The difference between Type 1 and 2

LEARNING TO COPE Emily Cole. 'Picture: Mick Young '(123744-02)
LEARNING TO COPE Emily Cole. 'Picture: Mick Young '(123744-02)
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Since the age of eight, Emily Cole has had to get used to injecting herself with insulin at least four times a day.

Now 14, the Gosport teenager was just 18 months old when she was rushed to hospital after having a life-threatening attack, called a diabetic ketoacidosis.

It was only once she was sent to hospital – after having seen a doctor – that Emily was diagnosed with Type 1 diabetes.

The condition destroys beta cells in the pancreas, meaning that the body can no longer produce insulin.

Insulin is needed in order to help the body use glucose for energy.

Those with Type 1 diabetes require insulin injections in order to live.

It means a patient will have to inject insulin daily for the rest of their lives.

Emily, pictured, a Year 10 pupil at Brune Park Community College, in Military Road, Gosport, says: ‘It’s not exactly the best of things, it takes a lot of time and you have to be patient with it.

‘If you’re out somewhere and you want to go do something, I have to take time to go and do an injection or go to a bathroom to do it.

‘The insulin that I have, one’s called NovoRapid, it pretty much helps me with my food, it gives insulin with the food.

‘And before I go to bed I have to use a different type of insulin called Lantus, which helps me through the night.

‘I have roughly around four injections a day, but sometimes I might need to have more.

‘It’s whenever I eat, anytime I eat.’

But to begin with, Emily found it difficult to adjust to such a routine.

‘I did have problems when I was younger, people used to call me weird and stuff because they didn’t know about it,’ she says.

‘It doesn’t really leave your side.

‘I don’t particularly like it because I feel different and stuff but all my friends understand.

‘It’s something I don’t really like, but because I’ve had it for so long, people say “oh you get used to it” but you don’t.

‘It’s something you’re always going to have, it’s a part of you but it’s something you’re going to have to live with, you don’t really have a choice.

‘When I was about eight I started doing my own injections.

‘At first it was really hard, my hand couldn’t fit around the pen or reach the end to push the insulin through.

‘And sometimes I got quite frustrated, after a while you learn the tricks about it.

‘You don’t actually have to hold the pen, you can push it against something.

‘It looks like a normal pen but a little bit thicker and more rounded and it has a clear section where you can see the amount of insulin.’

Emily needs to inject the insulin before or after each meal. And she is aware of the dangers if she doesn’t take her insulin properly.

She went on a course to find out more about the condition, and why it’s important she takes her injections and keeps an eye on her diet.

She needs to calorie count in order to make sure she is delivering the right amount of insulin in to her body.

She says: ‘You have to prick your little finger and test the blood, a little bit of blood goes up the test strip and you have to do at least four a day.

‘The course was about people with diabetes and there was a girl who had already lost her leg because she hadn’t looked after herself and I didn’t want to end up like her.

‘She just didn’t do anything, she just left it.

‘I’m not scared but I’m cautious as to what could happen.

‘If you don’t do the tests or take the insulin, then you have the chance of going blind or losing limbs.

‘I get quite upset about it.’

November is National Diabetes Month.

It is organised by the National Diabetes Education Programme, which aims to raise awareness of both Type 1 and Type 2 diabetes.

Dr Partha Kar is a diabetic consultant at Queen Alexandra Hospital, in Cosham.

He explains the difference between the two.

He says: ‘With Type 1, if a person doesn’t have their insulin then they die.

‘In the past before insulin was invented, that’s what happened.

‘They will have to be on it for a lifetime.

‘You can develop Type 1 at any point, but it is usually when you are younger.

‘But with Type 2, it is diagnosed pretty much as you grow older or have health problems.

‘There is an important distinction to be made – Type 1 cannot be prevented or cured at present.

‘Type 2 can be prevented.

‘The second one means the body is usually producing insulin, but it isn’t being used effectively because the pancreas is knackered.’

According to Dr Kar, in the Portsmouth and south east Hampshire area, around 30,000 people have diabetes.

But of this figure, only around five or six have Type 1.

‘Having a better diet and doing exercise can help people control their Type 2 diabetes,’ says Dr Kar.

‘They should also speak to their GPs, community nurses, or the diabetic team at the hospital if they want any help or are concerned about things.

‘If it isn’t controlled then one of the things it can lead to is amputations of limbs.’

As previously reported, Portsmouth has one of the worst foot amputation rates in the country. Figures from the NHS Information Centre show the city has almost double the number of amputation patients compared to the national average.

Between April 2008 and March 2011, there were 369 amputations, giving an annual rate of 5.2 in every 1,000 patients seen.

The national average is 2.7 and Hampshire has a rate of 3.8.

Diabetes can cause poor circulation, which often means people do not realise there is an ulcer or cut on their foot.

Over time this becomes infected and cannot be treated, which can lead to the amputation of a toe or foot.

Diabetes signs to look out for

FEELING tired and thirsty, weight loss and going to the toilet frequently could be signs of diabetes.

Dr Partha Kar is a diabetes consultant at Queen Alexandra Hospital, Cosham, and explains what people should do if they are concerned.

He says: ‘Most people lose a lot of weight, drink a lot of water and need to go to the toilet a lot more.

‘They will also feel tired.

‘The thirst comes from having high sugar levels in the blood.

‘If you are getting up between 10 to 12 times in the night to go to the loo, then this could be a sign.

‘The majority of Type 2 diabetes is picked up when patients have come in for other tests.’

The Portsmouth area is estimated to have around 30,000 diabetic patients – with most of these being Type 2.

Dr Kar says: ‘Because the social and economical conditions are lower in Portsmouth, people don’t always have the means to maintain a healthy lifestyle, and so the rates are higher.

‘But we are improving our care and we are driven to do this.

‘If you have either type of diabetes, then make sure you are talking to someone about it.

‘This could be your GP, a community nurse, or the team at the diabetes centre in QA.’

To contact the centre, call (023) 9228 6260, or go to

Lifestyle helps manage diabetes

FOR a few weeks Kerry Hilliar had been feeling unwell.

And when the 36-year-old started feeling hot, she put it down to the summer weather.

But when Kerry, of Allaway Avenue, in Paulsgrove, Portsmouth, collapsed in her home, she decided to visit the doctors.

‘I was quite surprised when I was told I had Type 2 diabetes,’ says Kerry.

‘It explained why I had been blacking out and why I collapsed.

‘I was diagnosed with diabetes when I was pregnant with my first child, but it was only during my pregnancy.’

Kerry, who works as a cleaner at Queen Alexandra Hospital, in Cosham, was diagnosed with the condition six years ago.

The difference with being diagnosed with Type 2 diabetes, compared to Type 1, is that lifestyle changes can help control the condition.

Kerry says: ‘I would say to anyone with Type 2 diabetes, that they should make sure they exercise and eat healthy.

‘Because I made changes when I was pregnant, I haven’t had to change much.

‘It’s important because no one wants to be on tablets for the rest of their life.

‘I want to make sure I’m there for my children.’