WE are on the verge of a diabetic epidemic. The condition which was once thought to be a result of the genetic lottery is set to become the biggest problem facing the health service in the new millennium.
New research has discovered the first cases of "adult" diabetes - the kind found in older people who have spent decades nurturing an unhealthy, fat-fuelled lifestyle - in overweight children, sending alarm bells ringing throughout medical circles.
Experts describe the news as "frightening" in terms of the cost of dealing with the condition and the impact on children’s health.
But it is all the more concerning because this particular kind of diabetes, known as Type 2, could be prevented by healthy living. Without changes to our national diet of fried food, it seems we are sitting on a diabetic time bomb.
Official figures predict the number of people with the condition will double over the next decade, resulting in almost one in ten Scots being diagnosed as diabetic.
Edinburgh’s two main hospitals have already witnessed a 42 per cent rise in the number of diabetes patients in the last five years - the Western General alone has had a 78 per cent increase.
And we have only ourselves to blame. Scotland is a nation of couch potatoes, more prone than ever to the dangers of a poor diet, excessive drinking, smoking and taking too little exercise.
The Government has now promised fresh initiatives aimed at tackling today’s couch-potato generation, whose soaring obesity levels and sedentary lifestyle could well be setting them on the road to diabetes misery. But adults, as well as children, have got to take the potential consequences of a lazy lifestyle on board.
While many may argue that if diabetic Steve Redgrave can win five Olympic rowing medals then it can’t be that serious, they are deadly wrong.
Both Type 1 diabetes - the result of a defect in insulin-producing cells possibly caused by family history or a virus - and "self-inflicted" Type 2 are chronic conditions which, if not diagnosed in time and properly managed, can affect other parts of the body.
The results can be devastating: blindness, kidney failure, heart disease, stroke and nerve damage, and amputation due to poor circulation. Patients may end up needing an organ transplant, in a coma or housebound.
Sufferers face a lifetime of carefully monitoring every morsel of food they eat, injecting themselves with insulin, and blood tests to check their blood-sugar levels. Exercise, over-excitement, even a simple cold, could seriously affect their health.
Pat Duffy has been living with diabetes for the last three years. The 61-year-old was diagnosed with Type 2, which is linked to an unhealthy lifestyle and which is now emerging in children.
"I had been feeling under the weather for more than a year," she recalls. "I couldn’t figure out what was wrong and went back and forward to the doctor. Finally, I developed the classic symptoms of a terrible thirst and sudden weight loss.
"Diabetes was a bit of a shock and a relief at the same time, because it cleared up the mystery.
"Now I have to watch my diet and take tablets to help control my insulin levels. Self-discipline becomes a way of life, the secret is doing all things in moderation. I’ve had to cut back on the amount of sugar in my diet, but that’s good for my health anyway."
Type 2 diabetes normally affects the 40 to 75 age group and carries a high risk of heart attack and strokes. More common, however, is Type 1, which Martin Maxwell, 60, has had for 21 years.
"I was just getting over the worst bout of flu I ever had," he remembers. "I went to the doctor because I noticed blurred vision, excessive thirst and sudden weight loss. The GP came right out and told me flat that I had diabetes, almost certainly triggered by the flu.
"My life changed that day and it was a bolt out of the blue. At first, there was a sense of disbelief, followed by anger at ‘why me’, but finally I just had to accept the situation and get on with the rest of my life."
It’s a bad enough condition for adults. But diabetes is particularly challenging for children and their parents.
Luckily for Ali Asghar and Sarah Scoular, their parents realised the raging thirsts and constant need to visit the toilet were symptoms that shouldn’t be ignored.
Sarah was four and had just started school when her mum, a qualified nurse, spotted the tell-tale signs.
"Sarah had started to wet the bed - something she hadn’t done since she was out of nappies," says Morag. "I caught her one day in the fridge gulping milk straight from the carton and I knew something wasn’t right. I’m a qualified nurse and diabetes immediately came to mind."
She brought a urine-test dipstick from work and tested her daughter at their South Queensferry home. "I realised the implications right away. I knew that Sarah was at risk of falling into a coma if we didn’t get her treatment immediately."
Sarah is now eight, a lively, happy girl whose life revolves around three insulin injections and at least four glucose thumb-prick tests every day. Everything she eats is closely monitored, from each sip of juice to every bite of fruit and beyond.
Danger is all around - too much playground exercise, the excitement of a sleepover at a friend’s house and even the icing on a birthday cake can tip her blood-sugar levels into the danger zone.
Her Type 1 diabetes, possibly the result of a virus, has had an impact on the whole family.
