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Non-insulin-dependent diabetes





NHS Choices Syndication


Non-insulin-dependent diabetes

"Becoming diabetic forced me to change my life around"

Charles Torkington, 54, an IT specialist from Thirsk in North Yorkshire, says that being diagnosed with diabetes gave him the determination to change his diet and his life.

“I was a pilot for 30 years, and was fit and active. But when I left the forces eight years ago, my life changed. I studied IT and stopped exercising due to work pressures. My weight went up to just over 15 stone (95kg).

“Then I started getting pains in my legs, which I thought were linked to a back injury. My doctor said it was either cancer or diabetes. A week later, he rang to say I had diabetes. My blood sugar levels were so high they were off the scale.

“My GP put me on an exercise and diet regime, reducing portion size and cutting out alcohol completely. I now eat lots of vegetables, salmon and skinned chicken, and no processed food at all.

“I run up the stairs instead of walking, I walk to get the weekend shopping, and polish the car vigorously by hand. I also walk three or four miles in the countryside at weekends.

“I’m now 11 stone 8lb (74kg) and feel so much better. I’ve got loads of energy and my blood sugar is under control. Becoming diabetic forced me to change my life. I’m very happy now.”

Published Date
2014-07-23 09:39:25Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Type 2 diabetes






NHS Choices Syndication


Non-insulin-dependent diabetes

"Diabetes can severely affect African-Caribbean and Asian people"

In this video, Grace Vanterpool MBE, a nurse consultant in diabetes, talks about her support work and raising awareness of the condition.

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Published Date
2014-07-23 09:40:42Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Type 2 diabetes






NHS Choices Syndication


Non-insulin-dependent diabetes

"If you have worries, get tested"

Clare Mehmet, a 58-year-old retired telecommunications interpreter, found out by chance that she had type 2 diabetes 10 years ago.

“I was waiting for a train when I saw a poster saying, ‘You could have diabetes: Are you thirsty all the time? Are you always tired? Is your vision blurred?’ I was shocked because I’d been experiencing all the symptoms, but put it to the back of my mind. So I promptly made an appointment with my GP, who confirmed that I had type 2 diabetes.

“At first I was terrified. I always thought people with diabetes were seriously ill, but once I looked into the condition I realised that as long as you change your diet and keep yourself fit and healthy, you can lead a full and active life.

“I’ve joined lots of support groups since I was diagnosed with diabetes, and I do voluntary work to raise awareness about the condition. It’s important that people watch out for the signs. Late diagnosis can cause serious complications, such as blindness, kidney failure, heart diseasestroke and nerve damage, which could lead to blood flow problems and even amputation. So if you have any worries, get tested.”

Published Date
2014-07-23 09:37:35Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Type 2 diabetes






NHS Choices Syndication


Non-insulin-dependent diabetes

"My children can’t believe how good their mum looks!"

Shafina Bibi was shocked to hear she had diabetes, but now she’s changed her lifestyle and has never felt better.

“I was devastated when I found out I had diabetes,” says Shafina Bibi, 35. “I never dreamed it would happen to me.”

Shafina moved to the UK from Pakistan nearly 15 years ago. As someone of South Asian origin, she had a higher risk of getting diabetes. She was diagnosed with type 2 diabetes in 2001 and feared the worst.

“Being South Asian and overweight, I was more at risk,” Shafina says. In fact, the more overweight and unfit you are, the greater your risk of developing the condition. More than 80% of people with type 2 diabetes are overweight.

Shafina also developed temporary gestational diabetes during pregnancy, and this put her at an even greater risk of developing type 2 diabetes. “But, in spite of all these high-risk factors, I never dreamed it would happen to me,” Shafina says. “Suddenly, I was told I was at greater risk of serious complications such as heart attacks, blindness and kidney damage. I felt very frightened and alone.

“When the diabetes educator from the community diabetes team called to invite me to their ‘new to type 2’ group education session, it was a huge relief. The educator held the group at my local community centre and spoke in Urdu, my first language, which put me at ease. She explained all about type 2 diabetes, making it absolutely clear that we should keep fit and slim by exercising, cutting back on fat and eating more fruit and veg. It began to sink in that if I wanted to see my grandchildren, I’d have to lose some weight.

“When you’re a mother of five, finding time to look after yourself is hard. After my youngest was born nearly four years ago, I became very overweight and felt far too tired to exercise.

“But I left the session feeling really motivated. I reduced the oil in my cooking and cut out butter and ghee. I began eating more fruit and veg and moved from full-fat to semi-skimmed milk. Now, when I feel peckish, I eat an apple rather than half a packet of biscuits. I walk my children to school every day and make sure I’m going as fast as I can.

“In the last seven months, I’ve lost nearly four stone (25kg) and my blood sugar levels have come right down. I feel full of energy. My children can’t believe how good their mum looks.”

Published Date
2014-07-23 11:22:30Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Type 2 diabetes






NHS Choices Syndication


Non-insulin-dependent diabetes

"There's no reason why you can’t achieve your dreams"

After his victory in the rowing at the 2000 Sydney Olympics, Sir Steve Redgrave became the only British athlete to win five consecutive Olympic gold medals.

But what many people don’t realise is that Sir Steve achieved this final triumph against all the odds. Three years before the Sydney Olympics, he discovered he had diabetes.

“It was November 1997 and I had this tremendous thirst coming back from training one day,” he says. “After drinking three or four pints of fluids, I knew something wasn’t quite right.”

Sir Steve’s grandfather was also diabetic, so the athlete wasn’t totally ignorant of the condition. While training abroad, he and his team mates were given dipsticks to test their dehydration levels, and Sir Steve could also test his urine for sugar levels.

“For some reason, I decided to do my own test and it came back positive,” he says. “I called my wife, who’s a doctor, and she suggested going to see my GP. My blood sugar level was 32 (the norm is somewhere between 4 and 7), and I was sent to see a specialist. From that day on I’ve been taking insulin.”

The Olympic champion was 35 years old when he was diagnosed with type 2 or “adult-onset” diabetes, where the body doesn’t make enough insulin or the cells in the body don’t use insulin properly. He thought it was the end of his career.

“The little I knew about diabetes was that there were few sportspeople with the condition competing at the level I wanted to be at. I thought it was impossible to be diabetic and do what I did, so obviously I was a little depressed. I took it in my stride to some extent, because I’d already achieved four Olympic gold medals. But after a consultation, my specialist said he didn’t see any reason why I couldn’t achieve my dreams in Sydney. He said it wouldn’t be straightforward, and he was certainly right about that.”

Initially, Sir Steve was put on a low-sugar diet, but he soon found he didn’t have the energy to carry out the physically endurance training needed to compete at the highest level. His specialist decided that, as he’d performed well on his previous diet (of 6,000 calories a day and which included high-sugar content), he should go back on that diet and adjust his insulin dose accordingly.

“After I won in Sydney, my specialist and I did a press conference and another diabetes specialist stood up and said, ‘You’re a very lucky man,'” Sir Steve recalls. “He said if I’d come to the clinics of any of the specialists in that room, they’d have said I couldn’t do it. They were amazed.”

In theory, he could have been given tablets to control his blood sugar level, but Sir Steve says they wouldn’t have given him enough insulin in his system for the amount of training he was doing.

“I was testing my blood sugar levels, using a pin prick to draw a spot of blood 10 times a day. Normally, people with diabetes do it just once. If you’re not diabetic, your body naturally adjusts your insulin levels, so I was just trying to mimic as closely as possible what the body does naturally.”

Sir Steve now uses an insulin pump. Instead of injecting several times a day, the pump is attached all day, every day, feeding a small amount of the medication into the body all the time. The pump is about the size of a pack of playing cards and is attached to the side of the abdomen. The infusion unit only needs changing every three days.

“It’s a lot more convenient,” he says. “Particularly when you’re out and about. And you can take it off to shower or exercise. The down side is that I sometimes wake up during the night with it wrapped around me.

“There are fundamental changes you have to make when you discover you have diabetes, but there’s no reason why you can’t achieve your dreams. I made the decision that diabetes was going to live with me; I wasn’t going to live with diabetes.”

Published Date
2014-10-10 14:31:15Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Diabetic,Insulin,Type 2 diabetes






NHS Choices Syndication


Non-insulin-dependent diabetes

Causes of type 2 diabetes

Type 2 diabetes occurs when the pancreas doesn’t produce enough insulin to maintain a normal blood glucose level, or the body is unable to use the insulin that is produced  known as insulin resistance.

The pancreas (a large gland behind the stomach) produces the hormone insulin, which moves glucose from your blood into your cells, where it’s converted into energy.

In type 2 diabetes, there are several reasons why the pancreas doesn’t produce enough insulin.

Risk factors for type 2 diabetes

Four of the main risk factors for developing type 2 diabetes are:

  • age  being over the age of 40 (over 25 for South Asian people)  
  • genetics  having a close relative with the condition (parent, brother or sister)
  • weight  being overweight or obese
  • ethnicity  being of South Asian, Chinese, African-Caribbean or black African origin (even if you were born in the UK)

See the introduction page for a full list of the risk factors for type 2 diabetes.

The four risk factors listed above are discussed in more detail below.

Age

Your risk of developing type 2 diabetes increases with age. This may be because people tend to gain weight and exercise less as they get older.

Maintaining a healthy weight by eating a healthy, balanced diet and exercising regularly are ways of preventing and managing diabetes.

White people over the age of 40 have an increased risk of developing type 2 diabetes. People of South Asian, Chinese, African-Caribbean and black African descent have an increased risk of developing type 2 diabetes at a much earlier age.

However, despite increasing age being a risk factor for type 2 diabetes, over recent years younger people from all ethnic groups have been developing the condition.

It’s also becoming more common for children, in some cases as young as seven, to develop type 2 diabetes.

Genetics

Genetics is one of the main risk factors for type 2 diabetes.

Your risk of developing the condition is increased if you have a close relative – such as a parent, brother or sister – who has the condition. The closer the relative, the greater the risk.

A child who has a parent with type 2 diabetes has about a one in three chance of also developing it (see below).

Being overweight or obese

You’re more likely to develop type 2 diabetes if you’re overweight or obese (with a body mass index (BMI) of 30 or more).

In particular, fat around your tummy (abdomen) increases your risk. This is because it releases chemicals that can upset the body’s cardiovascular and metabolic systems.

This increases your risk of developing a number of serious conditions, including coronary heart disease, stroke and some types of cancer.

Measuring your waist is a quick way of assessing your diabetes risk. This is a measure of abdominal obesity, which is a particularly high-risk form of obesity.

Women have a higher risk of developing type 2 diabetes if their waist measures 80cm (31.5 inches) or more. Asian men with a waist size of  89cm (35 inches) or over have a higher risk, as do white or black men with a waist size of 94cm (37 inches) or over.

Use the BMI calculator to find out if you’re a healthy weight for your height.

Exercising regularly and reducing your body weight by about 5% could reduce your risk of getting diabetes by more than 50%.

Read more about losing weight.

Ethnicity

People of South Asian, Chinese, African-Caribbean and black African are more likely to develop type 2 diabetes.

Type 2 diabetes is up to six times more common in South Asian communities than in the general UK population, and it’s three times more common among people of African and African-Caribbean origin.

People of South Asian and African-Caribbean origin also have an increased risk of developing complications of diabetes, such as heart disease, at a younger age than the rest of the population.

Other risks

Your risk of developing type 2 diabetes is also increased if your blood glucose level is higher than normal, but not yet high enough to be diagnosed with diabetes.

This is sometimes called “pre-diabetes”  doctors sometimes call it impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT).

Pre-diabetes can progress to type 2 diabetes if you don’t take preventative steps, such as making lifestyle changes. These include eating healthily, losing weight (if you’re overweight) and taking plenty of regular exercise.

Women who have had gestational diabetes during pregnancy also have a greater risk of developing diabetes in later life.

