What is diabetes?

Diabetes is a condition whereby the body is not able to regulate your blood sugar levels effectively and causes blood sugar levels to become too high. If left without treatment, this can cause other complications such as with your blood vessels and affect your eyesight, your kidneys and put you at increased risk of heart attack or stroke (1).

What are the different types of diabetes? (1, 2)

There are two main types of diabetes:

Type 1 – where your immune system attacks the cells which produce insulin

Type 2 – where the body does not produce enough insulin or the cells do not respond to the insulin which is being produced

Type 2 diabetes is much more common in the UK with 90% of the adult population with diabetes having Type 2 Diabetes (T2DM).

Pre-diabetes is where your blood sugar levels are raised, but no so far as to diagnose you with diabetes. Having pre-diabetes puts you at a much higher risk to develop diabetes going forward.

Gestational diabetes is where a woman who is pregnant has increased blood sugar levels. This needs treatment to avoid complications for the mother and baby. If someone has had gestational diabetes, then their lifetime risk of developing diabetes also increases. This is diagnosed with a specific type of test for women during their pregnancy if they are at an increased risk.

What are the symptoms of diabetes? (1)

Diabetes can cause you to feel a lot of different symptoms, such as:

• feeling very thirsty

• needing to pass urine very frequently (e.g. overnight)

• fatigue

• loss of weight

• issues with vision (e.g. blurred)

• recurrent thrush

Type 1 diabetes can present within a number of days, type 2 diabetes can present over months/years as the onset is much slower.

How does diabetes happen? (1)

Insulin is a hormone produced by the pancreas which is a leaf-shaped gland which sits behind your stomach in your abdomen and helps to regulate the levels of glucose in the bloodstream and allows cells to take it up for energy. That then causes blood sugar to fall, which causes insulin to fall – normally. If the insulin is not being made, or does not work as it should, your blood sugar levels will become higher and your body will not be able to derive energy from the sugar which you are consuming. 

There is no lifestyle change you can make to reduce your risk of type 1 diabetes, however, healthy eating and regular exercise can help to reduce your risk of type 2 diabetes (3). 

How do doctors test for diabetes? 

A blood test which is sent to the laboratory called HbA1c helps understand how much glucose has been in your bloodstream on average for the past 3 months. This is much more accurate and representative than a single finger prick test to check your sugar levels. If you do have a finger prick check for your blood sugar which is high, the doctor will likely suggest a further test in the laboratory. In pregnancy, this test will be different.

Other things which may help is checking your weight, and also checking your urine which may show sugar in your urine, or ketones which can be found more commonly in type one diabetes (4). 

If you are concerned about your risk of diabetes, you can see if you are eligible for an NHS Health Check. 

What treatments are available?

There are different types of medicines available to treat all types of diabetes – depending on the type that you have and the severity of the condition.. These range from diet and lifestyle advice, to tablet medicines to injections. Some patients require insulin injections to replace the insulin their body is not producing. Other tablet medications may help by helping your body to get rid of sugar, or making your cells more likely to respond to the insulin which is being produced (5).

There are different options for blood sugar monitoring and these should be discussed with your GP or diabetes specialist. Traditionally, patients would monitor their blood sugars through finger pricks and keep a diary. More recently, it is possible to have a wearable device which links to an app on your phone to give you a more detailed picture of the pattern of your blood sugars.

What are the complications of untreated diabetes?

If you have untreated or poorly controlled diabetes then there is a risk of complications such as (2):

• stroke

• heart attacks

• kidney damage

• sexual dysfunction

• nerve damage (numbness and tingling in fingers and toes)

• foot problems

• issues with vision

• issues during pregnancy

• severe wound infections

Therefore it is important that people with diabetes take their treatments consistently and attend screening and health checks which they will be offered such as diabetic eye screening and foot checks.

What charities can help with people living with diabetes?

Diabetes UK helps those living with diabetes (6). This is particularly helpful if you would like help thinking about young adults with diabetes, new ways of cooking and they run local support groups. Their helpline number is 0345 123 2399.