Diabetes The number of people who are living with diabetes continues to rise, fuelled by the high prevalence of obesity in the UK.

In this article

Type 1 Type 2 Eat a balanced diet

Alcohol Exercise Smoking

Medication Act now

Diabetes is a condition where blood glucose (sugar) levels are poorly controlled. Latest figures show that over 2 million people in the UK have diabetes and an estimated 1 million people are undiagnosed and don’t realise they have diabetes.

There are two different types of diabetes:

Type 1 diabetes, which used to be called insulin-dependent diabetes, occurs when the body fails to produce insulin, the hormone required for controlling blood sugar levels. People with type 1 diabetes require regular insulin injections to correct this. All type 1 diabetes patients should have access to a qualified dietitian, as diet is an important part of their clinical care. Type 1 diabetes usually affects young people, often in childhood, and is the least common of the two forms of diabetes accounting for between five to 15 per cent of all people with this disease.

Type 2 diabetes develops slowly. It's much more common than type 1 diabetes, accounting for at least 75 per cent of cases. Type 2 diabetes often develops later in life although cases in obese children and young adults are becoming more common. It's strongly related to being overweight.

Although the body continues to secrete insulin, often in large amounts, people who are on the path of type 2 diabetes don’t respond efficiently. This is known as insulin resistance. Later, insulin production declines and this signals the onset of type 2 diabetes. In the early stages, diet and lifestyle measures can often be sufficient to control and even reverse insulin resistance. In the later stages of the disease, some people will need tablets and later insulin injections to manage their diabetes.

You can reduce your risk of developing type 2 diabetes by achieving and maintaining a healthy weight. Studies show that for overweight people at risk of diabetes, losing just five per cent of your body weight can more than halve the chance of progressing to diabetes. It's worth noting that despite diabetes being a condition of sugar regulation, specific restriction of sugars isn’t necessary, except as part of ensuring a balanced diet overall.

If you're living with diabetes you need to reduce your risk of developing associated diseases such as coronary heart disease, kidney and eye disease. This means losing weight, keeping your blood pressure and blood glucose as near normal as possible and having your cholesterol and tri-glycerides checked regularly.

By choosing to eat a healthy balanced diet you'll already have started to manage diabetes by helping to control your blood glucose levels, blood fats and blood pressure. It will also help to regulate your weight. If you're overweight it's especially important to try and achieve and maintain a lower weight. Even small weight losses lead to surprisingly big reductions in the risk of diabetes and will also reduce your risk of heart disease, high blood pressure and stroke (see article on Cardiovascular disease).

Finding the balance between the amount of carbohydrates and fat is important. Cut down on the amount of fat you eat - particularly saturated (animal) fats, as this type of fat is linked to heart disease. Choose monounsaturated fats, e.g. olive oil and rapeseed oil. Aim to eat a portion of oily fish at least twice a week.

Eat regular meals based on starchy carbohydrate foods - such as bread, pasta, chapattis, potatoes, yam, noodles, rice and cereals. Include plenty of fresh fruits and vegetables.

Where possible, choose wholegrain carbohydrates, these are high in fibre and will help you to control your blood glucose levels (see article on Carbohydrates).

Whether diabetic or not, an adult needs daily:

• two servings of protein foods eg lean meat, fish, eggs or pulses (eg lentils)
• at least five servings of starchy carbohydrate foods
• at least five servings of fruit and vegetables
• three servings of low-fat dairy foods

For more information, see the Food Standards Agency'seatwell plate.

Drink alcohol in moderation. As with non-diabetics, drink a maximum of two to three units for women and three to four units for men per day. Spread your drinking throughout the week and avoid binge drinking. Remember that alcohol contains calories so keep it to a minimum to help you lose weight. A unit is a small glass of wine or half a pint of beer, or a pub measure of spirits. If you're taking tablets to help control your blood sugars, remember that alcohol can make hypoglycaemia (low blood sugars) more likely to occur, so never drink on an empty stomach.

Whatever your weight, being fit and active reduces your risk of diabetes. Physical activity, when combined with a healthy balanced diet, will help you to manage your diabetes and prevent long-term complications.

People with diabetes are at an increased risk of cardiovascular disease. Stopping smoking will help to decrease your risk of cardiovascular disease and minimise the chance of developing other complications of diabetes.

People with diabetes may often need additional treatments to work alongside their healthy lifestyle such as medication to control their diabetes. This may be in the form of tablets or insulin. Finding out what works for you is important and you should discuss your options as well as any concerns that you may have with your healthcare team.

In recent years great strides have been made in the treatment of diabetes, but no one can deny the impact a diagnosis of diabetes can have on individuals. It's important that you begin to make these changes to your diet as soon as you're diagnosed. Managing diabetes is a daily challenge and carries its own health risks, especially the increased likelihood of heart disease.

This article was last medically reviewed by the MRC Human Nutrition Research in July 2008.
First published in March 2001.