Published Date
2014-07-23 11:35:50Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Diabetic,Gestational diabetes,Insulin,Obesity,Type 2 diabetes,Weight gain






NHS Choices Syndication


Non-insulin-dependent diabetes

Complications caused by diabetes

If diabetes isn’t treated, it can lead to a number of other health problems.

High glucose levels can damage blood vessels, nerves and organs.

Even a mildly raised glucose level that doesn’t cause any symptoms can have long-term damaging effects.

Heart disease and stroke

If you have diabetes, you’re up to five times more likely to develop heart disease or have a stroke.

Prolonged, poorly controlled blood glucose levels increase the likelihood of atherosclerosis (where the blood vessels become clogged up and narrowed by fatty substances).

This may result in poor blood supply to your heart, causing angina (a dull, heavy or tight pain in the chest). It also increases the chance that a blood vessel in your heart or brain will become blocked, leading to a heart attack or stroke.

Nerve damage

High blood glucose levels can damage the tiny blood vessels in your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness, which can lead to ulceration of the feet.

Damage to the peripheral nervous system, which includes all parts of the nervous system that lie outside the central nervous system, is known as peripheral neuropathy.

If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation.

Diabetic retinopathy

Diabetic retinopathy is when the retina (the light-sensitive layer of tissue at the back of the eye) becomes damaged. Blood vessels in the retina can become blocked or leaky or can grow haphazardly. This prevents light from fully passing through to your retina. If it isn’t treated, it can damage your vision.

Annual eye checks are usually organised by a regional photographic unit. If significant damage is detected, you may be referred to an ophthalmologist (a doctor who specialises in treating eye conditions).

The better you control your blood glucose levels, the lower your risk of developing serious eye problems.

Diabetic retinopathy can be managed using laser treatment if it’s caught early enough. However, this will only preserve the sight you have rather than improve it.

Kidney disease

If the small blood vessels of your kidney become blocked and leaky, your kidneys will work less efficiently. It’s usually associated with high blood pressure, and treating this is a key part of management.

In rare, severe cases, kidney disease can lead to kidney failure, and a kidney replacement treatment with dialysis, or sometimes kidney transplantation, will be necessary.

Foot problems

Damage to the nerves of the foot can mean small nicks and cuts aren’t noticed, and this, in combination with poor circulation, can lead to a foot ulcer.

About 1 in 10 people with diabetes get a foot ulcer, which can cause a serious infection.

If you have diabetes, look out for sores and cuts that don’t heal, puffiness or swelling, and skin that feels hot to the touch. You should also have your feet examined at least once a year.

If poor circulation or nerve damage is detected, check your feet every day and report any changes to your doctor, nurse or podiatrist (foot care specialist).

Read more about foot care and diabetes.

Sexual dysfunction

In men with diabetes, particularly those who smoke, nerve and blood vessel damage can lead to erection problems. This can usually be treated with medication.

Women with diabetes may experience:

If you experience a lack of vaginal lubrication, or you find sex painful, you can use a vaginal lubricant or a water-based gel.

Miscarriage and stillbirth

Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If your blood glucose level isn’t carefully controlled during the early stages of pregnancy, there’s also an increased risk of the baby developing a birth defect.

Pregnant women with diabetes will usually have their antenatal check-ups in hospital or a diabetic clinic, ideally with an obstetrician (a doctor who specialises in pregnancy care).

This will allow your care team to keep a close eye on your blood glucose levels and control your insulin dosage more easily, as well as monitoring the growth and development of your baby.

The Diabetes UK website has more information about diabetes complications.

Published Date
2014-08-20 10:50:20Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Angina,Black people,Diabetes,Diabetic,Diabetic retinopathy,Eye,Foot,Getting active,Healthy eating,Heart and vascular diseases,Hyperglycaemia,Hypertension,Kidney disease,Miscarriage,Nausea,Pregnancy (difficulties),Stillbirth,Stroke,Type 2 diabetes




Living with type 2 diabetes – NHS Choices






























































Living with type 2 diabetes 

Type 2 diabetes – looking after yourself 

If you have type 2 diabetes, you’ll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you’ll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There’s evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don’t need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don’t need to completely exclude sugary and high fat foods from your diet, but they should be limited. It’s possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it’s very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don’t smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

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Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

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Pregnancy  show

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

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Get educated show

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

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Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

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Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

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  • show glossary terms

Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

stevehessle said on 23 August 2014

I don’t know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I’m getting better control.

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DaiB said on 05 March 2012

I might question the ‘Eat Healthily’ advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it’s not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

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Healthy living with diabetes

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Go on a diabetes course

If you have diabetes, structured education programmes can help you manage your condition

Diabetes and pregnancy

How type 1 and type 2 diabetes can affect you and your baby. Plus gestational (pregnancy) diabetes

Diabetes and feet

Foot health is especially important for people with diabetes. Find out how to take care of your feet and when to get help

Go on a self-help course

Find out about free courses for people with long-term conditions to boost your confidence, pain relief and coping skills

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important








Living with type 2 diabetes – NHS Choices






























































Living with type 2 diabetes 

Type 2 diabetes – looking after yourself 

If you have type 2 diabetes, you’ll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you’ll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There’s evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don’t need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don’t need to completely exclude sugary and high fat foods from your diet, but they should be limited. It’s possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it’s very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don’t smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

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Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

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Pregnancy  show

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

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Get educated show

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

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Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

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Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

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Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

stevehessle said on 23 August 2014

I don’t know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I’m getting better control.

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DaiB said on 05 March 2012

I might question the ‘Eat Healthily’ advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it’s not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

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Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Travelling with diabetes

Guide including diet, travelling with medicines, vaccines, insurance and air travel advice

Go on a diabetes course

If you have diabetes, structured education programmes can help you manage your condition

Diabetes and pregnancy

How type 1 and type 2 diabetes can affect you and your baby. Plus gestational (pregnancy) diabetes

Diabetes and feet

Foot health is especially important for people with diabetes. Find out how to take care of your feet and when to get help

Go on a self-help course

Find out about free courses for people with long-term conditions to boost your confidence, pain relief and coping skills

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important








Type 2 diabetes – Treatment – NHS Choices


































































Type 2 diabetes – Treatment 

Treating type 2 diabetes 

There’s no cure for diabetes, so treatment aims to keep your blood glucose levels as normal as possible and to control your symptoms, to prevent health problems developing later in life.

If you’ve been diagnosed with diabetes, your GP will be able to explain your condition in detail and help you to understand your treatment.

They will also closely monitor your condition to identify any health problems that may occur. If there are any problems, you may be referred to a hospital-based diabetes care team.

Making lifestyle changes

If you’re diagnosed with type 2 diabetes, you’ll need to look after your health very carefully for the rest of your life.

This may seem daunting, but your diabetes care team will be able to give you support and advice about all aspects of your treatment.

After being diagnosed with type 2 diabetes, or if you’re at risk of developing the condition, the first step is to look at your diet and lifestyle, and make any necessary changes.

Three major areas that you’ll need to look closely at are your:

  • diet
  • weight
  • level of physical activity

By eating healthily, losing weight (if you’re overweight) and exercising regularly you may be able to keep your blood glucose at a safe and healthy level without the need for other types of treatment.

Diet

Increasing the amount of fibre in your diet and reducing your fat intake, particularly saturated fat, can help prevent type 2 diabetes, as well as manage the condition if you already have it. You should:

  • increase your consumption of high fibre foods, such as wholegrain bread and cereals, beans and lentils, and fruit and vegetables
  • choose foods that are low in fat  replace butter, ghee and coconut oil with low fat spreads and vegetable oil
  • choose skimmed and semi-skimmed milk, and low fat yoghurts
  • eat fish and lean meat rather than fatty or processed meat, such as sausages and burgers
  • grill, bake, poach or steam food instead of frying or roasting it
  • avoid high fat foods, such as mayonnaise, chips, crisps, pasties, poppadums and samosas
  • eat fruit, unsalted nuts and low fat yoghurts as snacks instead of cakes, biscuits, bombay mix or crisps

The Diabetes UK website has more information and advice about healthy eating.

Weight

If you’re overweight or obese (you have a body mass index (BMI) of 30 or over), you should lose weight, by gradually by reducing your calorie intake and becoming more physically active (see below).

Losing 5-10% of your overall body weight over the course of a year is a realistic initial target. You should aim to continue to lose weight until you’ve achieved and maintained a BMI within the healthy range, which is:

  • 18.5-24.9kg/m² for the general population
  • 18.5-22.9kg/m² for people of South Asian or Chinese origin

If you have a BMI of 30kg/m2 or more (27.5kg/m2 or more for people of South Asian or Chinese origin), you need a structured weight loss programme, which should form part of an intensive lifestyle change programme.

To help you achieve changes in your behaviour, you may be referred to a dietitician or a similar healthcare professional for a personal assessment and tailored advice about diet and physical activity.

Physical activity

Being physically active is very important in preventing or managing type 2 diabetes.

For adults who are 19-64 years of age, the government recommends a minimum of:

  • 150 minutes (2 hours and 30 minutes) of “moderate-intensity” aerobic activity, such as cycling or fast walking, a week, which can be taken in sessions of 10 minutes or more, and
  • muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hips, back, tummy (abdomen), chest, shoulders and arms).

An alternative recommendation is to do a minimum of:

  • 75 minutes of “vigorous-intensity” aerobic activity, such as running or a game of tennis every week, and
  • muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms).

Read more about the physical activity guidelines for adults.

In cases where the above activity levels are unrealistic, even small increases in physical activity will be beneficial to your health and act as a basis for future improvements.

Reduce the amount of time spent watching television or sitting in front of a computer. Going for a daily walk  for example, during your lunch break – is a good way of introducing regular physical activity into your schedule.

If you’re overweight or obese (see above), you may need to be more physically active to help you lose weight and maintain weight loss.

Your GP, diabetes care team or dietician can give you more information and advice about losing weight and becoming more physically active.

The Diabetes UK website has more information and advice about getting active and staying active.

Medicines for type 2 diabetes hide

Type 2 diabetes usually gets worse over time. Making lifestyle changes, such as adjusting your diet and taking more exercise, may help you control your blood glucose levels at first, but they not be enough in the long term.

You may eventually need to take medication to help control your blood glucose levels. Initially, this will usually be in the form of tablets, and can sometimes be a combination of more than one type of tablet. It may also include insulin or other medication that you inject.

Metformin

Metformin is usually the first medicine that’s used to treat type 2 diabetes. It works by reducing the amount of glucose that your liver releases into your bloodstream. It also makes your body’s cells more responsive to insulin.

Metformin is recommended for adults with a high risk of developing type 2 diabetes, whose blood glucose is still progressing towards type 2 diabetes, despite making necessary lifestyle changes.

If you’re overweight, it’s also likely you’ll be prescribed metformin. Unlike some other medicines used to treat type 2 diabetes, metformin shouldn’t cause additional weight gain.

However, it can sometimes cause mild side effects, such as nausea and diarrhoea, and you may not be able to take it if you have kidney damage.

Sulphonylureas

Sulphonylureas increase the amount of insulin that’s produced by your pancreas. Examples of sulphonylureas include:

You may be prescribed one of these medicines if you can’t take metformin, or if you aren’t overweight. Alternatively, you may be prescribed sulphonylurea and metformin if metformin doesn’t control blood glucose on its own.

Sulphonylureas can increase the risk of hypoglycaemia (low blood sugar), because they increase the amount of insulin in your body. They can also sometimes cause side effects including weight gain, nausea and diarrhoea.

Glitazones (thiazolidinediones, TZDs)

Thiazolidinedione medicines (pioglitazone) make your body’s cells more sensitive to insulin so that more glucose is taken from your blood.

They’re usually used in combination with metformin or sulphonylureas, or both. They may cause weight gain and ankle swelling (oedema). You shouldn’t take pioglitazone if you have heart failure or a high risk of bone fracture.

Another thiazolidinedione, rosiglitazone, was withdrawn from use in 2010 due to an increased risk of cardiovascular disorders, including heart attack and heart failure.

