistant to the effects of insulin. It’s just purely one of those scientific anomalies no one really quite understands quite what this means or the implications for either Alzheimer’s or indeed diabetes, but it’s one of these things you hear very occasional, sort of banded around usually within academic circles. It’s not something to worry about. Personally I definitely don’t think about Type 3 diabetes. The main three don’t forget are Type 1, Type 2 and gestational diabetes. ”

We also asked for a definition of pre-diabetes.  Max told up “Although there are three main types of diabetes, there’s also a stage before diabetes and that’s called pre-diabetes. It’s noticed impaired glucose tolerance and it’s a condition where your blood “

¼ Patients Fear Side-Effects So Much They Stop Taking Their Medicine

Confusing ‘Patient Information Leaflets’, poor GP-Patient relationships and a lack of understanding into how medicines work leads to many stopping their treatment.

Medical Compliance
Medical Compliance

• 73% of British adults have been prescribed medication in the last year, and almost half in the last month alone.
• This week is National Medication Adherence Week (16th- 23rd October) which aims to highlight the serious national impact that failing to properly take medication has.

• The full scale of the issue was revealed in 2013 by a landmark investigation – the first large-scale study into the issue in the UK – called the Aston Medication Adherence Study. The results showed that around a quarter to a third of the patients were non-adherent to their medication.
• Reasons for failing to take medication range from a fear of side-effects to the nearly two thirds who simply forget their prescription programme. 1 in 5 stopped taking their medication as they did not feel ill and thought they did not need it – failing to understand how and why medicine works.

PatientTalk.Org interviewed Paul O’Hanlon,a  Medical Adherence Expert, to find out more.

PatientTalk.Org – So Paul first question, what is compliance and what is the issue?

O’Hanlon – Compliance is about a patient who has been prescribed a course of medicine over a few days, over a many months or maybe for the rest of their lives, it’s about them taking that medicine at the right time of day every day of the week they are meant to take.

PatientTalk.Org – Ok and what are the costs to the NHS and to the health of the nation?

O’Hanlon – Well what we have found when we started to look at compliance or we use the term medicine adherence we find that a significant proportion so up to 50% of patients are actually not taking their medicines correctly and this has two big consequences. First is that the actual consequence of the waste of those medicines which we estimate at about 300 million pounds a year just in wasted medicine but there is an even bigger issue and this is the human impact, the fact that by these patients not taking their medicines correctly it impacts their health, impacts on their long term conditions and that has a  further cost to the NHS to additional G.P visits, additional hospital visits, hospital interventions , off almost 500 million a year in people’s health.

PatientTalk.Org – Ok and which conditions are most impacted?

O’Hanlon – The most important ones that we are focusing on are the long term conditions such as blood pressure, high cholesterol , diabetes of which as the population is ageing we are living with more and more of these conditions so it’s a growing problem.

PatientTalk.Org – Ok and has it any effect on the anti-biotic resistance?

O’Hanlon – Well not taking a full course of anti-biotics as prescribed has a part to play in the increase of anti-biotic resistance, that’s not really key to the area that we are focusing on, were focusing more on patients with long term conditions who are on medicines for many many months if not years or till the end of their life’s, that’s the adherence we are really focusing on.

PatientTalk.Org – Ok and what are the chances of adverse events in reality for the average patient?

O’Hanlon – Oh quite significant, I mean the occasional missed dose is not going to do much harm but when a person does have a chronic illness, let’s say diabetes where the control of the sugar and blood is very important, if they are not controlling that blood sugar there can be many long term complications one of which can be a significant reduction in blood circulation in the limbs and at the moment we are seeing up a hundred amputations a week in the NHS as a result of poor medication adherence in diabetes so the consequences can be huge.

PatientTalk.Org – Ok and how better compliance be achieved?

O’Hanlon – Well the starting point is if a patient has any doubts about what they are doing with their medicines and feels they are not managing them as well as they could  then go talk to the pharmacist , the pharmacist has a number of solutions it could be something as simple as providing a medication adherence pack this could , this is pack that sorts the patients medication out for them for the week and just makes sure that its simpler, there are many new technologies emerging or it just be the fact that the patients’ needs to understand what their medicines are for so its starting point to say go and talk to your pharmacist they are experts on medicines and they can really help.

PatientTalk.Org – Ok and can G.P’s do anything to help?

