Research amongst patients with Type 2 Diabetes on insulin reveals how emotional and psychological factors are negatively impacting their condition
A quarter suffer from anxiety over getting hypos (low blood glucose levels) with more than 40% preferring to have high blood glucose levels instead of risking another hypo. This can lead to serious long term health risks
A new campaign launches today called ‘Diabetes Highs & Lows: Better Balance for a Better Future’ which highlights how emotional and psychological factors can have an impact on effective T2 diabetes management
The campaign includes the launch of a patient support website, DiabetesHighsAndLows.co.uk which is dedicated to helping patients with T2 diabetes better manage their blood glucose levels. The website is developed and funded by Sanofi.
A quarter of people with T2 diabetes feel anxious or fearful about ‘hypos’ (low blood glucose levels), with 42% preferring to have high blood glucose levels instead, despite the risk of life threatening conditions in the future.[i]
The findings also revealed that a significant proportion of patients with T2 diabetes believe that other people think they are to blame (15%), and some patients believe that other people think they are just greedy (14%) 1 . Likewise, 25% of patients with T2 diabetes only tell close friends, family or their healthcare professional about their diabetes, and 58% feel self-conscious or avoid injecting in front of other people, negative emotions are stopping people managing their condition properly.[i]
Another Sanofi-funded study conducted in adults with Type 1 and Type 2 diabetes in the UK, and published in the journal Diabetic Medicine, showed even modest improvement in blood glucose control could help prevent almost a million serious medical complications such as eye disease, kidney disease, foot ulcer and amputations, and potentially blindness, which could avoid billions in future NHS costs.[ii]
With the UK having the worst control of T2 diabetes blood glucose levels in Europe[iii], Sanofi, who conducted the report, is launching a new patient support website to help the 52% of T2 diabetes patients who find it hard to balance their blood glucose levels.[i]
The Sanofi ‘Diabetes Highs and Lows: Better Balance for a Better future’ campaign aims to help people with Type 2 diabetes feel in control and positive about how they can balance their blood glucose levels. A new website, developed and funded by Sanofi has been launched, diabeteshighsandlows.co.uk, which includes key information on recognising and managing blood glucose highs and lows.
[i] Sanofi Data on File 2016. “Highs and lows: better balance for a better future” market research
[ii] Baxter et al, Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the
number of clinical complications and the associated financial benefit. Diabetic Medicine (2016). DOI: 10.1111/dme.13062
[iii] Khunti K et al. Study of Once Daily Levemir (SOLVETM) insights into the timing of insulin initiation in people with poorly
controlled Type 2 diabetes in routine clinical practice. Diabetes, Obesity and Metabolism (2012)
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 “
Coffee, Diet and Health- what are the health benefits of coffee and how do different countries view coffee and health?
Despite a cultural love of coffee, over a third (39%) of Europeans are uncertain about the potential health benefits of coffee. Coffee remains integrated into the European lifestyle: predominantly drunk at home, at work or in cafes, with 40% of respondents saying coffee gets their day off to a good start.
The consumer research, conducted by the Institute for Scientific Information on Coffee (ISIC), surveyed over 4,000 people across 10 European countries, to understand their beliefs, behaviours, and knowledge regarding a healthy diet.
The results show that although 70% of Europeans believe they are healthy, many still don’t know what lifestyle changes they can make to help reduce their risk of common, serious health conditions such as type 2 diabetes, Alzheimer’s disease, and cardiovascular disease. Age was an important determining factor: with the youngest and oldest respondents revealing the biggest knowledge gaps.
European respondents told us that they are healthy. Given the overall rise in obesity and related health problems in Europe, some respondents may be over-confident about their own health:
· 70% of Europeans overall described themselves as either ‘fairly healthy’ or ‘very healthy’
· The French were most likely to describe themselves as either ‘fairly healthy’ or ‘very healthy’ (83%)
· The Danes were most likely to describe themselves as either ‘fairly unhealthy’ or ‘very unhealthy’ (51%)
· Coffee drinkers were 12% more likely to report better levels of health than non-coffee drinkers
· 76% of Europeans said they need more information on maintaining a healthy lifestyle
· 46% of women and 40% of men said their New Year’s resolution was to eat more healthily in 2016
Day-to-day health anxieties are prioritised over longer-term health risks, according to the survey results, despite the fact that cancer, cardiovascular (heart) disease and excessive alcohol consumption are some of the biggest public health concerns in Europe:
· 24% of respondents wanted to better manage their stress levels (the most stressed country was Italy, with 32% of Italians worried about stress), and 28% wanted to feel more energetic and less fatigued (the most tired country was Finland, with 45% of Finns worried about fatigue); compared to just 12% overall who were concerned about getting cancer, and 10% who were concerned about their heart health
· 18-24 year olds are as likely to cut down on coffee for their New Year’s resolution as they are to cut down on alcohol (9% for both). Danes are 2% more likely to cut down on alcohol than coffee
Respondents often struggled to recognise the potential health benefits of coffee:
· 71% of Europeans believe that drinking coffee does not help to reduce the risk of type 2 diabetes (75% of those aged 55+ held this belief). However, scientific research suggests that drinking 3-4 cups of coffee a day is associated with an approximate 25% lower risk of developing type 2 diabetes[6,7]
· 63% of Europeans believe that drinking coffee does not help to reduce the risk of mental decline in older people, for example Alzheimer’s and Parkinson’s disease (64% of those aged 55+ who answered this question held this belief). Yet research suggests that moderate, life-long consumption of coffee is associated with a reduced risk of developing Alzheimer’s[8,9]
· 42% of Europeans believe that drinking coffee increases the risk of cardiovascular (heart) disease (54% of those aged 18-24 held this belief). But scientific studies have suggested an association between moderate coffee consumption and a reduced risk of cardiovascular disease[10,11]
Age plays a large role in defining respondents’ awareness of coffee’s role in a healthy diet:
· On average, 18-24 year olds were the least successful at recognising the potential health benefits of coffee: for example, just over a quarter (28%) did not know that coffee can help increase concentration and alertness
· Older respondents displayed very poor knowledge of diseases that could potentially pose the highest statistical risk to them: over half (56%) of those aged 35 and above are not aware of the potential health benefits of coffee relating specifically to cognitive decline, type 2 diabetes, and cardiovascular disease risk
67% of Europeans stated that they could not imagine life without coffee. The health effects of coffee consumption have been extensively researched: moderate consumption of coffee at 3-5 cups per day has been associated with a range of desirable physiological effects and fits within a healthy diet and active lifestyle. Pregnant and breastfeeding women are advised by EFSA to consume no more than 200mg of caffeine, per day, from all sources. This is equivalent to no more than two cups per day.
Professor Chris Seal, Professor of Food and Human Nutrition at Newcastle University, UK said: “Many Europeans enjoy a cup of coffee, but clearly some feel guilty about drinking it – and unnecessarily so. Moderate, regular coffee consumption at 3-5 cups per day has been linked to a number of positive health benefits, such as reducing the risk of cardiovascular disease and type 2 diabetes. Hopefully, this means people will now enjoy their cup of coffee without the guilt.”
1. 4119 respondents across 10 European countries were surveyed by ISIC in November 2015
11. Ding M. et al (2014) Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 129(6):643-59
12. Harvard T.H. Chan School of Public Health, ‘Moderate coffee drinking may lower risk of premature death’
With diabetes becoming a common medical condition across the globe I thought it would be useful if I shared this fascinating infographic. It gives an excellent introduction of insulin resistance and type 2 diabetes.
Please do feel free to share your diabetes story with our readers in the comments section below.