Read more about the withdrawal of rosiglitazone.

Gliptins (DPP-4 inhibitors)

Gliptins work by preventing the breakdown of a naturally occurring hormone called GLP-1. GLP-1 helps the body produce insulin in response to high blood glucose levels, but is rapidly broken down.

By preventing this breakdown, the gliptins (linagliptin, saxagliptin, sitagliptin and vildagliptin) prevent high blood glucose levels, but don’t result in episodes of hypoglycaemia.

You may be prescribed a gliptin if you’re unable to take sulphonylureas or glitazones, or in combination with them. They’re not associated with weight gain.

GLP-1 agonists

Exenatide is a GLP-1 agonist, an injectable treatment that acts in a similar way to the natural hormone GLP-1 (see the section on gliptins, above).

It’s injected twice a day and boosts insulin production when there are high blood glucose levels, reducing blood glucose without the risk of hypoglycaemia episodes ("hypos").

It also leads to modest weight loss in many people who take it. It’s mainly used in people on metformin plus sulphonylurea, who are obese. A once-weekly product has also been introduced.

Another GLP-1 agonist called liraglutide is a once-daily injection (exenatide is given twice a day). Like exenatide, liraglutide is mainly used for people on metformin plus sulphonylurea, who are obese, and in clinical trials it’s been shown to cause modest weight loss.

Acarbose

Acarbose helps prevent your blood glucose level from increasing too much after you eat a meal. It slows down the rate at which your digestive system breaks carbohydrates down into glucose.

Acarbose isn’t often used to treat type 2 diabetes because it usually causes side effects, such as bloating and diarrhoea. However, it may be prescribed if you can’t take other types of medicine for type 2 diabetes.

Nateglinide and repaglinide

Nateglinide and repaglinide stimulate the release of insulin by your pancreas. They’re not commonly used, but may be an option if you have meals at irregular times. This is because their effects don’t last very long, but they’re effective when taken just before you eat.

Nateglinide and repaglinide can cause side effects, such as weight gain and hypoglycaemia (low blood sugar).

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Insulin treatment show

If glucose-lowering tablets aren’t effective in controlling your blood glucose levels, you may need to have insulin treatment. This can be taken instead of or alongside your tablets, depending on the dose and the way that you take it.

Insulin comes in several different preparations, and each works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don’t last very long (rapid-acting).

Your treatment may include a combination of these different insulin preparations.

Insulin injections

Insulin must be injected because if it were taken as a tablet, it would be broken down in your stomach like food and unable to enter your bloodstream.

If you need to inject insulin, your diabetes care team will advise you about when you need to do it. They will show you how to inject it yourself and will also give you advice about storing your insulin and disposing of your needles properly.

Insulin injections are given using either a syringe or an injection pen, which is also called an insulin pen (auto-injector). Most people need between two and four injections of insulin a day.

Your GP or diabetes nurse will also teach a relative or a close friend how to inject the insulin properly.

You can read more about insulin and how to inject it on the Diabetes UK website.

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Treatment for low blood sugar (hypoglycaemia) show

If you have type 2 diabetes that’s controlled using insulin or certain types of tablets, you may experience episodes of hypoglycaemia.

Hypoglycaemia is where your blood glucose levels become very low. Mild hypoglycaemia (a "hypo") can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.

If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets. This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit. In most cases, these measures will be enough to raise your blood glucose level to normal, although it may take a few hours.

If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness. If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.

Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.

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Other treatments show

If you have type 2 diabetes, your risk of developing heart disease, stroke and kidney disease is increased.

To reduce your risk of developing other serious health conditions, you may be advised to take other medicines, including:

  • anti-hypertensive medicines to control high blood pressure
  • a statin, such as simvastatin or atorvastatin, to reduce high cholesterol
  • low-dose aspirin to prevent a stroke
  • an angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril, if you have the early signs of diabetic kidney disease

Diabetic kidney disease is identified by the presence of small amounts of albumin (a protein) in your urine. If treated early enough, it may be reversible.

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Monitoring blood glucose levels show

If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months. This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.

The HbA1c test is used to measure blood glucose levels over the previous two to three months. HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.

A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.

Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 59mmol/mol (7.5%). However, it can be as low as 48mmol/mol (6.5%) for some people.

Read more about the HbA1c test.

Monitoring your own blood glucose

If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.

Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels. Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.

A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful in detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia).

If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.

Blood glucose meters aren’t currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you’re unsure.

Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb).

Regularly monitoring your blood glucose levels will ensure that your blood glucose is as normal and stable as possible. As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment you’re taking.

In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood. A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short.

A normal blood glucose level is 4-6 mmol/l before meals (preprandial) and less than 10 mmol/l two hours after meals (postprandial), although this can vary from person to person. Your diabetes care team can discuss your blood glucose level with you in more detail.

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Care standards for diabetes show

The aim of treating diabetes is to help people with the condition control their blood glucose levels and minimise the risk of developing future complications.

The Department of Health has set out national standards for NHS organisations and professionals covering diabetes care and prevention. The diabetes national service framework was developed by diabetes clinical experts and diabetes patients. Good diabetes care includes:

  • awareness of the risk factors for type 2 diabetes
  • advice and support to help people at risk of type 2 diabetes reduce that risk
  • access to information and appropriate support for people with type 1 diabetes and type 2 diabetes, including access to a structured education programme, such as the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) or X-PERT Health
  • an agreed care plan to help all people with diabetes to manage their care and lead a healthy lifestyle, including a named contact for their care
  • information, care and support to enable all people with diabetes to optimise their blood glucose level, maintain an acceptable blood pressure and minimise other risk factors for developing complications
  • access to services to identify and treat possible complications, such as screening for diabetic retinopathy and specialised foot care
  • effective care for all people with diabetes admitted to hospital, for whatever reason

You can read more about diabetes care on the Diabetes UK website.

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Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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JavierStroud said on 01 September 2014

I think some of the advice here is outdated and will change soon.

Firstly: all human beings have varying degrees of insulin resistance, blood glucose levels and insulin levels. We can all increase our insulin sensitivity, reduce our insulin production and reduce our blood glucose level. So to start with, you can be cured of type 2 diabetes if you make the right life style changes – not all of which are correct on this site.

Regarding diet: consume less of the foods mentioned above (wholegrain bread, cereals, beans and lentils). Have lots of vegetables. Fruits in moderation (and the least sugar laden as possible). The aim is to reduce carbohydrates to as low as possible. We do not need them in our diet, we can make the necessary amount in our liver.

So where do we get the necessary fuel from? We get it from fat. So substitute the carbs for good fats; coconut oil, butter, olive oil and fish oil. Not vegetable oil as advised above in this article

Losing weight (fat) is a brilliant idea because to do so you need to metabolise fat and avoid carbs. If you are losing fat (not water and muscle like with most diets do) then you are doing the changes mentioned above
1/ Reducing your average insulin level
2/ Increasing your insulin sensitivity
3/ Decreasing your blood glucose level

Also: calories have little to do with this. If you don’t make the right diet & lifestyle changes and you calorie restrict, you will drop your metabolism and lose muscle mass. This results in bouncing back into being overweight again.

The activity recommendation above is fine. But increase low level activity. Don’t bother counting calories, exercise affects insulin sensitivity and the ability of the muscles to mop up access glucose in the blood.

The drugs are necessary for treating the excess sugar in your blood. But the problem with type 2 diabetes is a bad diet, and that is due to bad governmental advice like here. So cut out the carbs, food’s a drug

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Clownfish said on 10 April 2014

Can anyone help.I was diagnosed with Diabetes last year and despite taking the medication regularly I still have all the symptoms,some of which are quite severe. Is their anything that can be done to help these symptoms. Why bother taking the medication if it does not improve things.

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mjsanders08 said on 10 April 2013

@ B Oneil,

I had a look at that study and it is far from conclusive so I agree with the comment that Type 2 diabetes cannot be reversed.

That study looked at 11 people with type 2 diabetes! That isn’t a lot of people and they had only had Diabetes for 4 years. Therefore, it may not be possible to reverse in patients who’ve had the condition longer than 4 yrs. Also, they only studied the individuals up to 12 weeks after the dietary restriction (which they claim reverses Diabetes). This is only 3 months! May be they go back to a Diabetic state after 4 months! Also, its not clear whether you will have to have dietary restriction for the rest of your life to maintain a non-diabetic state. The question remains – can you dietary restrict for a short time, as in this study, and then go back to a normal diet and STILL be non-diabetic.

The jury is definately out on this one and until there have been clinical trials to the affect, then the claim that Diabetes cannot be reverse still stands.

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ChrisKennish said on 16 May 2012

The link at the bottom of the "Monitoring Blood Glucose Levels" section to "Find out how to test your glucose levels" is broken.

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Brian Oneil said on 26 July 2011

You claim diabetes connot be cured yet in
Professor Roy Taylor of the Magnetic resonance centre in Newcastle has doe test which were successful
In reversing diabeties
Mr B Oneil

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saeybia said on 20 July 2010

You state that type 2 diabetics can be treated using an insulin pump!!! However the NICE guidelines say they cannot!!

Who is correct? I personally would love a pump rather than injecting 4 times a day! but because of the NICE guide I cannot

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Map of Medicine

See more about diabetes by going to the Map of Medicine

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Non-insulin-dependent diabetes

Introduction

Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.

In England in 2010, there were approximately 3.1 million people aged 16 or over with diabetes (both diagnosed and undiagnosed).

By 2030, this figure is expected to rise to 4.6 million, with 90% of those affected having type 2 diabetes (see below).

The charity Diabetes UK estimates that around 850,000 people in England have diabetes, but haven’t been diagnosed.

Many more people have blood glucose (sugar) levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as “pre-diabetes”, and if you have it you have a greater risk of developing full-blown diabetes.

It’s very important for diabetes to be diagnosed as early as possible, because it will get progressively worse if left untreated.

You should therefore visit your GP as soon as possible if you have symptoms, which include feeling thirsty, passing urine more often than usual and feeling tired all the time (see the list below for more diabetes symptoms).

Type 1 and type 2 diabetes

There are two main types of diabetes  type 1 and type 2.

Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin. This is known as insulin resistance.

Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body doesn’t produce any insulin at all. In the UK, about 90% of all adults with diabetes have type 2. 

Type 1 diabetes usually develops before the age of 40 – often in the teenage years, while type 2 diabetes tends to be diagnosed in older people.

The danger of type 2 diabetes

The rapid rise in the number of adults developing type 2 diabetes is due to:

  • increasing levels of obesity
  • a lack of exercise
  • increase in unhealthy diets
  • an ageing population

Even if you feel healthy, you may have a higher than normal blood glucose level (pre-diabetes) and be at risk of getting the condition.

It’s therefore important to take preventative measures by making any necessary lifestyle changes, such as eating more healthily, losing weight (if you’re overweight) and becoming more physically active.

Read more about the lifestyle changes you can make to help treat and prevent type 2 diabetes.

Diabetes can cause serious long-term health problems. It’s the most common cause of visual impairment and blindness in people of working age. It’s also responsible for most cases of kidney failure and lower limb amputation (other than accidents).

People with diabetes are up to five times more likely to have cardiovascular disease and stroke than those without diabetes.

Read more about the complications of type 2 diabetes.

Diabetes symptoms

Diabetes can cause a variety of symptoms. The main symptoms of undiagnosed diabetes include:

  • urinating frequently, particularly at night
  • feeling very thirsty
  • feeling very tired
  • unexplained weight loss and loss of muscle bulk
  • itching of the genitals or frequent episodes of thrush
  • cuts and wounds that heal slowly
  • blurred vision

The symptoms of type 2 diabetes may not be so obvious, because the condition usually develops slowly over a number of years. It may only be picked up during a routine medical check-up.

You should visit your GP as soon as possible if you notice any of the above symptoms.

You can also use the diabetes self-assessment tool on this page to find out your risk of developing type 2 diabetes.