O’Hanlon – Certainly, G.P’s, nurses, pharmacists we all have a part to play and I suppose this is one of the big parts of this campaign, not only are we wanting to raise awareness of medication nonadherence in patients, this is also a shout out to the health professionals, to government, to the NHS, we really need to start putting our heads together and finding some real fixes to this problems so it’s not just G.P’s it’s the whole healthcare community.

Over 45s putting health at risk by ignoring heart health

• New research released today sees 70% of people aged 45 and over say they are not worried

Over 45s putting health at risk by ignoring heart health
Over 45s putting health at risk by ignoring heart health
about their heart health, despite the fact that over 2.3 million people are thought to be living with some form of coronary heart disease in the UK
• Almost half did not know heart disease is the biggest health-related cause of death in the UK, despite the fact that 152,436 people die of the disease every year, an average of 417 people per day
• Around one in seven in that age group admit they have never done anything to try and actively improve their heart health – however, if the two main causes of heart disease are unhealthy blood and high cholesterol a simple lifestyle change can make a big difference to help prevent such diseases and strokes occurring.

Millions of people aged 45 and over could be seriously jeopardising their health because of a lack of concern over the state of their hearts. That’s the warning coming today, after new research shows that 70% of people aged 45 – the age group most at risk – and over are not concerned about their heart health at all.

Whilst an estimated 2.3 million people in the UK are living with a condition of coronary heart disease, the research shows that the majority of the population do not regard it as being a life threatening concern. Even the over 45’s, those at the greatest risk from heart problems, are only slightly more concerned than those under 45, with only 27% in that age group, worried!

Furthermore, around one in seven 45 and overs don’t do anything to actively improve their heart health – only slightly less than 26% under 45s who admitted the same.

Across all age groups, over half (51%) were not aware that heart disease is the biggest health-related cause of death in the UK.

152,436 people have died in the UK over the last year from heart disease, an average of 417 people per day. If this rate continues over the next 20 years over 3 million people will be at risk.

The survey also questioned people as to what lifestyle changes they have made to help improve their heart health.

Less than half of all British adults say they exercise more, 39% have cut down on their intake of saturated fats, and 37% have cut down on their salt intake.

The study also showed a lack of awareness around what can lead to a heart attack, with almost a third not realising that blood clots can be a contributor.

National Eye Exam Month – Five great reasons to have an eye test!

Why you should have an Eye Exam?
Why you should have an Eye Exam?
As August is National Eye Exam Month we thought we would share with our readers five signs that you may need an eye test.

As a person with vision issues (I’m now both long and short sighted) I know the value of regular eye tests. Being in my late forties mean that my eyesight is changing fast. So regular check ups from my optician mean that I reduce otherwise significant vision problems.

So we thought we would share with you five great reasons to have an eye test!

a) Regular and unexplained headaches. This is often a sign of worsening vision. If this applies to you them we would suggest a trip to your optician.

b) Improve your performance at work at at school/college. Regular eye examinations help children from some learning difficulties especially with reading.

c) Certain condition such as multiple sclerosis (eg optic neuritis) are often first discovered by an optometrist . Others include high cholesterol, diabetes and glaucoma. As we know early detection means early intervention.

d) Find out if you need spectacles or maybe contact lenses.

e) Finally the eyes act as a window to overall health and wellbeing.

So This August when not get you eyes test!

Diabetes Week – Find out more about diabetes and some shocking news from the UK.

Diabetes Week 2014
Diabetes Week 2014
As some of you may know this week is diabetes week. An awareness raising week run by Diabetes UK – the countries largest diabetes patient support group. Normally we would , of course , help raise awareness of the event within our reader communities!

However the morning news in the UK was all about some recent research from the British Medical Journal. The recently published paper tells us that over one third of the UK population was at risk of prediabetes. That is that they were close to contracting diabetes type 2 unless action was taken.

We thought therefore that it would be useful to mention a few of the warning signs of prediabetes. If you are concerned that you could be diabetic it is important that you see a healthcare professional as soon as possible.

a) You have a relative who has or has had type two diabetes.
b) You are aged over 4–45. Even earlier if you are of South Asian descent. the news this morning suggested 24.
c) Suffer from obesity ie are carrying too much weight.
d) Have high cholesterol
e) Given birth to a large baby

Have you been diagnosed with diabetes? Why not share your story in the comments box below.

It would also be great if you could share the graphic we have produced to promote Diabetes Week 2014.