What is diabetes?

Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either does not make enough insulin or cannot effectively use the insulin it does make.

Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.

There are 2 main types of diabetes:

  • Type 1 diabetes is an autoimmune disease. This is where the body’s immune system attacks and destroys the cells in the pancreas that produce insulin.
  • Type 2 diabetes occurs when your body does not produce enough insulin or the body’s cells becomes resistant to insulin, and sugar builds up in your blood.

Type 2 diabetes is far more common than type 1.

 Type 2 diabetes

Type 2 diabetes accounts for approximately 90% to 95% of all diagnosed cases of diabetes; type 1 diabetes accounts for approximately 5-10%. There are more than 3.8 million people living with diabetes in the UK, and 90% of those are type 2 cases, according to updated figures.

Diabetes UK say these numbers mean one in ten people over the age of 40 now has type 2 diabetes, and there are a further 1 million who do not know they have the condition. By 2030 it is predicted this number will rise to 5.5 million.

One of the main drivers behind these figures is the dramatic increase in obesity rates. Three in five adults in England are overweight or obese, and while not every case of type 2 diabetes is caused by excessive weight, it is the single greatest risk factor for developing the condition.

Diabetes UK’s Chief Executive Chris Askew said: “Millions of type 2 diabetes cases could be prevented if we help people understand their risk and how to reduce it. Even though the older people get the more likely they are to have type 2 diabetes, it is never too early to know your risk so that you can make changes to prevent or delay it.

“The signs of type 2 diabetes are often not obvious, that’s why spotting them early can be life-changing. Early diagnosis means that fewer people will experience diabetes-related complications such as sight loss, amputation, kidney failure, stroke and heart disease, because they could seek support to manage their condition effectively as soon as possible.”

Prediabetes

Prediabetes is when your blood glucose levels are higher than normal, but not high enough for you to be diagnosed with type 2 diabetes. Most people do not experience any symptoms.

Having prediabetes means that you are at high risk of developing type 2 diabetes. This also increases the risk of developing conditions such as heart disease, peripheral arterial disease and stroke (cardiovascular diseases).

At the present time around 12.3 million people are at increased risk of type 2 diabetes in the UK.

If prediabetes is treated, it can help to prevent the development of diabetes and cardiovascular disease. The most effective treatments are lifestyle changes, including eating a healthy balanced diet, losing weight if you are overweight, and doing regular physical activity.

What is the HbA1c blood test?

This blood test looks at glycated haemoglobin (HbA1c) which can indicate whether you have prediabetes or diabetes.

Glycated haemoglobin is made when the glucose (sugar) in your bloodstream, sticks to your red blood cells, this bonding process is called glycation. Your body can’t use the sugar properly, so more of it sticks to your blood cells and builds up in your blood. Red blood cells are active for around 2-3 months, so this is a way of assessing your average blood sugars in the past 2-3 months. If a person has high blood glucose, more red blood cells become glycated, giving a higher HbA1c level.

Does this test differ from a fasting glucose measurement?

Yes, it does. Fasting glucose is a snapshot of your blood glucose level at that one moment in time and is influenced by a variety of factors, so has a more limited value.

What can my results tell me?

HbA1c is used to monitor average blood glucose levels in someone with diabetes and to help treatment decisions. It can also be used to make a diagnosis of type 2 diabetes and to identify pre-diabetes.  For those who are found to be prediabetic, making lifestyle changes may help to avoid or delay the onset of type 2 diabetes.

HbA1c  (mmol/mol or %) 

Normal- Below 42 mmol/mol or 6.0%

Prediabetes – 42 to 47 mmol/mol or 6.0% to 6.4%

Diabetes-  48 mmol/mol or over 6.5% or over

  • In someone with no symptoms, a diagnosis of diabetes should never be based on the single abnormal HbA1c reading, and at least one additional test is essential. If the second result is normal, then it would be prudent to monitor and review this patient.
  • In someone who has symptoms of diabetes e.g. thirst, increased urination, weight loss, drowsiness or recurrent infections, diabetes can be diagnosed with more confidence based on a single abnormal result.

Is the test suitable for me?

HbA1c is not always the most appropriate way to assess blood sugar e.g. it cannot be used in children or young people, pregnancy, people who are acutely unwell, alcoholics, anaemia, in chronic renal failure, patients who have had a splenectomy and pancreatic surgery, certain haemoglobinopathies, iron and vitamin B12 deficiency It can also be affected by steroids, antipsychotics, aspirin, and vitamins C and E.

Do you include the HbA1c test in your health assessments?

HbA1c is included in all Preventicum health assessments and we look forward to discussing this diabetes test with you further, at your next Preventicum assessment.

 

Source: Diabetes UK, www.nhs.uk , www.diabetes.org.uk

ESSENTIAL

Consultation with a Preventicum doctor
Lasting up to 50 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have.

Detailed physical examination with a Preventicum doctor
An examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure

Over 45 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function in women, HbA1c (diabetes test), vitamin D, and PSA on men over 50 years.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

Echocardiogram
A non-invasive ultrasound examination using high-frequency sound waves to create detailed pictures of your heart. We look at the structure and function of your heart including the valves and can record dynamic changes within this moving organ to see how the heart is managing blood flow around the body.

Resting electrocardiogram (ECG)
ECG is used in diagnosing many electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Body Composition Analysis
The InBody 720 provides a detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 20-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.

ELITE

Consultation and physical examination with a Preventicum doctor
Lasting up to 60 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have. Your doctor will also carry out a physical examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure.

Over 50 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function, HbA1c (diabetes test), vitamin and mineral profile including vitamin D, and PSA on men over 50 years.

Magnetic Resonance Imaging (MRI)
MRI scans of your brain, heart, central arteries and organs of the abdomen and the pelvis as well as a whole spinal scan including your cervical, thoracic and lumber spine. Our two, state-of-the-art MRI scanners are equipped with ‘in-bore’ technology, ambient lighting and a choice of music or film to create an immersive audio video visual experience.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

VO2max*
Cardiopulmonary exercise testing, also known as VO2max, is a measure of aerobic, cardiac fitness and endurance capacity.
*Please note that during COVID-19 restrictions, this aerosol generating test is not being offered. You may book to return for this at a later date, or we will refund you the cost for this test.

Resting electrocardiogram (ECG)
ECG is used to diagnose electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Pure Sports musculoskeletal movement screen and strength & conditioning coaching
A consultation and movement screen with a specialist musculoskeletal physiotherapist at Pure Sports (on-site) to determine injuries, exercise history and gait analysis. A sports coach will then take you through an in-depth strength assessment using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

Body Composition Analysis
A detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Radiologist consultation
A results consultation with one of our highly experienced consultant radiologists. A virtual tour viewing hundreds of your MRI scan images, including a video of your beating heart and you will be given a USB of your images to take away on the day.

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 30-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.