Last year, people with diabetes took 15 million days off work, spent 120 million days underperforming in their jobs and cost US business an estimated $27 billion. More than 280,000 people died as a result of their diabetes.

By 2030 one in twenty adults over 20 years old is expected to have the condition, a statistic that will have a major impact on the nation’s productivity. Not only will we be spending more on medication and other medical costs, we will be producing less, as more of us are forced to stay off work. We will be dying younger and spending longer in hospitals, stretching an already overburdened healthcare system.

These figures do not include the social costs to America, the pain and suffering of those affected, the unpaid time given by carers and families and the wasted money spent by undiagnosed diabetics.

At present more than 50 million Americans do not know they have diabetes and continue to lead the kind of lives which do little to tackle their condition. Healthcare professionals have a part to play in tackling this, with better screening techniques, earlier diagnosis and prompter treatment.

Severe vision loss could be slashed by more than 50% if sight-saving laser therapies are implemented in a timely manner, while earlier detection of liver and kidney disease could improve kidney function in many sufferers by as much as 70%. An improved system of foot care would virtually eliminate cases of lower limb amputation completely.

Diabetes affects the entire nation and we should all be involved in fighting it.

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Youngsters who have for years adhered to a management plan may begin ignoring their regime and denying their diabetes as a reaction to the physical and mental changes they are going through. During this period, when blood glucose levels are already becoming harder to regulate, problems can arise from a failure to apply the guidelines.

Such problems are compounded for young women, especially around the time of their menstrual period, when hormone levels influence glucose levels and can cause an irregular cycle.

Teenagers inherently want to fit in with the crowd and their diabetes, with its associated management techniques including injections, special meals and rigid timings can hamper the opportunity to conform, having a negative impact on a teenager’s self image.

It is important during this period for parents to support their children and emphasize the skill and judgment they need to develop, without denying them the freedom to express themselves. Being open with your teenage is especially important now and you should stress the potentially harmful long term effects and consequences of not being aware of their condition.

Be prepared for a tough fight and don’t expect them to understand your warnings about the future. But it is important to stress the damaging effects of a high incidence of glucose levels and how it can be harmful to them. Educators have an important role to play in this period, as does literature. There are many excellent books written especially for teenagers, outlining how diabetes affects them, and it’s probably a good idea to give your child access to at least one of them.

Most importantly, talk with your child. If you are diabetic yourself discuss openly your own feelings and how you manage the condition.

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A healthy food plan is essential for managing your condition, but with so much information currently available knowing what’s right and wrong can be a confusing business. Whatever choices you make there are a few simple rules which are universally recognized to be beneficial.

Ÿ Try and reduce portion sizes. Cut the amount of fried foods you include in meals, whether at home or in a restaurant.

Ÿ Make fresh fruit and vegetables a major part of your diet. Try and eat non-starchy vegetables, such as green beans, spinach and broccoli with every meal.

Ÿ Drink diet soda whenever you have the chance - better still have a glass of water.

Ÿ Switch to brown rice, whole-wheat pasta and other whole grain carbohydrates.

Ÿ Include dried beans and lentils in your cooking.

Ÿ Try and eat fish at least twice a week.

Ÿ When buying meat, whether at the store or in a restaurant, opt for leaner cuts, such as loin of pork or beef. Always remove the skin from chicken.

Ÿ Reduce your dairy food consumption and opt for fat-free milk, cheese and yogurt. Try replacing cow’s milk in drinks with Soya or rice alternatives.

Ÿ When you’re frying avoid solid fats and choose liquid oils which contain less saturated fat.

Ÿ Avoid calorie-packed snack foods such as cookies, chips and cakes; alternatively look for low-calorie versions.

Most importantly, develop and stick to a meal plan. Your doctor will be able to help you with this. Make sure it fits your lifestyle and is achievable; sticking to it will not only control weight but help balance blood glucose, blood pressure and your cholesterol levels.

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As always, a large part of the problem is a lack of knowledge, either on the part of parents, children or the schools and colleges they attend. Ignorance, of the issues surrounding the condition and its safe management, frequently lie at the heart of discrimination, so it’s important that healthcare professionals and educators alike are actively involved in resolving them.