Causes of type 2 diabetes

Insulin is a hormone produced by the pancreas – a large gland located behind the stomach.

Insulin controls the amount of glucose in your blood. It moves glucose from the blood into your cells, where it’s converted into energy.

In type 2 diabetes, not enough insulin is produced to maintain a normal blood glucose level (insulin deficiency), or your body is unable to use the insulin that’s produced effectively. This is known as insulin resistance.

Read more about the causes of type 2 diabetes.

At risk groups

Although all adults are at risk of developing type 2 diabetes, a number of groups have a particularly high risk of developing the condition.

Your risk of developing type 2 diabetes is increased if:

  • you’re over 40 years of age (over 25 if you’re South Asian)
  • you have a close family member with diabetes (a parent, brother or sister)
  • you’re overweight or obese, with a waist size of over 80cm (31.5 inches) for women and 94cm (37 inches) for men, or 89cm (35 inches) for South Asian men 
  • you’re of South Asian, Chinese, African-Caribbean or black African origin (even if you were born in the UK) 
  • you’ve ever had a cardiovascular disease, such as a heart attack or stroke
  • you’re a woman with polycystic ovary syndrome (PCOS) and also overweight
  • you’re a woman and you’ve had gestational diabetes or given birth to a baby of over 10 pounds 
  • you have a severe mental health condition, such as depression, schizophrenia or bipolar disorder, and you’re taking medication for it
  • you’ve been told you have impaired glucose tolerance or impaired fasting glycaemia

Treating type 2 diabetes

There is no cure for diabetes. However, treatment aims to keep your blood glucose levels as normal as possible, which will control your symptoms and minimise the risk of health problems developing later on.

If you’re diagnosed with diabetes, you may be referred to a diabetes care team for specialist treatment, or your GP surgery may provide first-line diabetes care.

In some cases, it may be possible to control your diabetes symptoms by making changes to your lifestyle, such as eating a healthy diet and taking regular exercise (see below).

However, as type 2 diabetes is a progressive condition, you may eventually need to take medication to keep your blood glucose at normal levels. You may need to take tablets initially, but move on to injected therapies, such as insulin, at a later stage.

Read more about treating type 2 diabetes.

Living with diabetes

If you have type 2 diabetes, you will be advised to look after your health very carefully.

Caring for your health will also make treating your diabetes easier and minimise your risk of developing complications. You should:

Read more about living with type 2 diabetes.

Published Date
2014-08-20 10:46:41Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Diabetic,Gestational diabetes,Healthy eating,Hyperglycaemia,Insulin,Type 2 diabetes




Living with type 2 diabetes – NHS Choices






























































Living with type 2 diabetes 

Type 2 diabetes – looking after yourself 

If you have type 2 diabetes, you’ll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you’ll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There’s evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don’t need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don’t need to completely exclude sugary and high fat foods from your diet, but they should be limited. It’s possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it’s very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don’t smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

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Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

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Pregnancy  show

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

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Get educated show

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

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Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

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Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

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  • show glossary terms

Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

stevehessle said on 23 August 2014

I don’t know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I’m getting better control.

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DaiB said on 05 March 2012

I might question the ‘Eat Healthily’ advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it’s not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

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Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Travelling with diabetes

Guide including diet, travelling with medicines, vaccines, insurance and air travel advice

Go on a diabetes course

If you have diabetes, structured education programmes can help you manage your condition

Diabetes and pregnancy

How type 1 and type 2 diabetes can affect you and your baby. Plus gestational (pregnancy) diabetes

Diabetes and feet

Foot health is especially important for people with diabetes. Find out how to take care of your feet and when to get help

Go on a self-help course

Find out about free courses for people with long-term conditions to boost your confidence, pain relief and coping skills

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important








Type 2 diabetes – Treatment – NHS Choices


































































Type 2 diabetes – Treatment 

Treating type 2 diabetes 

There’s no cure for diabetes, so treatment aims to keep your blood glucose levels as normal as possible and to control your symptoms, to prevent health problems developing later in life.

If you’ve been diagnosed with diabetes, your GP will be able to explain your condition in detail and help you to understand your treatment.

They will also closely monitor your condition to identify any health problems that may occur. If there are any problems, you may be referred to a hospital-based diabetes care team.

Making lifestyle changes

If you’re diagnosed with type 2 diabetes, you’ll need to look after your health very carefully for the rest of your life.

This may seem daunting, but your diabetes care team will be able to give you support and advice about all aspects of your treatment.

After being diagnosed with type 2 diabetes, or if you’re at risk of developing the condition, the first step is to look at your diet and lifestyle, and make any necessary changes.

Three major areas that you’ll need to look closely at are your:

  • diet
  • weight
  • level of physical activity

By eating healthily, losing weight (if you’re overweight) and exercising regularly you may be able to keep your blood glucose at a safe and healthy level without the need for other types of treatment.

Diet

Increasing the amount of fibre in your diet and reducing your fat intake, particularly saturated fat, can help prevent type 2 diabetes, as well as manage the condition if you already have it. You should:

  • increase your consumption of high fibre foods, such as wholegrain bread and cereals, beans and lentils, and fruit and vegetables
  • choose foods that are low in fat  replace butter, ghee and coconut oil with low fat spreads and vegetable oil
  • choose skimmed and semi-skimmed milk, and low fat yoghurts
  • eat fish and lean meat rather than fatty or processed meat, such as sausages and burgers
  • grill, bake, poach or steam food instead of frying or roasting it
  • avoid high fat foods, such as mayonnaise, chips, crisps, pasties, poppadums and samosas
  • eat fruit, unsalted nuts and low fat yoghurts as snacks instead of cakes, biscuits, bombay mix or crisps

The Diabetes UK website has more information and advice about healthy eating.

Weight

If you’re overweight or obese (you have a body mass index (BMI) of 30 or over), you should lose weight, by gradually by reducing your calorie intake and becoming more physically active (see below).

Losing 5-10% of your overall body weight over the course of a year is a realistic initial target. You should aim to continue to lose weight until you’ve achieved and maintained a BMI within the healthy range, which is:

  • 18.5-24.9kg/m² for the general population
  • 18.5-22.9kg/m² for people of South Asian or Chinese origin

If you have a BMI of 30kg/m2 or more (27.5kg/m2 or more for people of South Asian or Chinese origin), you need a structured weight loss programme, which should form part of an intensive lifestyle change programme.

To help you achieve changes in your behaviour, you may be referred to a dietitician or a similar healthcare professional for a personal assessment and tailored advice about diet and physical activity.

Physical activity

Being physically active is very important in preventing or managing type 2 diabetes.

For adults who are 19-64 years of age, the government recommends a minimum of:

  • 150 minutes (2 hours and 30 minutes) of “moderate-intensity” aerobic activity, such as cycling or fast walking, a week, which can be taken in sessions of 10 minutes or more, and
  • muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hips, back, tummy (abdomen), chest, shoulders and arms).

An alternative recommendation is to do a minimum of:

  • 75 minutes of “vigorous-intensity” aerobic activity, such as running or a game of tennis every week, and
  • muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms).

Read more about the physical activity guidelines for adults.

In cases where the above activity levels are unrealistic, even small increases in physical activity will be beneficial to your health and act as a basis for future improvements.

Reduce the amount of time spent watching television or sitting in front of a computer. Going for a daily walk  for example, during your lunch break – is a good way of introducing regular physical activity into your schedule.

If you’re overweight or obese (see above), you may need to be more physically active to help you lose weight and maintain weight loss.

Your GP, diabetes care team or dietician can give you more information and advice about losing weight and becoming more physically active.

The Diabetes UK website has more information and advice about getting active and staying active.

Medicines for type 2 diabetes hide

Type 2 diabetes usually gets worse over time. Making lifestyle changes, such as adjusting your diet and taking more exercise, may help you control your blood glucose levels at first, but they not be enough in the long term.

You may eventually need to take medication to help control your blood glucose levels. Initially, this will usually be in the form of tablets, and can sometimes be a combination of more than one type of tablet. It may also include insulin or other medication that you inject.

Metformin

Metformin is usually the first medicine that’s used to treat type 2 diabetes. It works by reducing the amount of glucose that your liver releases into your bloodstream. It also makes your body’s cells more responsive to insulin.

Metformin is recommended for adults with a high risk of developing type 2 diabetes, whose blood glucose is still progressing towards type 2 diabetes, despite making necessary lifestyle changes.

If you’re overweight, it’s also likely you’ll be prescribed metformin. Unlike some other medicines used to treat type 2 diabetes, metformin shouldn’t cause additional weight gain.

However, it can sometimes cause mild side effects, such as nausea and diarrhoea, and you may not be able to take it if you have kidney damage.

Sulphonylureas

Sulphonylureas increase the amount of insulin that’s produced by your pancreas. Examples of sulphonylureas include:

You may be prescribed one of these medicines if you can’t take metformin, or if you aren’t overweight. Alternatively, you may be prescribed sulphonylurea and metformin if metformin doesn’t control blood glucose on its own.

Sulphonylureas can increase the risk of hypoglycaemia (low blood sugar), because they increase the amount of insulin in your body. They can also sometimes cause side effects including weight gain, nausea and diarrhoea.

Glitazones (thiazolidinediones, TZDs)

Thiazolidinedione medicines (pioglitazone) make your body’s cells more sensitive to insulin so that more glucose is taken from your blood.

They’re usually used in combination with metformin or sulphonylureas, or both. They may cause weight gain and ankle swelling (oedema). You shouldn’t take pioglitazone if you have heart failure or a high risk of bone fracture.

Another thiazolidinedione, rosiglitazone, was withdrawn from use in 2010 due to an increased risk of cardiovascular disorders, including heart attack and heart failure.

Read more about the withdrawal of rosiglitazone.

Gliptins (DPP-4 inhibitors)

Gliptins work by preventing the breakdown of a naturally occurring hormone called GLP-1. GLP-1 helps the body produce insulin in response to high blood glucose levels, but is rapidly broken down.

By preventing this breakdown, the gliptins (linagliptin, saxagliptin, sitagliptin and vildagliptin) prevent high blood glucose levels, but don’t result in episodes of hypoglycaemia.

You may be prescribed a gliptin if you’re unable to take sulphonylureas or glitazones, or in combination with them. They’re not associated with weight gain.

GLP-1 agonists

Exenatide is a GLP-1 agonist, an injectable treatment that acts in a similar way to the natural hormone GLP-1 (see the section on gliptins, above).

It’s injected twice a day and boosts insulin production when there are high blood glucose levels, reducing blood glucose without the risk of hypoglycaemia episodes ("hypos").

It also leads to modest weight loss in many people who take it. It’s mainly used in people on metformin plus sulphonylurea, who are obese. A once-weekly product has also been introduced.

Another GLP-1 agonist called liraglutide is a once-daily injection (exenatide is given twice a day). Like exenatide, liraglutide is mainly used for people on metformin plus sulphonylurea, who are obese, and in clinical trials it’s been shown to cause modest weight loss.

Acarbose

Acarbose helps prevent your blood glucose level from increasing too much after you eat a meal. It slows down the rate at which your digestive system breaks carbohydrates down into glucose.

Acarbose isn’t often used to treat type 2 diabetes because it usually causes side effects, such as bloating and diarrhoea. However, it may be prescribed if you can’t take other types of medicine for type 2 diabetes.

Nateglinide and repaglinide

Nateglinide and repaglinide stimulate the release of insulin by your pancreas. They’re not commonly used, but may be an option if you have meals at irregular times. This is because their effects don’t last very long, but they’re effective when taken just before you eat.

Nateglinide and repaglinide can cause side effects, such as weight gain and hypoglycaemia (low blood sugar).

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Insulin treatment show

If glucose-lowering tablets aren’t effective in controlling your blood glucose levels, you may need to have insulin treatment. This can be taken instead of or alongside your tablets, depending on the dose and the way that you take it.

Insulin comes in several different preparations, and each works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don’t last very long (rapid-acting).

