CASE STUDY #01
“I didn’t realise how
destructive diabetes can be
if you don’t take it seriously”
Yian Jones
Yian was diagnosed with type
2 in 1990. “It got picked up by
chance,” he says. “I went for
a routine medical. I’ll never
forget the way the doctor told
me. He said, ‘You’re diabetic,
old son.’ I was 21.”
Yian had been essentially
symptom-free, but he was
overweight. “I never watched
what I ate. The doctor put me
on metformin and insulin, and
it should have prompted me
to make lifestyle changes.”
As many before him have
found, however, major
overhauls aren’t easy. And
Yian, by his own admission,
didn’t take the diagnosis
seriously enough: “I didn’t
feel like I had to do anything,
and carried on as normal. My
weight continued to balloon.
I wasn’t looking after myself.”
He peaked at 290kg and
had a gastric bypass in 2010.
Then, by eating more healthily
and exercising, he lost half
his weight. “I thought it would
be the end of my problems,”
he says, “but diabetes had
already taken hold.”
The problems started
with neuropathy – loss of
sensation in his feet. He
developed charcot foot,
a weakening of the bones
that can lead to disability. He
has so far avoided amputation,
but isn’t out of the woods and
lost the sight in his right eye
from retinopathy, a commoncomplication. His wife, he
says, is amazing – “nothing
seems to faze her” – and they
try to remain active. “I’m 50
years old,” Yian says. “I don’t
want to feel like an old man.”
He feels there’s not enough
information available about
the risks of diabetes. “I didn’t
realise how destructive
diabetes can be if you don’t
take it seriously. You need
someone to tell you, ‘If you
carry on, you will lose your
eyesight, or the feeling in
your fingers and feet.’”
He’s now committed to
raising awareness, talking to
Diabetes UK workshops and
medical students. “I tell them
the truth,” he says. “I never
looked after myself, but now
I do. If sharing my story can
help others, that’s what I’ll do.”“Cardiovascular problems used to be the
big killer [for those with type 2 disease],”
says Armitage. “But recent data from
Sweden shows that if you control your
risk factors – don’t smoke, keep your
blood pressure normal – the increased
risk of heart problems is trivial.”
The trouble is that not everyone is
able to control their risk factors. “We see
awful complications,” says Howarth.
“Diabetes causes an amputation every
hour in the UK.” And that, in turn, means
that although relatively small amounts of
money are dedicated to prevention, vast
amounts are spent on its harmful effects.
He draws a comparison between the
welcome injection of a £44m fund
to improve treatment at early stages
and the £12bn per year that is spent
on diabetes, largely on dealing with
preventable complications. Prevention,
he says, is not only better than cure:
it’s a damn sight cheaper, too.CURING THE INCURABLE
Prevention may be the goal, but there
have been major advances in treatment,
too. It has recently been shown that a
diagnosis is not always a life sentence. The
Diabetes Remission Clinical Trial, funded
by Diabetes UK, divided more than 200
volunteers into two groups. They gave
half of them the best currently prescribed
diabetes care, including medication
and dietary advice. The other half
were put on a strictly controlled diet:
soups and shakes adding up to just
800kcal per day – about a third the
usual quota for an adult man.
At the end of the 12-week study, 45%
of the dieting group no longer met the
diagnostic criteria for diabetes. Even more
remarkably, when they checked up on the
subjects two years later, they found that
70% of those who had gone into remission
were still free of the disease.
“We don’t talk about reversing it,”
cautions Howarth. “We stress the word
remission. It means the disease has
stopped causing the symptoms.” There’s
plenty they don’t know – it has only
been three years since the trial began,
and it may be that the subjects still seeBad
Blood
MEN’S HEALTH 97