Dear Doctor: Diabetes and M.E.
Our medical advisor, Dr Gregor Purdie, answers a reader's question about type 2 diabetes and how to prevent it.
Q: I have had M.E. for 27 years. Recently I was also informed that I am pre-type 2 diabetic, with a reading of 6.4 in Oct and 6.2 in August. My GP suggested I go on a course to learn about type 2 diabetes and reduce the risk of full-blown type 2. The course would involve a series of weekly, fortnightly and monthly meetings. Unfortunately, driving for half an hour each way, and then doing an intensive hour-long class – which includes exercise – is just not possible for me. My GP does not understand. Is there is anything else I can do?
Dr Purdie says: Type 2 diabetes comes about when the body can no longer produce enough of the hormone insulin to meet the body’s metabolic needs. In healthy individuals, insulin ensures that dietary glucose is directed to the body’s cells, and is used by them as part of normal metabolism. In people with diabetes, glucose tends to accumulate in the body. This can lead to complications throughout the body, and in particular can affect the circulation, kidneys, eyes, skin and nerves.
Your question specifically mentions prediabetes (which is often picked up on screening tests for other conditions such as high blood pressure or investigation of fatigue, for example). At this stage, the body is beginning to have difficulty managing glucose metabolism, but it tends not to have symptoms yet. A classic symptom of full-blown diabetes would be if you find yourself increasingly thirsty, so if this starts happening, please get it checked out at the earliest possible opportunity. Intervention at that stage is very valuable in correcting the problem.
Diabetes has particular problems for people with M.E. In particular, if you have been advised to lose weight, then while changing your diet may help, the standard advice is to also look at increasing exercise. That is much more challenging for people with M.E. and, as yet, there are no specific guidelines for people with M.E who are diagnosed with diabetes. There are, however, other ways you can tackle it.
The first step is to ensure you have a good, balanced diet. Cut out sugary foods and sugary drinks (the latter can be replaced by the sugar-free versions). Some people swear by a good drink of plain water. It is also important to cut down on fats and salt for the benefit of your heart and circulation. The less fatty food, the better.
Make sure that you eat your five portions of fruit and vegetables per day. Lean meat and fish can be eaten daily. Wholemeal bread and brown rice are better than the white varieties, being higher in fibre which, as well as aiding glucose control, is good for the bowels.
You will see on many labels on food in the supermarkets what is called the traffic light system. The protein, carbohydrate, fat and salt levels are coloured to show red, amber or green. You want to look for foods that are green particularly in the carbohydrate, fat and salt categories. Carbohydrates include sugars and cereals, and often the sugar levels are reported as well. It is the latter which is the most important.
If changing your diet is not sufficient to get your symptoms under control, and you do go on to develop type 2 diabetes, your GP can prescribe medication to help your body manage the excess glucose, and can refer you to appropriate resources and health professionals as and when required.
For further information and support on preventing and living with diabetes, contact Diabetes UK