Your treatment may include a combination of these different insulin preparations.

Insulin injections

Insulin must be injected because if it were taken as a tablet, it would be broken down in your stomach like food and unable to enter your bloodstream.

If you need to inject insulin, your diabetes care team will advise you about when you need to do it. They will show you how to inject it yourself and will also give you advice about storing your insulin and disposing of your needles properly.

Insulin injections are given using either a syringe or an injection pen, which is also called an insulin pen (auto-injector). Most people need between two and four injections of insulin a day.

Your GP or diabetes nurse will also teach a relative or a close friend how to inject the insulin properly.

You can read more about insulin and how to inject it on the Diabetes UK website.

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Treatment for low blood sugar (hypoglycaemia) show

If you have type 2 diabetes that’s controlled using insulin or certain types of tablets, you may experience episodes of hypoglycaemia.

Hypoglycaemia is where your blood glucose levels become very low. Mild hypoglycaemia (a "hypo") can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.

If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets. This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit. In most cases, these measures will be enough to raise your blood glucose level to normal, although it may take a few hours.

If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness. If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.

Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.

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Other treatments show

If you have type 2 diabetes, your risk of developing heart disease, stroke and kidney disease is increased.

To reduce your risk of developing other serious health conditions, you may be advised to take other medicines, including:

  • anti-hypertensive medicines to control high blood pressure
  • a statin, such as simvastatin or atorvastatin, to reduce high cholesterol
  • low-dose aspirin to prevent a stroke
  • an angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril, if you have the early signs of diabetic kidney disease

Diabetic kidney disease is identified by the presence of small amounts of albumin (a protein) in your urine. If treated early enough, it may be reversible.

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Monitoring blood glucose levels show

If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months. This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.

The HbA1c test is used to measure blood glucose levels over the previous two to three months. HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.

A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.

Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 59mmol/mol (7.5%). However, it can be as low as 48mmol/mol (6.5%) for some people.

Read more about the HbA1c test.

Monitoring your own blood glucose

If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.

Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels. Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.

A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful in detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia).

If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.

Blood glucose meters aren’t currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you’re unsure.

Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb).

Regularly monitoring your blood glucose levels will ensure that your blood glucose is as normal and stable as possible. As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment you’re taking.

In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood. A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short.

A normal blood glucose level is 4-6 mmol/l before meals (preprandial) and less than 10 mmol/l two hours after meals (postprandial), although this can vary from person to person. Your diabetes care team can discuss your blood glucose level with you in more detail.

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Care standards for diabetes show

The aim of treating diabetes is to help people with the condition control their blood glucose levels and minimise the risk of developing future complications.

The Department of Health has set out national standards for NHS organisations and professionals covering diabetes care and prevention. The diabetes national service framework was developed by diabetes clinical experts and diabetes patients. Good diabetes care includes:

  • awareness of the risk factors for type 2 diabetes
  • advice and support to help people at risk of type 2 diabetes reduce that risk
  • access to information and appropriate support for people with type 1 diabetes and type 2 diabetes, including access to a structured education programme, such as the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) or X-PERT Health
  • an agreed care plan to help all people with diabetes to manage their care and lead a healthy lifestyle, including a named contact for their care
  • information, care and support to enable all people with diabetes to optimise their blood glucose level, maintain an acceptable blood pressure and minimise other risk factors for developing complications
  • access to services to identify and treat possible complications, such as screening for diabetic retinopathy and specialised foot care
  • effective care for all people with diabetes admitted to hospital, for whatever reason

You can read more about diabetes care on the Diabetes UK website.

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Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

JavierStroud said on 01 September 2014

I think some of the advice here is outdated and will change soon.

Firstly: all human beings have varying degrees of insulin resistance, blood glucose levels and insulin levels. We can all increase our insulin sensitivity, reduce our insulin production and reduce our blood glucose level. So to start with, you can be cured of type 2 diabetes if you make the right life style changes – not all of which are correct on this site.

Regarding diet: consume less of the foods mentioned above (wholegrain bread, cereals, beans and lentils). Have lots of vegetables. Fruits in moderation (and the least sugar laden as possible). The aim is to reduce carbohydrates to as low as possible. We do not need them in our diet, we can make the necessary amount in our liver.

So where do we get the necessary fuel from? We get it from fat. So substitute the carbs for good fats; coconut oil, butter, olive oil and fish oil. Not vegetable oil as advised above in this article

Losing weight (fat) is a brilliant idea because to do so you need to metabolise fat and avoid carbs. If you are losing fat (not water and muscle like with most diets do) then you are doing the changes mentioned above
1/ Reducing your average insulin level
2/ Increasing your insulin sensitivity
3/ Decreasing your blood glucose level

Also: calories have little to do with this. If you don’t make the right diet & lifestyle changes and you calorie restrict, you will drop your metabolism and lose muscle mass. This results in bouncing back into being overweight again.

The activity recommendation above is fine. But increase low level activity. Don’t bother counting calories, exercise affects insulin sensitivity and the ability of the muscles to mop up access glucose in the blood.

The drugs are necessary for treating the excess sugar in your blood. But the problem with type 2 diabetes is a bad diet, and that is due to bad governmental advice like here. So cut out the carbs, food’s a drug

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Clownfish said on 10 April 2014

Can anyone help.I was diagnosed with Diabetes last year and despite taking the medication regularly I still have all the symptoms,some of which are quite severe. Is their anything that can be done to help these symptoms. Why bother taking the medication if it does not improve things.

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mjsanders08 said on 10 April 2013

@ B Oneil,

I had a look at that study and it is far from conclusive so I agree with the comment that Type 2 diabetes cannot be reversed.

That study looked at 11 people with type 2 diabetes! That isn’t a lot of people and they had only had Diabetes for 4 years. Therefore, it may not be possible to reverse in patients who’ve had the condition longer than 4 yrs. Also, they only studied the individuals up to 12 weeks after the dietary restriction (which they claim reverses Diabetes). This is only 3 months! May be they go back to a Diabetic state after 4 months! Also, its not clear whether you will have to have dietary restriction for the rest of your life to maintain a non-diabetic state. The question remains – can you dietary restrict for a short time, as in this study, and then go back to a normal diet and STILL be non-diabetic.

The jury is definately out on this one and until there have been clinical trials to the affect, then the claim that Diabetes cannot be reverse still stands.

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ChrisKennish said on 16 May 2012

The link at the bottom of the "Monitoring Blood Glucose Levels" section to "Find out how to test your glucose levels" is broken.

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Brian Oneil said on 26 July 2011

You claim diabetes connot be cured yet in
Professor Roy Taylor of the Magnetic resonance centre in Newcastle has doe test which were successful
In reversing diabeties
Mr B Oneil

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saeybia said on 20 July 2010

You state that type 2 diabetics can be treated using an insulin pump!!! However the NICE guidelines say they cannot!!

Who is correct? I personally would love a pump rather than injecting 4 times a day! but because of the NICE guide I cannot

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Pharmacy services: New Medicine Service (NMS)


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If you are prescribed a medicine to treat a long-term condition for the first time, you may be able to get extra help and advice about your medicine from your local pharmacist through a new free scheme called the New Medicine Service (NMS).

Media last reviewed: 16/09/2013

Next review due: 16/09/2015

Map of Medicine

See more about diabetes by going to the Map of Medicine

Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Online clinic on diabetes

Get answers to your questions on diabetes and related conditions from specialist doctors

Find out how your local NHS manages diabetes care









Type 2 diabetes – NHS Choices


























































Type 2 diabetes 

Introduction 


Gestational diabetes (during pregnancy)

Blood glucose levels can sometimes increase during pregnancy, making difficult for insulin to absorb it all. This is called gestational diabetes, which affects about 5% of pregnant women.

Gestational diabetes can increase the risk of health problems developing in an unborn baby, so it’s important to keep your blood glucose levels under control.

In most cases, gestational diabetes disappears after the baby is born. However, women who develop the condition have about a 30% risk of developing type 2 diabetes in later life.

Read more about gestational diabetes.

Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.

In England in 2010, there were approximately 3.1 million people aged 16 or over with diabetes (both diagnosed and undiagnosed).

By 2030, this figure is expected to rise to 4.6 million, with 90% of those affected having type 2 diabetes (see below).

The charity Diabetes UK estimates that around 850,000 people in England have diabetes, but haven’t been diagnosed.

Many more people have blood glucose (sugar) levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as “pre-diabetes”, and if you have it you have a greater risk of developing full-blown diabetes.

It’s very important for diabetes to be diagnosed as early as possible, because it will get progressively worse if left untreated.

You should therefore visit your GP as soon as possible if you have symptoms, which include feeling thirsty, passing urine more often than usual and feeling tired all the time (see the list below for more diabetes symptoms).

Type 1 and type 2 diabetes

There are two main types of diabetes  type 1 and type 2.

Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin. This is known as insulin resistance.

Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body doesn’t produce any insulin at all. In the UK, about 90% of all adults with diabetes have type 2. 

Type 1 diabetes usually develops before the age of 40 – often in the teenage years, while type 2 diabetes tends to be diagnosed in older people.

The danger of type 2 diabetes

The rapid rise in the number of adults developing type 2 diabetes is due to:

  • increasing levels of obesity
  • a lack of exercise
  • increase in unhealthy diets
  • an ageing population

Even if you feel healthy, you may have a higher than normal blood glucose level (pre-diabetes) and be at risk of getting the condition.

It’s therefore important to take preventative measures by making any necessary lifestyle changes, such as eating more healthily, losing weight (if you’re overweight) and becoming more physically active.

Read more about the lifestyle changes you can make to help treat and prevent type 2 diabetes.

Diabetes can cause serious long-term health problems. It’s the most common cause of visual impairment and blindness in people of working age. It’s also responsible for most cases of kidney failure and lower limb amputation (other than accidents).

People with diabetes are up to five times more likely to have cardiovascular disease and stroke than those without diabetes.

Read more about the complications of type 2 diabetes.

Diabetes symptoms

Diabetes can cause a variety of symptoms. The main symptoms of undiagnosed diabetes include:

  • urinating frequently, particularly at night
  • feeling very thirsty
  • feeling very tired
  • unexplained weight loss and loss of muscle bulk
  • itching of the genitals or frequent episodes of thrush
  • cuts and wounds that heal slowly
  • blurred vision

The symptoms of type 2 diabetes may not be so obvious, because the condition usually develops slowly over a number of years. It may only be picked up during a routine medical check-up.

You should visit your GP as soon as possible if you notice any of the above symptoms.

You can also use the diabetes self-assessment tool on this page to find out your risk of developing type 2 diabetes.

Causes of type 2 diabetes

Insulin is a hormone produced by the pancreas – a large gland located behind the stomach.

Insulin controls the amount of glucose in your blood. It moves glucose from the blood into your cells, where it’s converted into energy.

In type 2 diabetes, not enough insulin is produced to maintain a normal blood glucose level (insulin deficiency), or your body is unable to use the insulin that’s produced effectively. This is known as insulin resistance.

Read more about the causes of type 2 diabetes.

At risk groups

Although all adults are at risk of developing type 2 diabetes, a number of groups have a particularly high risk of developing the condition.

Your risk of developing type 2 diabetes is increased if:

  • you’re over 40 years of age (over 25 if you’re South Asian)
  • you have a close family member with diabetes (a parent, brother or sister)
  • you’re overweight or obese, with a waist size of over 80cm (31.5 inches) for women and 94cm (37 inches) for men, or 89cm (35 inches) for South Asian men 
  • you’re of South Asian, Chinese, African-Caribbean or black African origin (even if you were born in the UK) 
  • you’ve ever had a cardiovascular disease, such as a heart attack or stroke
  • you’re a woman with polycystic ovary syndrome (PCOS) and also overweight
  • you’re a woman and you’ve had gestational diabetes or given birth to a baby of over 10 pounds 
  • you have a severe mental health condition, such as depression, schizophrenia or bipolar disorder, and you’re taking medication for it
  • you’ve been told you have impaired glucose tolerance or impaired fasting glycaemia

Treating type 2 diabetes

There is no cure for diabetes. However, treatment aims to keep your blood glucose levels as normal as possible, which will control your symptoms and minimise the risk of health problems developing later on.