With careful management, and modern medical knowledge, diabetic youngsters are able to play a full role in all aspects of school and college life - and it is important that they do so. But many children are still forced to confront issues of discrimination, whether from their fellow students or teachers, despite legislation protecting them.

Children with diabetes sometimes face problems in obtaining the care they need in schools and day care centers. Whether you are a parent or student, understand the rights of people with diabetes, and what you can do to make sure your school is offering fair treatment.

Every student with a disability has the right to a positive public education experience free from discrimination, and these rights are guaranteed in federal law. With a number of acts offering legal protection nationally, and most states having their own additional protections, every school and college receiving federal funding must employ personnel who are aware of diabetes and how it affects your child.

If your school or college does not have this provision they will have to train staff accordingly. Don’t be afraid to get involved and negotiate with school or college officials to achieve this.

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Once you are pregnant it is important to maintain your blood glucose at near normal levels, especially in the early stages, when your baby is growing most rapidly. You run the highest chance of miscarriage during this phase and high glucose levels can increase the risk of complications. Your doctor will be able to advise you on a suitable meal plan.

Sufferers taking hypoglycaemic medication or controlling their condition through diet and exercise will be moved to insulin injections and you will need to adjust to this by monitoring your body’s glucose levels carefully. Gradually, over the course of your pregnancy your need for insulin will increase. You can help regulate it by sticking to an agreed meal plan and learning to adjust your jabs as required.

Food intake is especially important during pregnancy; after all, you are controlling both the nutrition and glucose levels of two people now and you will have to accommodate your food intake accordingly, increasing your daily intake by around 300 calories.

Over the course of your pregnancy you will become an expert in controlling your blood sugar levels and it is important throughout never to miss meals and snack breaks. If you suffer from morning sickness contact your doctor immediately, and if sticking to three large meals a day becomes uncomfortable, split them into six or even eight smaller servings.

Your doctor will know exactly how you need to manage your condition over the course of your pregnancy and be able to advise you throughout.

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But management does not end there as your child’s emotional and physical well being is particularly at risk if they are diabetic. School life has been touched upon elsewhere in this blog, so here we will concentrate on your child’s life outside of the education system.

Often the families of children with diabetes worry that they will be excluded from activities or made to feel awkward and embarrassed by their condition. However, an open attitude and frank discussion with their friends will frequently result in exactly the opposite. Indeed, research shows that peer groups will often value your child and readily accept them just the way they are, if they are honest about the disease, while a secretive attitude can lead to resentment and exclusion.

Talk with your doctor and other health professionals, they will often be able to counsel your child on managing their diabetes, and advise them on how best to cope with their feelings of being different. A healthy social life is important to your child, not just for their psychological well being but also for them to lead a physically active and rewarding life.

Remember, exercise is a vital part of managing their condition and there is no reason why your child should not participate in sports and other social activities such as hiking and camping. They will help him or her to maintain a healthy insulin balance and lower blood sugar levels.

There is absolutely no reason for diabetes to impact on your child’s potential for success in both social integration and sporting achievement. Provided with the correct knowledge and tools to participate your child will develop the self-esteem, confidence and other positive effects of a normal physical life.

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Much emphasis and research continues to surround the role of insulin in Type 2 diabetes, the most frequently occurring form of the condition. In particular, scientists are studying the relationship between energy created at a muscular level and its response to insulin generation in relation to impaired phosphate movement, as an early stage symptom of diabetes. This research is helping us to understand the problems of weight management among many insulin-resistant sufferers, who appear to have a lower calorific requirement than the rest of the population.

Insulin delivery is also the subject of much research and new implantable insulin delivery capsules are at an advanced stage. When commercially available these tiny pumps will be capable of measuring blood sugar levels and releasing exact quantities of insulin, mimicking natural delivery methods. Early progress in using the body’s own nutrients, to create insulin, means their life spans could be indefinite once biocompatibility issues can be overcome and the body prevented from attacking such devices.

