Farm Doctor: Who is at risk of diabetes?

In this month’s Farm Doctor series, farmer’s daughter and qualified doctor Camilla Baker breaks down a common health concern affecting over 4 million people in the UK – diabetes. 

“This is a condition where the body cannot control the amount of sugar in the blood,” Camilla explains. “Generally, there are two main types of diabetes – Type 1 and Type 2.

“It is a serious condition, but one that can be managed very effectively.”

See also: Farm Doctor: Could you recognise heart attack symptoms?

Type 1 Diabetes

Type 1 diabetes is typically diagnosed in children and young people when one of the organs in the body, the pancreas, stops making an important hormone called insulin, which is vital for controlling sugar levels in the blood.

It is thought to be an autoimmune condition, where the body accidently attacks itself.

“People with a family history of Type 1 are at a higher risk of developing the condition, and it typically develops quickly, over a few days or weeks.

“So, it is particularly important for parents to be aware of the signs of Type 1 diabetes”, explains Camilla.

These include: 

• Feeling very thirsty or asking for lots of water
• Passing urine often, or more than normal
• Feeling tired or having less energy than normal
• Becoming very sick, with tummy pain and vomiting.

“If a parent is concerned that their child has these symptoms, it’s important to get them reviewed by a doctor urgently,” says Camilla.

“If your child is diagnosed with diabetes, it can be a scary and overwhelming time.

“There is a lot of support available for both children and their parents, and it is a condition that is managed very well, with support from lots of different nurses, doctors and specialists.”

Type 2 diabetes

Type 2 diabetes is generally diagnosed in people over the age of 40; however, it is being increasingly diagnosed in younger people.

“In Type 2 diabetes, the body does not respond as well to the insulin that is being made,” Camilla explains. 

“Symptoms develop at a slower rate, over a period of weeks or months, and it can be diagnosed at a general check up. Sometimes, the complications of Type 2 are noticed first.”

Lots of factors can put people at risk of developing Type 2, including having a family history of the condition or being from certain ethnic backgrounds (such as Afro-Caribbean, South Asian or Hispanic). These things cannot be changed.

“We can, however, make sure that we live a healthy lifestyle and maintain a healthy weight.

“Being overweight is one of the main risk factors for developing Type 2 diabetes,” says Camilla.

Diagnosis

Diabetes is diagnosed with blood tests, looking at the levels of sugar in the blood.

If the level of sugar is high, diabetes is diagnosed. If sugar is detected in the urine (on a dip stick test), this may also indicate a diagnosis of diabetes.

A special test called HbA1c can be used to diagnose Type 2 diabetes and to monitor how well the condition is controlled.

Management

“The main aim of treatment is to keep blood sugar levels within a healthy range and to prevent and detect complications,” explains Camilla. 

“People with Type 1 diabetes are always treated with insulin as their body does not make it. Insulin can be given in different ways, but is typically administered by injection or pump.

“Type 2 diabetes can be managed in different ways. Sometimes, a change in diet and lifestyle alone can bring sugar levels into control. Other management options include tablets and insulin injections.”

Complications  

High blood sugar levels can lead to severe and life-changing complications.  

People with Type 1 are at a higher risk of having very high blood sugar levels as they don’t have any insulin.

“Sometimes, very high blood sugar levels can cause extreme drowsiness, and even coma.

“This is why it is so important to keep blood sugar levels within a normal range,” says Camilla.

In Type 2 diabetes, effects of high blood sugar levels are more chronic. It can lead to eye problems, kidney damage, and nerve problems, especially in the feet.

“People with poorly controlled Type 2 are at risk of developing infections in the toes or feet due to nerve damage – they often have difficulty feeling when things are wrong.

“It is important to have regular checkups to look for problems with the feet, and to maintain a healthy weight, avoid smoking, and maintain a normal blood pressure,” says Camilla, as these can worsen the complications of Type 2 diabetes.

Daniel Bradley, Worcestershire farmer

Worcestershire farmer Daniel Bradley was diagnosed with Type 1 diabetes when he was just four and a half years old.

Having now lived with the condition for 30 years, he says that consistency is the key to managing his symptoms, particularly when working with the suckler cows and ewes on his family’s farm.

During the week, he also works away as a design manager at Weaving Machinery.

“Working outside of farming allows you to know your exact work patterns, so you know pretty reliably how much energy you are consuming, how much food you need to eat, and how much insulin you will need to counteract this,” he explains.

“In farming, particularly with livestock work, which is very variable and hands on, the change in routine means you could be sitting in the tractor feeding cattle at one hour, or rounding up escapees the next.

“The unpredictability means you have consumed more energy than expected, and you have to counteract the effects of this.

“At lambing time especially, because it is so physically demanding, I make sure that I snack regularly to try and keep a better blood sugar average.”

© Adobe Stock

Tracking blood sugar patterns

To track and monitor his blood sugar levels, Daniel uses a Libre sensor, which attaches to his arm and gives live, real-time updates and readings.

“It constantly measures your sugar levels, and has Bluetooth connectivity to an app on your phone which gives you live updates every 10 minutes,” Daniel explains.  

“The most useful function I’ve found is that you can track the pattern of your blood sugar, so you can see whether it’s stable, rising, or falling, and as a result you can react more quickly.

“Prior to having the sensor you’d have to go into the house, wash your hands, get the equipment out and do a finger prick test. Now, I just have to get my phone out, and I have a reading instantly.”

Sharing

Another important benefit of the sensor, particularly for farmers that often work long and solitary hours, is a feature that allows blood sugar levels to be shared with loved ones or registered health practitioners.

Daniel explains: “You can connect your sensor so that your partner can track what your blood sugar is doing as well.

“You can set an alarm threshold, so that if the sensor detects your levels are above or below this, it raises a noisy alarm.

“If it is linked to someone else’s phone it is really good, especially if you are working far out on the farm on your own.”