If you’re diagnosed with diabetes, you may be referred to a diabetes care team for specialist treatment, or your GP surgery may provide first-line diabetes care.

In some cases, it may be possible to control your diabetes symptoms by making changes to your lifestyle, such as eating a healthy diet and taking regular exercise (see below).

However, as type 2 diabetes is a progressive condition, you may eventually need to take medication to keep your blood glucose at normal levels. You may need to take tablets initially, but move on to injected therapies, such as insulin, at a later stage.

Read more about treating type 2 diabetes.

Living with diabetes

If you have type 2 diabetes, you will be advised to look after your health very carefully.

Caring for your health will also make treating your diabetes easier and minimise your risk of developing complications. You should:

Read more about living with type 2 diabetes.

Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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The 42 comments posted are personal views. Any information they give has not been checked and may not be accurate.

fogly said on 10 September 2014

How can you reply to a comment? I’m new to this site. I want to inform diabetics of a huge factor in managing blood sugar. I was suprised how many people were misinformed. Carbs! Trial and error of different foods with home bs testing is the only way to know how things like fruit affect your bs. Everyone is different. Yes I take meds, but not shots. But by closely watching carbs my AC1 was 12.9 and is now 5.6. Please read food labels and test your bs often, to know how different foods will affect you. I would only comment on things tried and true for my own health. Diabetics, you are not alone!

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h1tm4n32 said on 31 July 2014

I Came to see about type 1 diabetes and what do i find nothing, all about type 2, here’s me thinking type 1 is just in need of information as well

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Bilbo baggies said on 23 July 2014

I came on this site to read others experiences but although there are quite a few who’s questions are just like my experience, there are no replies so it doesn’t help to share. Am I not understanding how to access them ?

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daza66 said on 12 June 2014

i have been type 2 diabetic for nearly 2 years now,
i have been going to my GP now since i was diagnosed type 2 diabetis with Dizzyness,tiredness,confusion,headaches all these are symptoms, my GP sent me too hospital ENT.. the consultent sent me for a brain scan and that came back normal,i then went back see the dr at ENT and he said these symtoms sound like they phycological
i think the dr wrong

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PeteORiordan said on 11 June 2014

I suffer with type 2 as well as having fibromyalgia and osteoarthritis. I have been going through a lot just lately and my other problems have been taking centre stage, but the article about diabetes has shown me I need to treat all my ailments with the same respect.

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Alice in Wonderland1 said on 17 April 2014

Hi There,

I’m looking for assistance, my husband has Type 2 Diabetes and his sugar is up and down. I’ve made healthy Diabetics food and it seems his sugar is high, but if he skips one meal such as lunch for an example his sugar is down and at normal sugar rate.

I made Spaghetti Bol on Monday evening with an Salad. Also made an Low GI Fruit Cocktail Dessert, and his sugar reading the next morning was 10.2. For breakfast that morning he had leftover Spaghetti with coffee little milk. Later that day he had no lunch, no sugar, not any snacks and we checked his sugar again and it read 7.2!

So we would just like to know what do we do, or if we are doing anything wrong.

Thank You

Kind Regards
Alice

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papergirl said on 17 February 2014

Hi I have recently been diagnosed with type 2 and found shopping a minefield until I heard about a free app for your phone from foodswitchuk. It’s brilliant as you can scan the barcode with your phone on the item that you want to buy and it will show you the traffic light system as to the sugars etc. I hope some of you will find it as helpful as I have.

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Austinoflincoln said on 14 January 2014

Hello fellow sufferers, On christmas eve 2013 I was told I had T2 diabetes and yes I tick a lot of the boxes ie overweight which I have to say was brought on by Addisons disease where my body no longer produced Cortisol so now I have to take steroids x2 daily and we all know what they do to you. It would appear that my hormone issues loss of testosterone as well which is controlled with gel and all this has led to my diabetes so now how do I cope with it? well to be honest I am finding it very hard to manage as I have loved chocolate for as long as I can remember but the liking of said substance became more profound when I quit smoking. I was told originally my hormone issues were all down to the Methotrexate used to control my arthritis and that was caused by stress in 08 I have considered many times to get a pack of B&H :o)
All my diet is now low sugar and fat as have cholesterol probs as well… what will happen next?Sorry I have rambled.

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MikeyJS said on 19 November 2013

To: Degsy43: You can check your blood sugary very easily by simply buying a blood glucose monitoring system from a pharmacy.

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Degsy43 said on 22 October 2013

I have had Type 2 Diabetes for just over 10 years and until recently I controlled it by diet. I am now on metformin.
I have no idea how my blood sugars are doing as my Doctors will no longer supply the test strips so I can go for (over ) 6 months before a blood test!
How do other people monitor their sugar levels?
This policy has only recently been introduced and it seems to have been introduced not on medical grounds but on financial grounds.
I now feel I have no control over my sugar levels and I find this VERY depressing.

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ani010 said on 10 October 2013

hello. today I have been given the news that i am type 2 diabetic, my levels after my first blood test last week were 20, and after this weeks blood test they were 23. ive been told that this is high and told that i am infect diabetic and that i need to see the practice nurse. so down to the reception i go to make an appointment, i was told that the first double appointment available is on 8th of november. my doctor had said that the new diet needs to start from today, so yeah thats fine, but what should I eat? drink? do i need to monitor my sugar levels? i just dont know. is this normal? please can someone help me? i just feel like ive been handed a bomb and pushed out to sea in a rubber dingy. im sorry if my spelling is rubbish but my vision i blurry and i am quite dizzy and tired right now. thank you for taking the time to read this. xx

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nash95 said on 18 April 2013

I’m 17 and I think I may have diabetes. I am experiencing all of the symptoms except the weight loss, although I am not gaining weight. Maybe I am overreacting, my grandmother has diabetes and so does my cousin, but I am so thirsty and tired which is really unlike me

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Fat Baldy 66 said on 19 February 2013

Yesterday, February 18th 2013, I was informed I had low level type 2 diabetes. had the wind knocked out of my sails and so I did not think to ask these questions of my GP;

Am I on Metformin for a long time?
Do I need to get a meter to test my blood?
Apart from losing some weight (I acknowledge I am ratehr heavy) is there anything else I can do?
What if anything must I been concerned about?
Is Type2 diabetes a lifelong diagnosis, or can I be ‘cured’?

Any ideas anyone?

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steveking40 said on 06 January 2013

i suffer with diabetes type 2 and for the last few months i have been getting eposiodes of small shaking type fits,with the cold weather here in the uk i have used a lot more heating,it seems that it effects me and is very upsetting and stressful does anyone else ever get like this,it takes hours then to cool me down using wet towel and ceiling and floor fans while in bed i still have the jumping and shakes,also because of the heat i cannot always use the cooker 🙁 does anyone have any advice or answers

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Aidan Bertie said on 31 October 2012

Very nice post,
I got more information from your post. Because before some day I trying to understand about types of diabetes. After reading your post I know all about which is in my mind.
Thanks For Sharing

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Mush55 said on 01 October 2012

My 7 year old daughter has been very up and down for past two months or so. Suffers with constant recurring tonsil problems which often need antibiotics, eventually I asked for some blood tests and was shocked when her glucose came back at 2.8 , it was done about 4.30 in the afternoon being roughly 4 hours since her lunch at school. Phosphate was also high at 1.93 but was told this wasm not a problem, whilst waiting for other results to come back I decided to home check and took blood two hours after dinner around 5.30 in the afternoon and reading was 11.2 what can possibly make these massive extremes ??? I am continuing with my checks and will update my findings after school today before and after food but would appreciate any feed back ……please …..

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Maryagross said on 21 September 2012

Thanks for sharing your information with us. Also, diabetes is in fact an incurable condition, which can only be treated or controlled and can never be cured. And the best way to control, prevent and treat type 2 diabetes is by taking a biguanide class of medicine called metformin. I had tried this drug for my type 1 diabetes treatment. To know more about metformin drug you can read this article.
http://diabetes-cure-with-metformin.blogspot.in

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Phil68 said on 24 August 2012

I just stumbled on this page while checking some details for a friend on another matter, just thought i’d write a few words 🙂

I’m always stunned by the way Dr’s categorize diabetes as just being related to weight, and how its completely random if the Dr seems to know just what to recommend about the subject.

I’ve had diabetes for 30 years+ and never weighed over 12.5 stone, and I know many many very overweight people, yet none are diabetic, and all of the 10 friends I have who are type 2 now have never been overweight. Kind of knocks the whole idea on its head ?

Eating too much doesn’t cause diabetes, never has and never will. As has been mentioned in the earlier posts, weight control is more likely to be a thyroid problem, even if it hasn’t fully shown up yet, and all Dr’s should be testing that as a matter of course.

I’ve even been told by a consultant that how my own insulin reacts is not possible – he laughed at me as I told him, so that didn’t help my confidence lol.

I now take care of my own diabetes, and keep a healthy blood/sugar of 7.3 average.

Some here have asked "Am i really diabetic?" when they have sugar levels of 6/7/8 etc., but rest assured . . . you ‘will’ know if you get it, with diabetes it’s not hit & miss random numbers – your level will go up and up, and over 10/15 easily. In a non-diabetic, the type of insulin is instant reacting/producing, so it stays in control.

Each person has a personal ‘normal’ level, and always below 10. Saying it should be 6.5 or 7.3 etc. is wrong, it varies soooo much, but if its staying over 10, you need to get it checked properly.

Checking just after a long sleep should give a low level as sleep lower your sugar (no exercise so the body slows down in all things, and stops burning body fat etc., hence lower glucose levels), and 15 mins after a meal should be higher, then low again (average 6-8) after another 15 mins.

Hope that helps somebody a little.

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Dissatisfied said on 21 August 2012

I am dental phobic
I have big teeth roots and my previous dentists have always had a problem to extract a tooth.
During the initial check up I asked if I could have gas, but they said as I am diabetic that gas would compromise my illness and no I could not have gas.I have had minor operations in which I had either sedation by injection or general anesthetic and neither presented any problems.
Can you advise me as to what options I have. I live in Wisbech.

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T2Dnomore said on 09 July 2012

I was diagnosed with T2 in 1993, read an article in 1998 in The Glade an Archery magazine, and changed my diet to low carb high fat. My BG and A1c have been in the normal range ever since. And no pills!!

I asked my doctor, if my BG and A1C are always normal, am I still diabetic? All he said was Thats an interesting question!!!

I don’t think I can be now. My latest A1c was 5.4 for example.

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Rikste67 said on 31 March 2012

@pauliepops

if your blood glucose before meals is between 4 and 7 you do fine. In the morning before breakfast it preferably should be between 5 and 6.
This is a good guideline and by the looks of your average you do fine.
This is what I have been told when i first was diagnosed with diabetes in 1995.
Hopefully it will help you a bit more.

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Pauliepops said on 30 March 2012

Hi Im fairly new to this i am type 2 and was never given the chance to help myself with weight loss i was
placed on methoram and simstatin tablets from the start. my readings are on average 6.8 t0 7.7 is this bad as i have been told i need to keep then under 6.00, please could someone help me with there experience.

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Snake009 said on 26 January 2012

Taking into account the hype over bodyweight (obesity) being a contributory factor in my “poor” readings from my most recent blood tests, I would like to ask a ‘simple’ question.

If (as my GP insists), my bodyweight is one of the major factors governing my apparently badly controlled cholesterol and blood-sugar levels – how is it that my previously ‘normal range’ results were achieved when I was almost a full stone heavier?

Is he suggesting that I should try to regain this weight in an attempt to reduce my levels to their previously ‘acceptable’ levels? (No! I don’t believe he is!)

Unfortunately, the facts appear to have dumbfounded him and it has left me confused and mistrusting of so-called “professional advice”.

