Episode 11: Diabetes

Introduction episode 11 of First Aid Unboxed

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Mark: Hi, and welcome to episode 11 of First Aid Unboxed with Louise Madeley from Madeley's First Aid Plus. So my name's Mark Wakeley. I'm purely here as the facilitator.
Mark: So we're recording in the morning. So good morning, Louise.
Louise: Good morning.
Mark: How are you? Are you well?
Louise: I'm very well, thank you.
Mark: Yes, good. Good, good, good. This episode, we're gonna be talking about diabetes.

Understanding Diabetes

Mark: I think the first thing we need to look at is, everybody knows this. Well, I think most people know there's two types of diabetes, type one and type two. Can you explain the difference between the two? And also, what is diabetes?
Louise: Well, diabetes, the word itself, actually just means too much urine being produced. So it's a frequency of urine. That's what diabetes, it's a non-Greek word, that's what it originally means. So there's different types of diabetes, diabetes mellitus and diabetes insipidus. The insipidus, we don't need to know about as far as the context of diabetes is concerned with what we're talking about today. We're talking about diabetes mellitus, types 1 and type 2. That's what we're looking at, which we class as the silent killer these days.
Mark: And what is the difference between 1 and 2?
Louise: Two differences in the cause. Type 1 and type 2 share common symptoms. Generally, going to the toilet a lot, going for a wee a lot, and that's where the name diabetes comes from, the frequency of urination. It could be that they're excessively thirsty, be exceptionally tired, much more than usual. Losing weight, although they're not trying to in any way, they will just suddenly start to lose weight. Genital itching and thrush, as in recurring thrush that they can't get rid of by usual means. Cuts and wounds that take a lot longer to heal. Blurred eyesight is another one. Increased hunger. There are lots of different symptoms when it comes to diabetes. It's really a question of if you start to get any symptoms whatsoever, get yourself to your GP, get checked out. Sometimes they can be very subtle symptoms, and you can put them down to lots of other things as well. So really, it's about seeing a GP as early as you can, so that they can weed out the other symptoms and work out whether or not it's diabetes or something else going on.

Diagnosing Diabetes

Mark: You can also buy blood test kits, can't you, nowadays?
Louise: You can, yeah. We do have glucometers, which we'll tell you, but to be honest, it's a bit like if you take somebody's blood pressure, it doesn't really mean that much in that moment. So yes, taking your blood sugar, it'll tell you what your blood sugar is in your blood, obviously. However, that's a bit like taking a photo and trying to do an assessment from a photo. It just can't be done. It has to be done through other means. We have other blood tests that we use that are much more accurate as to whether it's diabetes causing it or whether it's something else. For example, somebody with a severe infection will get a low blood sugar reading. They're not diabetic, it's due to the infection that they have. So there's lots of other reasons why people might have a snapshot of a low blood sugar. It's not about that. And the same with when we're testing whether somebody has high blood pressure. It's not one reading. If you run around a lot and increase your blood pressure and then take your blood pressure, it's going to be high. You know, it's not about doing that. It's about taking several readings, doing much more sophisticated blood tests. HbA1c, for example, which gives us a much better idea as to whether somebody has diabetes as opposed to a random low blood sugar.

Can Diabetes Be Cured?

Mark: And can diabetes be cured? Is it a curable condition?
Louise: In a word, no. Type 1, absolutely not. It's not something that you can cure. There's a lot of research going into screening people for Type 1, who may be at risk of developing Type 1 in the future, and new treatments that are being developed all the time. There's also evidence that some people with Type 2 can put their diabetes into remission through lifestyle factors. And we're talking about putting it into remission rather than, oh, we're completely cured, if that makes sense. So it's about changing lifestyle on a permanent basis. It's not, right, I have Type 2 diabetes, I know that I need to do something about this, I need to change my lifestyle, I'll change it for six months. My results then come back being considerably better, I get back to my old lifestyle. It's not about that, it's about lifestyle changes long term, in order to keep diabetes in remission permanently.
Mark: Okay, so once you've got it, you've got it, and if you change your lifestyle to put it in remission, it's not gone, it's just still there in the background, bubbling away as such.
Louise: Correct.

Diabetes Statistics

Mark: Although there's a lot of research going on at the moment, and these figures may change as time goes on, but yes, as things stand at the moment, it's considered that somebody is permanently in remission, but they will be monitored from then on. And let's have a little talk about the statistics here, because there's an awful lot of talk about diabetes being something that wasn't very prevalent, certainly type 2, and now is incredibly prevalent. What are the statistics now as far as type 2 diabetes, well, diabetes generally, but type 2 specifically?
Louise: Well, 700 people a day are diagnosed with type 2 diabetes, that's in the UK, 700, that's a huge amount. Currently, there's approximately 4.6 million people with diabetes. One million of those don't know they've got it, which is why we call it the silent killer. Yeah. Eighty percent have type 2, only five percent of that figure have type 1. And type 1 is the one that generally, you tend to get or realize that you've got when you're very young. So it's usually brought up in, if not infancy, then certainly in the first 18 years of life. Absolutely nothing that you can do about that except treat. Five percent have very rare different types. They're put into other types of diabetes as opposed to the general type 1 and type 2. And just to give you some idea economically of what that means, the NHS spends approximately 10 billion pounds a year. It's 10 percent of its budget on diabetes. Eight billion, which is 80 percent of which are avoidable complications.