"Sarah copes admirably but she can have her stroppy days," explains Morag. "We try to keep things normal - she goes to McDonald’s, but we make sure we watch what she eats. But it affects us all - my husband and I haven’t had a night away together since she was diagnosed. I feel I can’t relax," she adds. "I get up in the middle of the night and check her, I’m always watching her, checking her food, hoping she’s alright. It’s hard, but you just have to get on with it."
How Sarah developed Type 1 diabetes is a mystery - unlike Ali, there is no history of the condition in her family.
Ali’s diabetes had such a grip that by the time it was diagnosed he ended up in hospital fighting for his life.
The 11-year-old from Dalkeith first complained of pains in his legs, thirst and constant toilet trips last November.
Parents Nabila and Mohammed were horrified to learn diabetes had already left their son suffering from a chronic lack of insulin by the time he was diagnosed. The state can lead to coma and is the biggest cause of death in children with Type 1 diabetes.
"I couldn’t sleep or eat properly for days," recalls Nabila. "Other people in the family have diabetes, but we didn’t realise Ali could get it too."
Like Sarah, Ali injects insulin three times a day and a careful check is kept on his blood-sugar levels.
His diagnosis has been a life-changing experience for the whole family. "It’s difficult," admits Nabila. "Ali is fine now but we have to watch him all the time. It’s just something we are learning to live with."
Gordon Martin, 49, chairman of the Edinburgh and district group of Diabetes UK, is not a diabetic himself, but in 1991 his ten-year-old son suddenly became very ill. He was rushed into hospital and diagnosed with Type 1.
"I had little knowledge of the condition before that, though my mother developed Type 2 diabetes in her 60s," he says.
But it prompted him to become involved with the diabetes support group which now has more than 1000 members, and it is this group which every year attempts to make the public aware of how their lifestyle can lead to diabetes.
"Every year we organize a caravan at the bottom of Castle Street during national diabetes week (June 9-15) to raise public awareness and campaign funds," he says.
"Last year, 600 people visited the caravan, both local people and visitors to the city, resulting in record donations of £3000, but more importantly, it helps save lives because we persuade people to think about their health seriously and to go and see their GP if they think they have the tell-tale signs."
Joan Allwinkle, 54, will be more affected than most by the diabetes explosion - she is a diabetes specialist nurse, based at the Royal Infirmary. "It’s daunting to think about diabetes doubling in ten years," she says. "There will be a huge increase in the numbers of new patients, all making demands on an already overstretched NHS."
She says the key to improving the situation is better health education to help wean children away from the couch and into healthier lifestyles.
"Eighty per cent of patients with Type 2 diabetes are overweight and it’s been known for years that an unhealthy lifestyle is the biggest risk factor. We should really be aiming at helping people avoid the condition in the first place - prevention is definitely better than cure."
The Edinburgh support group can be contacted at:
www.diabetesuk-edinburgh.org.uk The group is holding a seminar at the Holyrood Hotel, Edinburgh, on Saturday, March 2. For further details, contact Martin Maxwell on 0131-332 2604.
Additional reporting by Sandra Dick.
What is diabetes?
Diabetes means the level of glucose (sugar) in the blood is too high.
Normally, a hormone called insulin regulates blood sugars allowing the right amount to enter body cells during the course of a day. People obtain glucose through food. Blood-sugar levels rise after a meal and fall during physical activity. Insulin strikes the right balance making sure there’s never too much or too little in the system.
Two main types of diabetes exist. Type 1 is known as insulin dependent and occurs when the body experiences a severe lack of insulin. The condition normally develops in people under 40 and is treated by insulin injections and diet.
Type 2 is known as non-insulin dependent diabetes and normally occurs in people over 40 whose bodies produce some insulin, but not enough for their needs. A healthy, balanced diet is the main treatment, but can be supplemented by insulin tablets or injections.
Doctors now fear that Type 2 is growing among children because of their bad eating habits and couch-potato lifestyles, which will make them prematurely susceptible to heart problems.
Tell-tale signs of condition
TOO many people develop life-threatening complications because their diabetes is diagnosed too late, according to national campaigning body Diabetes UK.
There are many misconceptions about diabetes being a "mild" condition. But these misconceptions are potentially dangerous. Diabetes is serious - read on and find out if you are at risk.
The main symptoms to look out for are:
- Increased thirst
- Going to the loo all the time - especially at night
- Extreme tiredness
- Weight loss
- Genital itching or regular episodes of thrush
- Blurred vision
Remember that in Type 2 diabetes, the symptoms may not easily be recognised. But as more than 80 per cent of people with Type 2 are overweight, the more unfit you are, the greater your risk.
Fast diagnosis is essential, as diabetes can lead to blindness, kidney failure, heart disease, stroke and nerve damage that could lead to amputations.
But spotting diabetes early means that it can be treated and the risk of developing the serious complications can be greatly reduced.
A simple blood test will reveal if you have diabetes - ask your GP for one.