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geminii said on 02 December 2011

Newly diagnosed Late Onset Diabetics might well query their Thyroid Levels;

I was told I was diabetic but a better informed GP at my workplace told me I had a Thyroid Problem because I was putting on weight, tired, felt the cold, and my eyebrows had all but disappeared. Two blood tests over three months confirmed his diagnosis. Taking the thyroid medication got rid of all the diabetic symptoms for the last 18 years and I have been able to turn down the thermostat and save my heating bills!

Three of my friends have been diagnosed with Late Onset Diabetes and they have all gone on to need Thyroid Supplementation.

I believe these organs inter-relate yet patients are treated for the "most likely" without doing the tests for the other probable causes.

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shazx63 said on 03 November 2011

omg!….As a fairly recent diagnosed type 2 diabetic…Im even more confused after watching the show then reading some of the comments on here contradicting some of the things on TV! I was told that even as a Type 2 that once you got it there is no Cure 4 it only Management of the condition. Also when I mention to the nurse that Im so tired ll the time & I do get shakey & bit ‘drifty’ when Iv not eaten..She seems to scratch her head & wonder why as Im only bordermine type 2 diabetic…I feel a bit of a fake @ times but I do feel these things! :0(
Does anyone know of where I can get a diabetic menu planner from please as Im getting to grips roughly on what I should be eating but not being able to put a days menu together due to knowing what daily amounts of what are required as the dietition wasnt much help :0(
I am so confused with it all! :0(

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copelands said on 02 November 2011

I was really very concerned about part of your piece onType 2 Diabetes last Evening.

At one point the guy with diabetis was seen to take his blood glucose level and tell the "doctor" it was 3.9. The Doctor the sais "that’s waht we ant".
Frankly THAT IS NOT WHAT WE WANT. A reading of 3.9 is either on the edge of a hypo or well into one depending on the person. Bel;ive me your diabetic would not have been sitting there smiling if his reading was 3.9. He would be sweating, trembling qand beginning to become incoherent.

I only hope that as a result of your piec no-one goes out to drive a car at that level of glucose.

Additionally, a reading of 8.5 does NOT mean that your toes are going to drop off !!! it is slightly higher that the upper limit of 7.9 which is recommended.

It worries me that you are getting such important things wrong at such an early stage in the series.

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help please said on 13 October 2011

i have so many diseases in my family i am wondering if these diseases are hereditary to something that happened 10 years ago and linked or something because my dad has diabetes, chronic back problems, a history of skin things that cause cancer, glasses, and my uncle has or had colon cancer and my niece is four years old with epelepsy and i have had prostate cancer, like four or five different days with different pains all over my body like my lungs hurt my knees hurt at one point, my muscles in my feet hurt at one point, i broke my neck four years ago then in the same month both of my grandfathers died of bleeding in the brain its kind of like its contagious because i my three closest friends that have rare diseases that happened after it started happening and all this started occuring in the last 10 years.

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alionuska4 said on 02 August 2011

hello,I have a quesstion about diabet issue ,my brother wants to move from lithuania, for a work here,but unfortunatly he has this illnes,we would like to learn what he will need to do, which documents,papers he will need to have, to get insulin here.

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lesret said on 15 June 2011

Having been told I am type 2 diabetic some five years ago and placed on all the usual pills Glucophage etc..
I was a few months ago put on Victoza injections at 1.2ml per day.
I lost 1.5 stone over three month combined with both diet and exercise.
Fantastic I thought untill I received late last evening a FDA MedWatch Alert from the FDA warning of Risk of Thyroid C-cell Tumors and Acute Pancreatitis associated with the use of Victoza.
Where do Victoza users go from here.

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redman66 said on 06 May 2011

After working in a hospital for 19 years im now retired i found out is was a type 2 diabetic diagnose by a doctor i was working with im now under my own gp .
it was very hardat first but now im use to it.
last year i was put on to insulin and i have found that i now lost some weight i was 14st im now down to 13 st so i have lost a stone.
i some times have my on off days as well does anyone else feel like this.
would love to hear from anyone on this
thank you for reading thid little story..

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redman66 said on 05 May 2011

iv had type2 for 2years i have lost about 2stone but sometimes feel very tired is this part of this conditionwould like to loose more.

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aileen95 said on 16 April 2011

I have been a type 2 diabetic for over ten years and recently my control has slipped. I take Metformin. I am now trying to get control of my blood sugar again, but am given to understand that as a type 2 I am not allowed testing strips – because they are too expensive, and are restricted by the PCT. Surely this is a short sighted measure. Even folllowing low GI, without testing I wouldn’t have found that porridge, using old fashioned oats, which is supposed to be low GI and good for me; actually puts up my blood glucose to between 11 & 13 2 hours after eating. Not good. As I have stomach problems I have been eating porridge for breakfast and my evening meal.

No wonder my Hbac1 is going up. If I can’t test, how am I to find out which carbohydrates suit me – not all diabetics are the same. I am told that I can test once a WEEK, if I must test, but I need to be testing after meals and when I feel ‘odd’.

Also new drugs like Victoza and Sitagliptin are being put on Red Lists as ‘too expensive’, but if weight is lost and blood glucose control maintained at a non-diabetic level (as can be done) then surely it will save a great deal of money in the long term.

Also I should be able to take some control of my own illness. If I get a Hbac1 every year, how am I supposed to know how my glucose levels are and keep control of this illness.

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chrisnonso53 said on 28 February 2011

can diabetis be cause by spiritual influences

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John Falkner said on 12 February 2011

Obesity is the current in vogue condition to blame every illness on, including diabetes. It is so easy to say if you are fat you will get diabetes. I have type 2 insulin treated diabetes. At 55 after a very active life both in work and in hill and mountain climbing I realised that my fitness was fading. I put this down to age.I now realise it was the start of diabetes but I did not suspect that at the time. My father developed diabetes at age 62 and was treated by tablets and diet. Between 55 and 60 I put on two or three stones in weight much to my chagrin, for no apparent reason. At age 62 I developed full blown type 2 at the exact same time that my father had developed it. He was not an overweight man.but we obviously had the same gene. It is too easy to blame everyone for this particular illness, on big appetites and excessive drinking, I do neither and never have. I think diabetics get a bad press because as I said at the beginning obesity is such an easy explanation to put forward. I think it is more complicated than that.

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lindakp said on 03 February 2011

I get very upset when most articles state that Type 2 Diabetes is usually caused by obesity. I am not obese and never have been. If fact my BMI is in the healthy range.

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ourjoe said on 15 November 2010

There is a fantastic online learning course which is completely free to sign up for and I found it incredibly useful. Our whole department was recommended to complete the course as it pre-empts many issues with the safe delivery of insulin. The course is on the NHS Diabetes website http://www.diabetes.nhs.uk/safe_use_of_insulin/elearning_course/

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suntexi said on 06 November 2010

I agree that obesity is a symptom, not a cause of diabetes. My sister, my father, my two aunts and my grandmother (who later was diagnosed with type 2) are or were helplessly obese – no amount of dieting helped. Obesity is genetic (the geniuses have only just found THAT out). If you eat any carbs, then, because the body can’t use them, it stores them away. I can cut out carbs but all that happens is that I get hypoglycaemic. I’m on 40mg of Gliclacide per diem and that seems to generate enough insulin to cause hypos. It was reduced from 80mg as I couldn’t go shopping without needing a sugar fix to stop the hypo – practically every time. I’m also on 3x850mg Metformin which helps a bit. My 3-month blood sugar is now a fairly stable 7-7.5. My instant blood sugar, just before a hypo is about 3.5. I’m not a chocolate freak, I drink moderately, but I have another problem that prevents exercise – I suffer from atrial fibrillation, which is probably triggered by diabetes, and round and round we go. My blood pressure’s ok — typically 120/75 as is my cholesterol (about 2.5). The only time I came close to my recommended weight was at age 17 when I suffered a severe (3-month) bout of mononucleosis and my weight went down to 13st. 7lb. (I’m 6′ 4") and I was told that I looked like a corpse. I’d like to reduce my weight to 18st or less, but it’s literally, a losing battle. The local health centre won’t let me exercise there because of the Afib.
It’s all hopeless.

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marketshare said on 28 February 2010

What works for one person is not guaranteed to work for all. To be updated with all developments in diabetes you can visit http://everythingaboutdiabetes.blogspot.com

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Wrong diagnosis said on 18 February 2010

In 2006 I had a test done and I was very marginally diagnosed with type 2 diabetes, I was hovering over 16 stone and I liked my food too much but made an instantaneous change in lifestyle and lost a stone, as soon as I made the changes by cutting out sugar all together the next couple of tests were normal, I have not had any fasting tests since and don’t consider myself diabetic, just recently I have been getting letters from the doctors asking me to go for tests, I have previously written to him to request that my name be removed from the register. Having being diagnosed with cancer 2 years ago and thankfully making a good recovery I have lost over 5 stone and during my stay in hospital I mentioned this earlier diagnosis of diabetes but every test that was carried out was normal.
The question I would like to ask is what right do I have to get the diagnosis reversed and information removed from my medical records as I believe I may have been miss diagnosed in the first instance, I have no intention of having anymore tests carried out for this condition.
Thanks for reading

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Reverse Diabetes said on 07 January 2010

When I was informed that I had diabetes type 2, I thought it was the start of the down hill – in my late 30’s – But at 45, I made a major lifestyle change that introduced eating the right foods at the right times and doing a little exercise. After 6 months I had completely managed to reverse the situation and lose 4 stone of weight – two birds with one stone. I have now managed to do some 10k runs, a half marathon and really enjoy life – and for the past year (now 46) managed to keep the weight off and my sugar levels normal without any medication. More information on how I did this can be found on http://www.howireverseddiabetes.com – Now that I have reversed it I am a media role model for Diabetes UK and would love to get my message that change for the better can take place with a little effort. If anyone would like some help with answers to how I did it email me through the website – all the best to those who try to become healthier – Andrew

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jaxhogan said on 10 December 2009

I agree.

If diabetes is essentially the inability to process carbohydrates effectively, then it would seem to make sense to eat less of them!

I also believe than obesity is a SYMPTOM of diabetes, not a CAUSE. If your body doesn’t metabolise carbs properly, then you don’t get energy from them. So you eat more to compensate. QED.

I’ve been diabetic for nearly a year, and applying this thought process has brought my BG down from 17.9 to 5.1. That convinced me!

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TKes said on 26 November 2009

The diet recommended for type2 diabetics is based on carbohydrate-rich foods. Then a diabetic has to take a variety of drugs to reduce excess blood glucose. Wouldn’t it be better to eat less carbohydrates so as not to raise blood glucose too much in the first place?

That is what is recommended at http://www.diabetes-diet.org.uk, and it certainly works for me. I found after just one breakfast of scrambled eggs ij butter, my glucose was the lowest it’s been in years. It was amazing!

For several weeks now I have stuck to a very low carb diet and my glucose has st5ayed in the normal range. I guess I am now no longer diabetic?

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Living with type 2 diabetes – NHS Choices






























































Living with type 2 diabetes 

Type 2 diabetes – looking after yourself 

If you have type 2 diabetes, you’ll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you’ll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There’s evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don’t need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don’t need to completely exclude sugary and high fat foods from your diet, but they should be limited. It’s possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it’s very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don’t smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

back to top

Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

back to top

Pregnancy  show

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

back to top

Get educated show

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

back to top

Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

back to top

Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

back to top

  • show glossary terms

Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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Average rating

Based on
134
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Add your rating

Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

stevehessle said on 23 August 2014

I don’t know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I’m getting better control.