Complications of Diabetes

Mark: There are complications involved as well, isn't it? It affects, from my limited knowledge, I know that it can affect certainly eyesight and limbs and all kinds of things. People have amputations and stuff like that due to diabetes.
Louise: Well, it can mean anything. Yes, you get something called neuropathies, where the nerve endings don't work properly, so to speak. And as a result, you could, yes, you could lose a leg. You can lose your eyesight. Retinopathies, which is your eyes. But also things that people aren't necessarily aware of, like you can have a silent heart attack. So somebody having a heart attack and they have diabetes may not feel that pain in the chest that, generally, we've talked about male heart attacks and female and so on. But they may get no pain whatsoever whilst having a heart attack. So a lot of it is about education. It's about support. Most of this could be avoided if we worked on the education and support from day one and get people to understand about diabetes and work on it.

Main Treatments for Diabetes

Mark: And what are the main treatments for diabetes that are available?
Louise: You have things like hypoglycemic, so medications that can keep your blood sugar down low or within a certain range. There are different ranges of somebody with type 2, for example. So it could be that they can manage very well just changing their diet. For example, other people might need a tablet to help with it. Other people may require insulin as well. So it just depends on how affected by the diabetes you are, how unstable the hypos or hypers are when it goes too high, and just how stable everything is. You need to keep it within a specific range. And when it goes too low or too high, that's when you get long-term effects.
Mark: And I assume it takes some time to get the correct level of medication.
Louise: Yeah, same with any condition. Absolutely. Yeah.

Debunking Diabetes Myths

Mark: Okay. Now, there's a lot of myths surrounding diabetes as well.
Louise: Yeah.
Mark: And it's something you've talked to me about. So tell me a little bit about some of the myths and let's go busting some of those myths as well.
Louise: Okay. I love myth busting. Yeah, absolutely. For example, somebody says, it's only diabetes. You hear that an awful lot now. Well, it's only diabetes. It's okay. Diabetes is often perceived as a less serious and worrisome condition compared to other things, say cancer, heart disease, etc. What attitudes fail to take into account both significant direct impact of the condition and how it can be a gateway condition, so it can lead on to other things, such as heart disease, strokes, etc. So it's certainly not something to be ignored or hidden or anything else. It's something that we need to stand there and say, actually, we've got to do something about this and in the workplace, which is what I'm about really is trying to promote in the workplace. I mean, the figures stand for themselves. If you had a thousand people, thousand employees, roughly 80 of those will have diabetes statistically. So it's something that employers need to get on board with and need to look at. Direct impact of diabetes, we were saying a second ago, it could be that it's a limb amputation. Limb amputated every 30 seconds in this country. Leading cause of blindness in working age people. Three times more likely to lose their sight if they have diabetes. 75% of men experience erectile dysfunction from diabetes. And it's the ninth leading cause of death. One death every seven seconds as a result of diabetes.
Louise: And this is through the Diabetes Safety Organisation that I'm getting these stats from. They've done a huge amount of work. They are about promoting diabetes and reducing hypos, et cetera, in the workplace. And increasing education. It's a great organisation. I'm really impressed with the work that they're doing. So I'm getting on board with their diabetes hypo kits and so on. If you have diabetes, you're twice as likely to have a heart attack, for example. Twice as likely to have a stroke. 10% more likely to get cancer. Four times more likely to develop liver cancer. The list goes on, to be honest. You know, I could sit here for ages talking about myths and people don't realize, like we refer to it as a gateway disease, it absolutely is. It's not just having diabetes, which can be managed relatively well with the right medication and the right team behind you. It's actually about everything else. It puts you at so much risk of so many other things.
Mark: So that's the complications associated with the diabetes, really?
Louise: Absolutely, particularly for long term health outcomes.

Preventing Type 2 Diabetes

Mark: Is there a way we can avoid it, type 2 diabetes? Is it something that will happen? Is it genetic inside you, or is it often about lifestyle?
Louise: Type 2, there can be a genetic link there, but on the whole, it's to do with lifestyle, and it's to do with managing and educating, really, at young age. I've got one of my sons in here at the moment, and he's learning at the moment about diabetes and how to avoid developing diabetes in older life. And yeah, absolutely, looking at exercise, looking at diets, making healthy, good choices. If they start with the good habits now, then that will follow through their life. It needs to be started at day one, as young as possible, so it's just naturally within them, something that they learn automatically as young as they can.

