WE have all seen the ads. They read something along the lines of "Are you always tired? Are you always thirsty? Are you constantly having to pee?"

Most people, especially women, might smile and happily answer "Yes" to all of the above. But these three questions are no laughing matter.

They are, in fact, the first warning signs that you may be suffering from diabetes. And it is a killer.

Last year more than 100 people died of diabetes in Calderdale and as many as 7,500 are suffering from it. Experts predict by 2010 the numbers will have increased to 10,000. The latest national figures show Britain's diabetes population has risen by more than 167,000 since last year, bringing the total number to almost 2.5 million.

"These are truly alarming figures," says Douglas Smallwood, chief executive of Diabetes UK.

"Diabetes is one of the biggest health challenges facing the UK today. It causes heart disease, stroke, amputations, kidney failure and blindness, and more deaths than breast and prostate cancer combined."

Type 1 and type 2 are the most common forms of the deadly condition.

The causes of both are different, but both are a result of too much sugar in the blood.

Type 1 diabetes is caused by the body's failure to produce insulin, a hormone released by the pancreas to help control levels of sugar in the blood.

It's sometimes called juvenile diabetes or early-onset diabetes because it usually appears before the age of 40.

Type 2 diabetes is the most common form and is caused by the body not producing enough insulin or not using what it produces effectively.

Around 90 per cent of diabetes sufferers have type 2, which is strongly associated with obesity and lifestyle.

A big fat problem"Part of why we have seen such a huge increase can be attributed to improved screening from healthcare services and greater awareness among those at high risk of type 2 diabetes," he says.

"However there is no getting away from the fact that this large increase is linked to the obesity crisis."

Statistics prove we are fast becoming a nation of fatties.

Today there are around five million obese people in the UK, compared with almost 4.8 million last year.

Dr Marc Evans, consultant diabetologist, agrees that obesity is a major factor.

"The risk of diabetes increases if you've a family history of it, particularly on your mother's side and if you're overweight or obese," he says.

Evans says sufferers are getting increasingly younger.

"Diabetes used to be a condition you got in later life, mid 60s. But now it's affecting people in their mid 50s," he says.

"We need to do all we can to raise awareness of the seriousness of diabetes and help people understand how a healthy life- style can help reduce their risk of developing type 2 diabetes," he says.

The secret killer
What's really scary is that you could be a sufferer and none the wiser. According to local figures around 1,000 people in Calderdale fall into this category.

There are thought to be more than 500,000 people in the UK who have type 2 diabetes but don't know it.

The condition can go undetected for up to 10 years, and according to Diabetes UK half of people with the disease already have symptoms and complications by the time they're diagnosed.

"The four things to look out for are tiredness for no reason, drinking and passing water a lot, and a change in vision.

"That's when you need to pop along to your doctor and have a blood test," says Evans.

The main complications of diabetes are cardiovascular. It can be linked to heart attacks, strokes and the narrowing of blood vessels in your legs.

"You can also have what we call microvascular complications which is problems with the eyes and kidneys," Evans says.

Heart disease is the commonest cause of death in the UK, and a third of people who have a heart attack, have diabetes. And two-thirds of people who have a heart attack will have abnormalities in their blood glucose.
There's more bad news for women.

"If you've got diabetes and you're a woman, generally speaking, it's worse for you," Evans adds.

"Women are more susceptible to the metabolic changes that happen, it increases their risk of heart disease and other things."
Women are also more likely to be obese than men, perhaps due to the fact that they exercise less and are more likely to reward themselves with high-fat foods.

Coping with diabetes
"The first management strategy for diabetes is to adopt a healthy lifestyle," Evans says.

"Diet, exercise and lose weight. Reduce your calorie intake and avoid saturated fat, those sorts of things. We recommend 30 minutes of exercise, three times a week at least."

Eating seasonal fruit and vegetables is one way of helping to prevent diabetes, as part of an active, healthy lifestyle.

For those already with the condition, using naturally sweet, high fibre fruit and vegetables is a great way to add sweetness without putting blood sugar levels at risk.

For more information about coping with diabetes, contact Diabetes UK on 0845 1202960, Monday to Friday, 9am to 5pm, or visit its website.