HEALTHPLAN MAGAZINE

Over the past four years, the type 2 diabetes diagnosis count in Spain has surged from approximately four million to six million, establishing the country as the second-highest in the European Union for diabetes prevalence, trailing only Germany. Experts foresee a further escalation, projecting that by 2025, the number of affected individuals will reach nine million.

This upward trend is attributed to a surge in unhealthy dietary practices and rising obesity rates in Spain, particularly impacting the younger population.

On top of these figures, it is estimated that a further one-third of individuals with diabetes type 2 in Spain remain undiagnosed, according to a recent study by the Spanish Society of Internal Medicine (SEMI).

At this present time, Spain allocates an average annual expenditure of 2,817 euros per individual with diabetes, a figure lower than many other European countries. However, this reflects an 11.7 percent increase since 2019 when the per-person spending stood at 2,485 euros, coinciding with a 42 percent rise in the number of patients.

Despite the increase in numbers, in 2020, Spain succeeded in reducing premature deaths from diabetes, dropping from 11.98 per 100,000 inhabitants in 1990 to 4.32 per 100,000.

This positive trend contrasts with global statistics, where the World Health Organization highlights diabetes as the fourth leading cause of premature death in women and the eighth in men.

In this article we look at some of the most common questions related to type 2 diabetes and offer you some resources to manage the condition.

What is type 2 diabetes?

Type 2 diabetes is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel.

The pancreas produces insulin, a hormone that acts like a key, letting sugar into your cells for energy. In type 2 diabetes, cells resist insulin (Insulin Resistance), so the pancreas makes more. Eventually, it can't keep up, causing blood sugar to rise, leading to prediabetes and type 2 diabetes.

What are the symptoms of type 2 diabetes?

Many people may have type 2 diabetes without being aware of it because the symptoms may not necessarily cause them to feel unwell.

However, symptoms to look out for include:

• Peeing more than usual, particularly at night
• Feeling thirsty all the time
• Feeling very tired
• Losing weight without trying to
• Itching around your penis or vagina, or repeatedly getting thrush
• Cuts or wounds taking longer to heal
• Blurred vision

Learn more about the signs you may have diabetes.

Who is more at risk of developing type 2 diabetes?

Those who are more at risk of developing type 2 diabetes include:

• Those over the age of 40 (or 25 for south Asian people)
• Those who have a close relative with diabetes (such as a parent, brother or sister)
• Those who are overweight or obese
• Those of Asian, African-Caribbean or black African origin (even if you were not born there.)
• Those who smoke. Recent research has suggested that those who smoke are more likely to be diagnosed with diabetes.

Getting diagnosed

Type 2 diabetes is frequently discovered during blood or urine tests conducted for unrelated reasons. Nevertheless, it is crucial to consult your GP promptly if you experience any diabetes-related symptoms, as mentioned above.

The process of determining if you have type 2 diabetes typically involves the following steps:

• Consult your GP regarding your symptoms.
• Your GP will examine your urine and conduct a blood test to assess your blood sugar levels. Results usually take 1 to 2 days.
• If diabetes is confirmed, your GP will tell you the test results and discuss the next steps.

Upon a diabetes diagnosis, your GP will engage in a conversation with you during your appointment, addressing topics such as:

• What diabetes is.
• The implications of high blood sugar for your health.
• Whether medication is necessary.
• Guidance on diet and exercise.
• Lifestyle factors, including alcohol and smoking.

How can type 2 diabetes be treated? (Medication and lifestyle)

When it comes to managing type 2 diabetes, effective treatment strategies play a pivotal role in enhancing the well-being of individuals facing this condition. From lifestyle modifications and dietary interventions to pharmacological approaches, the spectrum of treatment options is diverse.

Medication

The majority of individuals with type 2 diabetes typically require medication for effective management. This is essential for maintaining blood sugar levels within a normal range, thereby minimising the risk of associated health issues. It's common for medication to be a lifelong necessity, although adjustments to the type or dosage may be necessary as your treatment plan evolves over time.

There are a number of medications tailored for treating type 2 diabetes, and discovering the right one, along with the appropriate dosage, may require some time.

However, if your blood sugar levels persist outside the healthy range or if you have specific health considerations like heart issues or weight management, additional medications, including insulin, may be introduced.