The development of insulin inhalers is currently being fast tracked in clinical trials and could be used to deliver amounts of the compound through the mouth. While they may not completely eradicate the necessity for daily injections they will deliver a rapid amount of insulin to the bloodstream

With so much research underway including vaccines, cell transplants and gene therapy the lives of the 20 million Americans living with diabetes are set to be vastly improved over the next decade.

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Preparation depends on the nature of your vacation and issues such as crossing time zones, different types of food and changes in activity are of paramount concern. Before embarking on any trip have a full medical examination and discuss your plans with a health care professional. Always get any immunization shots well ahead of departure so your body will have time to recover before leaving.

Make sure you have a prescription for your medication and a note detailing any allergies, food requirements and medications you cannot take. If necessary, have these translated into the language of the country you are visiting. You should make sure you have adequate supplies of your meds, including syringes, enough to last longer than your intended length of travel. Prescription laws vary from country to country and state to state, so make sure your doctor’s note explains your requirements thoroughly.

If you are traveling abroad and English is not the first language, it’s a good idea to get a list of English speaking doctors in your destination country.

No matter where you are going, wear a medical bracelet indicating you have diabetes, and learn to say things you may need to communicate, such as ‘I have diabetes’ ‘sugar’ or ‘fruit juice’

Finally, once you arrive at your destination relax for a couple of days and get used to your new surroundings. Don’t set off on a wilderness hike or camel safari the day after arrival; give your body time to adjust. After all, you’re on vacation.

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However, with a little regular attention many foot problems can be addressed if not completely eliminated.

Diabetes can cause nerve damage leading to a reduction of feeling in the feet, this is known as peripheral neuropathy and it is possible to have this without being aware. The condition means that otherwise minor ailments, such as cuts and sores can develop into serious problems and even lead to amputation. For this reason, a regular regime of foot care is advised, especially for older sufferers, who can cut their risk of complication by more than half.

Problems are most likely to occur in sufferers with kidney and eye complications, although all diabetics run a higher than average risk, making it vitally important to check for the warning signs. Healthcare in this area has improved greatly in recent years and clinics have established preventative care programs reducing the rate of amputation by more than 80%.

Follow the simple checklist below to minimize your chances of any trouble:

Ÿ Look out for any unusual redness, changes in skin color or swelling on the feet and lower legs.

Ÿ Have calluses, bunions and fungal infections promptly treated by professionals.

Ÿ Wash your feet thoroughly on a daily basis.

Ÿ Dry carefully, paying particular attention between the toes and use medicated talcum powder.

Ÿ Monitor and control your glucose levels.

Ÿ Buy comfortable, well fitting shoes with cushioned soles and always wear socks.

Ÿ Keep toenails in good order and file regularly.

Ÿ Have your feet examined by your doctor at every visit.

Ÿ Monitor the sensation in your feet regularly.

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Many now offer healthy alternatives and, with a little awareness, there’s no reason why you can’t enjoy the experience, without fear of breaking your own dietary guidelines. Remember it’s easy to eat a day’s worth of calories in one sitting, sending your blood sugar levels spiralling out of control. So keep your own personal diet rules in mind, and watch out for fat and salt loaded foods when ordering.

Be aware of the nutritional value of the food you are eating and compensate with your other meals that day, loading them with fresh fruit and vegetables. When placing your order avoid sugar packed sodas and choose a fresh juice or water.

Consider how your meal is prepared. While fish or chicken may seem healthy enough, if it has been deep fried it will contain high amounts of fat.

Avoid items labeled with words like King Size, Jumbo or Deluxe and don’t be lured by two-for-one deals. Go for regular or even child portions and look out for words like Lean, Grilled and Broiled, [and] avoiding toppings like mayo and other dressings by asking for them on the side. A typical slice of cheese will add 100 calories to your meal, as well as excess fat and salt - leave it out.

If there’s a salad bar or build your own option avoid items such as bacon bits, croutons and fatty dressings, choosing crunchy lettuce, fresh vegetables and peppers. When you eat Mexican try a burrito without refried beans and load up on the salsa instead. If pizza’s your thing choose thin crust and go light on the cheese.

Finally, watch out for easy to fall into traps. Fat-free muffins often contain high amounts of sugar and sodium, while even skinless chicken will be high in fat if it’s been fried.

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