GP Zone

Understanding Diabetes

DIAB002-5939

Almost 3.5 million people have been diagnosed with diabetes in the UK. Many more have the condition but do not know it. Type 1 and Type 2 are the most common forms. The causes of both types are different, but both result in too much glucose (sugar) in the blood.

  • Type 1 diabetes: Type 1 diabetes is caused by the failure of the cells that produce insulin. Insulin is a hormone released by the pancreas to help control levels of sugar in the blood. It can occur at any age but usually appears before the age of 40. Type 1 diabetes is always treated with insulin.
  • Type 2 diabetes: Type 2 diabetes is caused by the body not producing enough insulin or not using what it produces effectively. It is the most common form and accounts for around 90 per cent all diabetes. Type 2 diabetes is treated with dietary changes, medication and sometimes insulin.

Diabetes can increase the risk of developing other conditions, such as heart disease. It can be managed effectively and many people with diabetes lead a healthy, active life.

Are you at risk of diabetes?

You are more at risk of developing Type 2 diabetes if:

  • You’re overweight or have a high Body Mass Index (BMI)
  • You have a large waist (more than 80cm/31.5 inches in women, 94 cm/37 inches in men or 90cm/35 inches in South Asian men)
  • You’re from an African-Caribbean, Black African, Chinese or South Asian background and over 25
  • You’re from another ethnic background and over 40
  • You have a parent, brother or sister with diabetes
  • You have ever had high blood pressure, a heart attack or a stroke
  • You have a history of polycystic ovaries, gestational diabetes or have given birth to a baby over 10 pounds/4.5kg
  • You suffer from schizophrenia, bipolar illness or depression, or you are taking anti-psychotic medication. 

There are some changes you can make to your lifestyle to cut your risk of developing Type 2 diabetes in the future ie increasing your activity levels and healthy eating even if there is a family history of the condition.

Symptoms of diabetes

The symptoms of Type 1 and Type 2 diabetes are similar. However, Type 1 diabetes usually develops suddenly over weeks or even days.

Many people have Type 2 diabetes for years without knowing it because early symptoms can be vague and may not seem important at the time.

Common symptoms of diabetes are below, please seek medical advice if you experiencing these symptoms.

  • Feeling very thirsty;
  • Needing to pass urine a lot especially at night;
  • Tiredness;
  • Weight loss without trying;
  • Frequent infections or slow-healing sores;
  • Itchiness around the vagina or penis;
  • Recurring episodes of thrush; and
  • Blurred vision.

Freestyle Libre device

The Cornwall Area Prescribing Committee considered the use of the Freestyle Libre device. Its guidance to GPs is as follows:

  1. The routine prescribing of FreeStyle Libre® for all patients with Type 1 and Type 2 diabetes is not recommended.
  2. FreeStyle Libre® has not been demonstrated to be cost-effective and in the absence of a positive recommendation from a full technology appraisal (TA), produced and published by the National Institute for Health and Care Excellence (NICE), is not recommended for routine funding in primary care.
  3. This recommendation will be reviewed in the light of new evidence to support the cost effective use of FreeStyle Libre®.

Insulin pumps and continuous glucose meters

NHS Kernow pay for the cost of sensor augmented pump therapy (insulin pumps) for adults and children with Type 1 diabetes, that fit the National Institute of Clinical Excellence (NICE) criteria. Continuous glucose meters are currently considered as a separate device to an insulin pump and there is no dedicated commissioning pathway for continuous glucose monitoring for adults or children. 

We have agreed to work with the paediatric diabetes network in the region to pursue a regional approach to commission devices for Type 1 diabetes. We hope to have a regional clinical agreement by spring 2018.

If you have any further questions please email kccg.complaints@nhs.net.