Your GP or diabetes nurse will guide you in selecting the most suitable medications for your individual needs. It's worth noting that the impact of your medication might not be immediately noticeable, but consistent adherence is crucial to preventing potential future health complications.

Lifestyle

Diet: Maintaining a balanced diet and staying physically active is crucial for keeping your blood sugar levels in check. Adopting a healthy diet and engaging in regular physical activity not only helps manage blood sugar but also contributes to weight control and an overall sense of well-being.

While there are no specific restrictions on the types of foods you can eat with type 2 diabetes, it's advisable to limit certain items. Focus on a varied diet that includes fruits, vegetables, and some starchy foods like pasta while minimising your sugar, fat, and salt intake.

Consistency in meal habits is essential; avoid skipping breakfast, lunch, or dinner. If dietary adjustments are needed, consider making gradual changes each week for a smoother transition.

Physical activity: This plays a vital role in reducing blood sugar levels. Aim for 2.5 hours of weekly activity, which can be achieved through various means such as brisk walking, climbing stairs, or engaging in more strenuous activities like housework or gardening. The key is to choose activities that elevate your heart rate, promoting overall health and diabetes management.

Keep a healthy weight: Your weight plays a significant role in managing diabetes. Shedding excess weight, if you're overweight, can facilitate your body's ability to lower blood sugar levels while also improving blood pressure and cholesterol. To determine whether you fall into the overweight category, calculate your body mass index (BMI). If weight loss is recommended, it's generally advised to approach it gradually, aiming for around 0.5 to 1 kg per week for most individuals. Diabetes UK offers valuable information on maintaining a healthy weight and effective weight loss strategies.

There's evidence supporting the effectiveness of a short-term low-calorie diet (800 to 1,200 calories a day for approximately 12 weeks) in alleviating symptoms of type 2 diabetes, with some individuals experiencing symptom remission. However, it's crucial to note that a low-calorie diet may not be safe or suitable for everyone with type 2 diabetes, especially those who require insulin. Seeking medical advice before embarking on such a diet is essential. Diabetes UK provides additional insights into low-calorie diets, and the charity also offers practical tips on staying active.

Health problems linked to type 2 diabetes

Type 2 diabetes is associated with a range of health problems that can significantly impact an individual's well-being, they include:

Cardiovascular Complications:

• Increased risk of heart disease and stroke
• Fatty deposits in blood vessels can restrict blood flow

Neuropathy:

• Tingling, numbness, or pain, often starting in the extremities
• Peripheral neuropathy can lead to foot ulcers and infections

Kidney Disease:

• Damage to small blood vessels in the kidneys
• Risk of chronic kidney disease and potential kidney failure

Vision Problems:

• Diabetic retinopathy can damage blood vessels in the retina
• Increased risk of vision impairment and blindness if untreated

Immune System Impact:

• Compromised immune function
• Greater susceptibility to infections

Delayed Healing:

• Poorly controlled diabetes can slow down the healing process
• Increased risk of skin infections and other complications

Metabolic Complications:

• Disruption of normal metabolic processes
• Potential for weight gain and difficulty managing blood sugar levels

Complications in Pregnancy:

• Increased risk of complications for both the mother and the baby during pregnancy

Mental Health Impact:

• Higher prevalence of depression and anxiety among individuals with diabetes

It's important to note that effective management of type 2 diabetes through lifestyle changes, medication, and regular monitoring can help mitigate these health risks and improve overall well-being.

Support in Spain for those living with diabetes

For individuals with diabetes living in Spain, it is recommended that they see a doctor to help monitor the disease every three to four months.

Anyone needing help or more information about diabetes can visit AMADI, the diabetes support charity offering information and guidance to individuals with diabetes or their families. The organisation is equipped to conduct diabetes testing. Additionally, there is an English contact available for the team to reach out to, providing assistance in English.

The Spanish Diabetes Society, which is a non-profit organization., whose main aim is to advance the prevention and treatment of diabetes by sharing knowledge both nationally and internationally.

This article was brought to you by HealthPlan, experts in expat health insurance in Spain.

Disclaimer

The information provided in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It is important to consult with a qualified healthcare professional for personalised guidance regarding your specific health situation. Never disregard professional medical advice or delay seeking it because of something you have read in this article. If you think you may have a medical emergency, call your doctor or emergency services immediately. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Reliance on the information in this article is solely at your own risk.