Introduction to Diabetes Hypo Kits

Mark: So in front of us, we've got a, it says on the front here, a diabetes hypo kit.
Louise: Yes.
Mark: So tell me a little bit about that.
Louise: It's created by the Diabetes Safety Organization, and it's in association with Lifelines. What they've done is they've created a hypo kit. Now, the idea being, I'm just opening it up, if you can hear some noises, it's got a little kit inside, which has fast acting glucose shots in it, which is a caffeine and gluten free, fast acting shot. So there's a lot of myths, spoke about myths already, but if you're having a hypo, you just need to eat more sugar. That is not true. A hypo, hypoglycemic episode, in other words, is where blood sugar levels drop too low in the body. Symptoms can be blurred vision, weak and shaky, fatigue, sleepiness. This is when people refer to them as, I think he was drunk, for example. He's not, he's hypoglycemic. Or somebody runs into a shop, and they think they're shoplifting, they're not. They're just trying to put a Mars bar in their mouth as quickly as possible. These are natural things to do, grab the leukosate, et cetera. Somebody who's having a hypo, their entire being will tell them to head for sugar because their body and their brain knows they're going to die without it. They have a very reduced amount of sugar in their bloodstream. So these are called lifelines. This one's mango. We've got mixed berries and the other one's mango. They are literally little shots of goodness. They don't contain all the preservatives and nonsense that you can get in some glucose shots, which is why I quite like it. Not just that, it's also got the treatment card on it. So it's got it in four stages, very simple. The person is unconscious, called 999. Do not attempt to put anything in their mouth. Before you use the shot, make sure it's in date and it's sealed and intact, and it has not been opened. Then it just has one, two, three, four. Initial treatment, monitoring and waiting, additional treatment, recovery and further action. So it tells you in four very basic steps, if somebody is having a hypo in the office, exactly what to do. On the front of it as well, which is something I'm looking at doing with my first aid kits, it has a QR code, it says, scan me. As soon as you put your phone over that, it will give you a huge amount of education, everything you need to know about diabetes and what you can do to help long term and what you can do for the person who's having a hypoglycemic episode at that moment. So I love these kits. They should be in every workplace, in my opinion. They really are fantastic. They're very compact. They don't take up much room. They can sit next to your first aid kit. And it's about raising awareness. Anybody can walk up, put their phone on the ScanMe QR code, and learn a huge amount about diabetes. But it's all very user friendly. It's all in good language that everybody can understand.

Obtaining Diabetes Hypo Kits

Mark: And how can people get hold of these kits?
Louise: At the moment, through me or through the Diabetes Safety Organization, which is diabetessafetyorganisation.org, and speak to them. They're about 30 pounds each, and that's roughly the same price as a first aid kit. So if you're getting a first aid kit, might as well get one of these at the same time.

Litigation Risks and Diabetes Policies

Mark: The other thing that I wanted to mention as well is litigation risk. If you have people who have diabetes in your organization, it is important that risk assessments are followed, are done firstly, and policies are put in place, because you have somebody with a medical condition that may need treating and may need looking after whilst in the workplace. So both civil and criminal liability could follow if steps haven't been taken to identify and eliminate the risk, the same as all other medical conditions within the workplace.
Louise: So it's something that we need to get on board with. The Diabetes Safety Organization do a charter as well, which I quite like, which really, it's a question of signing the charter, a bit like a mental health charter, to say that you will be following certain steps, and you will be doing everything that you can in order to make sure that people with diabetes are safe, looked after, and productive in the workplace.

Key Takeaways

Mark: Okay, so I think we've covered most of what we were going to talk about to do with diabetes. Is there any quick takeaways that you can give people that may help them in this particular situation?
Louise: From an employer point of view, to provide diabetes awareness training for your staff. The risk of diabetes to their own health, the risk diabetes brings to others on site and in the workplace. Practical steps to help themselves, promote glucose testing according to DVLA regulations as well, for anybody who has drivers on site. And make sure that you have in place specific diabetes safety policies. They are important. It's highly likely, even if somebody hasn't expressly said, I have diabetes, it's still highly likely that you may well have somebody who does. In which case, you need to take those measures. Just make it part of your policy to educate.

How to Contact Louise Madeley

Mark: So if anybody wants to get hold of one of these diabetes hypo kits through you, what is the best way to get in contact with you?
Louise: My website is www.madeleysfirstaplus.co.uk or enquiries@madeleysfirstaplus.co.uk. And anything that we've talked about on any of the podcasts, people can get in touch with you and ask you any questions at the contact email. Anything at any time.

Mark: So diabetes, thank you very much indeed, Louise. That's fantastic. Or as we've already said, anybody wants any more information, just get in contact with Louise via the website or via the email address, and she'll be able to help you out a bit more.
Louise: Thank you, Louise, for that. And thank you for telling us all about diabetes and what things to look out for and what can be done about that. We will be back in the next episode with another episode of First Aid Unboxed with Louise Madeley from Madeley's First Aid Plus.
Mark: So thank you very much, Louise. Goodbye.
Louise: Thank you. Goodbye. Take care.
Mark: This is a 1386 audio production.
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Connect with Madeley's First Aid Plus
• Website: www.madeleysfirstaplus.co.uk
• Email: enquiries@madeleysfirstaplus.co.uk
• Phone: 01952 727 007
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Stay Tuned for Episode 12
Next week, we'll delve into managing diabetes in the workplace, discussing the essentials of diabetes hypo kits, effective responses to hypo emergencies, and best practices for supporting employees with diabetes.

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