Report this content as offensive or unsuitable

DaiB said on 05 March 2012

I might question the ‘Eat Healthily’ advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it’s not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

Report this content as offensive or unsuitable

Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Travelling with diabetes

Guide including diet, travelling with medicines, vaccines, insurance and air travel advice

Go on a diabetes course

If you have diabetes, structured education programmes can help you manage your condition

Diabetes and pregnancy

How type 1 and type 2 diabetes can affect you and your baby. Plus gestational (pregnancy) diabetes

Diabetes and feet

Foot health is especially important for people with diabetes. Find out how to take care of your feet and when to get help

Go on a self-help course

Find out about free courses for people with long-term conditions to boost your confidence, pain relief and coping skills

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important










NHS Choices Syndication


Non-insulin-dependent diabetes

See what the doctor sees with Map of Medicine

The Map of Medicine is used by doctors throughout the NHS to determine the best treatment options for their patients. NHS Choices offers everyone in England exclusive and free access to this cutting-edge internet resource, which lets you see exactly what your doctor sees.

The information in the Map has been approved by the UK’s leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: diabetes

 

Published Date
2011-09-11 16:20:52Z
Last Review Date
0001-01-01 00:00:00Z
Next Review Date
0001-01-01 00:00:00Z
Classification
Diabetes,Type 2 diabetes




Living with type 2 diabetes – NHS Choices






























































Living with type 2 diabetes 

Type 2 diabetes – looking after yourself 

If you have type 2 diabetes, you’ll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you’ll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There’s evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don’t need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don’t need to completely exclude sugary and high fat foods from your diet, but they should be limited. It’s possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it’s very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don’t smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

back to top

Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

back to top

Pregnancy  show

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

back to top

Get educated show

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

back to top

Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

back to top

Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

back to top

  • show glossary terms

Page last reviewed: 18/06/2014

Next review due: 18/06/2016

Ratings

How helpful is this page?



Average rating

Based on
134
ratings

All ratings











Add your rating

Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

stevehessle said on 23 August 2014

I don’t know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I’m getting better control.

Report this content as offensive or unsuitable

DaiB said on 05 March 2012

I might question the ‘Eat Healthily’ advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it’s not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

Report this content as offensive or unsuitable

Healthy living with diabetes

Diabetes can have serious health consequences, including heart disease and blindness. But with careful management you can reduce your risk

Travelling with diabetes

Guide including diet, travelling with medicines, vaccines, insurance and air travel advice

Go on a diabetes course

If you have diabetes, structured education programmes can help you manage your condition

Diabetes and pregnancy

How type 1 and type 2 diabetes can affect you and your baby. Plus gestational (pregnancy) diabetes

Diabetes and feet

Foot health is especially important for people with diabetes. Find out how to take care of your feet and when to get help

Go on a self-help course

Find out about free courses for people with long-term conditions to boost your confidence, pain relief and coping skills

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important










NHS Choices Syndication


Non-insulin-dependent diabetes

Symptoms of type 2 diabetes

The symptoms of diabetes include feeling very thirsty, passing more urine than usual and feeling tired all the time.

The symptoms occur because some or all of the glucose stays in your blood and isn’t used as fuel for energy.

Your body will try to get rid of the excess glucose in your urine.

The main symptoms, which are common to both type 1 diabetes and type 2 diabetes, are:

  • urinating more often than usual, particularly at night
  • feeling very thirsty
  • feeling very tired
  • unexplained weight loss
  • itching around the penis or vagina, or frequent episodes of thrush
  • cuts or wounds that heal slowly
  • blurred vision (caused by the lens of the eye becoming dry)

The signs and symptoms of type 1 diabetes are usually obvious and develop very quickly, often over a few weeks.

The signs and symptoms of type 2 diabetes aren’t always as obvious, and it’s often diagnosed during a routine check-up. This is because the symptoms are often mild and develop gradually over a number of years.

This means that you may have type 2 diabetes for many years without realising it.

Early diagnosis and treatment for type 2 diabetes is very important because it may reduce your risk of developing complications later on. Visit your GP as soon as possible if you think you may have diabetes.

Hyperglycaemia

Type 2 diabetes occurs when the pancreas (a large gland behind the stomach) can’t produce enough insulin to control your blood glucose level, or when the cells in your body don’t respond properly to the insulin that is produced.

Due to the lack of insulin or its inability to regulate blood glucose, your blood glucose levels may become very high. This is known as hyperglycaemia.

Hyperglycaemia can occur for several reasons, including:

  • eating too much
  • being unwell
  • ineffective  or not taking enough  diabetes medication 

Hyperglycaemia causes the main symptoms of diabetes, which include extreme thirst and frequent urination.

Published Date
2014-07-23 11:29:20Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Appetite loss,Diabetes,Diabetes clinics,Diabetes drugs,Diabetic,Dietary treatment,Drowsiness,Gestational diabetes,Healthy eating,Hyperglycaemia,Hypoglycaemia,Insulin,Jaundice,Nausea,Symptoms and signs,Thirst,Tiredness,Type 1 diabetes,Type 2 diabetes,Urinary problems,Weight loss






NHS Choices Syndication


Non-insulin-dependent diabetes

Treating type 2 diabetes

Medicines for type 2 diabetes

Type 2 diabetes usually gets worse over time. Making lifestyle changes, such as adjusting your diet and taking more exercise, may help you control your blood glucose levels at first, but they not be enough in the long term.

You may eventually need to take medication to help control your blood glucose levels. Initially, this will usually be in the form of tablets, and can sometimes be a combination of more than one type of tablet. It may also include insulin or other medication that you inject.

Metformin

Metformin is usually the first medicine that’s used to treat type 2 diabetes. It works by reducing the amount of glucose that your liver releases into your bloodstream. It also makes your body’s cells more responsive to insulin.

Metformin is recommended for adults with a high risk of developing type 2 diabetes, whose blood glucose is still progressing towards type 2 diabetes, despite making necessary lifestyle changes.

If you’re overweight, it’s also likely you’ll be prescribed metformin. Unlike some other medicines used to treat type 2 diabetes, metformin shouldn’t cause additional weight gain.

However, it can sometimes cause mild side effects, such as nausea and diarrhoea, and you may not be able to take it if you have kidney damage.

Sulphonylureas

Sulphonylureas increase the amount of insulin that’s produced by your pancreas. Examples of sulphonylureas include:

You may be prescribed one of these medicines if you can’t take metformin, or if you aren’t overweight. Alternatively, you may be prescribed sulphonylurea and metformin if metformin doesn’t control blood glucose on its own.

Sulphonylureas can increase the risk of hypoglycaemia (low blood sugar), because they increase the amount of insulin in your body. They can also sometimes cause side effects including weight gain, nausea and diarrhoea.

Glitazones (thiazolidinediones, TZDs)

Thiazolidinedione medicines (pioglitazone) make your body’s cells more sensitive to insulin so that more glucose is taken from your blood.

They’re usually used in combination with metformin or sulphonylureas, or both. They may cause weight gain and ankle swelling (oedema). You shouldn’t take pioglitazone if you have heart failure or a high risk of bone fracture.

Another thiazolidinedione, rosiglitazone, was withdrawn from use in 2010 due to an increased risk of cardiovascular disorders, including heart attack and heart failure.

Read more about the withdrawal of rosiglitazone.

Gliptins (DPP-4 inhibitors)

Gliptins work by preventing the breakdown of a naturally occurring hormone called GLP-1. GLP-1 helps the body produce insulin in response to high blood glucose levels, but is rapidly broken down.

By preventing this breakdown, the gliptins (linagliptin, saxagliptin, sitagliptin and vildagliptin) prevent high blood glucose levels, but don’t result in episodes of hypoglycaemia.

You may be prescribed a gliptin if you’re unable to take sulphonylureas or glitazones, or in combination with them. They’re not associated with weight gain.

GLP-1 agonists

Exenatide is a GLP-1 agonist, an injectable treatment that acts in a similar way to the natural hormone GLP-1 (see the section on gliptins, above).

It’s injected twice a day and boosts insulin production when there are high blood glucose levels, reducing blood glucose without the risk of hypoglycaemia episodes ("hypos").

It also leads to modest weight loss in many people who take it. It’s mainly used in people on metformin plus sulphonylurea, who are obese. A once-weekly product has also been introduced.

Another GLP-1 agonist called liraglutide is a once-daily injection (exenatide is given twice a day). Like exenatide, liraglutide is mainly used for people on metformin plus sulphonylurea, who are obese, and in clinical trials it’s been shown to cause modest weight loss.

Acarbose

Acarbose helps prevent your blood glucose level from increasing too much after you eat a meal. It slows down the rate at which your digestive system breaks carbohydrates down into glucose.

Acarbose isn’t often used to treat type 2 diabetes because it usually causes side effects, such as bloating and diarrhoea. However, it may be prescribed if you can’t take other types of medicine for type 2 diabetes.

Nateglinide and repaglinide

Nateglinide and repaglinide stimulate the release of insulin by your pancreas. They’re not commonly used, but may be an option if you have meals at irregular times. This is because their effects don’t last very long, but they’re effective when taken just before you eat.

Nateglinide and repaglinide can cause side effects, such as weight gain and hypoglycaemia (low blood sugar).

Insulin treatment

If glucose-lowering tablets aren’t effective in controlling your blood glucose levels, you may need to have insulin treatment. This can be taken instead of or alongside your tablets, depending on the dose and the way that you take it.

Insulin comes in several different preparations, and each works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don’t last very long (rapid-acting).

Your treatment may include a combination of these different insulin preparations.

Insulin injections

Insulin must be injected because if it were taken as a tablet, it would be broken down in your stomach like food and unable to enter your bloodstream.

If you need to inject insulin, your diabetes care team will advise you about when you need to do it. They will show you how to inject it yourself and will also give you advice about storing your insulin and disposing of your needles properly.

Insulin injections are given using either a syringe or an injection pen, which is also called an insulin pen (auto-injector). Most people need between two and four injections of insulin a day.

Your GP or diabetes nurse will also teach a relative or a close friend how to inject the insulin properly.

You can read more about insulin and how to inject it on the Diabetes UK website.

Treatment for low blood sugar (hypoglycaemia)

If you have type 2 diabetes that’s controlled using insulin or certain types of tablets, you may experience episodes of hypoglycaemia.

Hypoglycaemia is where your blood glucose levels become very low. Mild hypoglycaemia (a "hypo") can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.

If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets. This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit. In most cases, these measures will be enough to raise your blood glucose level to normal, although it may take a few hours.

If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness. If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.

Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.

Other treatments

If you have type 2 diabetes, your risk of developing heart disease, stroke and kidney disease is increased.

To reduce your risk of developing other serious health conditions, you may be advised to take other medicines, including:

  • anti-hypertensive medicines to control high blood pressure
  • a statin, such as simvastatin or atorvastatin, to reduce high cholesterol
  • low-dose aspirin to prevent a stroke
  • an angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril, if you have the early signs of diabetic kidney disease

Diabetic kidney disease is identified by the presence of small amounts of albumin (a protein) in your urine. If treated early enough, it may be reversible.

Monitoring blood glucose levels

If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months. This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.

The HbA1c test is used to measure blood glucose levels over the previous two to three months. HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.

A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.

Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 59mmol/mol (7.5%). However, it can be as low as 48mmol/mol (6.5%) for some people.

Read more about the HbA1c test.

Monitoring your own blood glucose

If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.

Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels. Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.

A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful in detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia).

If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.

Blood glucose meters aren’t currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you’re unsure.

Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb).

Regularly monitoring your blood glucose levels will ensure that your blood glucose is as normal and stable as possible. As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment you’re taking.

In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood. A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short.

A normal blood glucose level is 4-6 mmol/l before meals (preprandial) and less than 10 mmol/l two hours after meals (postprandial), although this can vary from person to person. Your diabetes care team can discuss your blood glucose level with you in more detail.

Care standards for diabetes

The aim of treating diabetes is to help people with the condition control their blood glucose levels and minimise the risk of developing future complications.

The Department of Health has set out national standards for NHS organisations and professionals covering diabetes care and prevention. The diabetes national service framework was developed by diabetes clinical experts and diabetes patients. Good diabetes care includes:

  • awareness of the risk factors for type 2 diabetes
  • advice and support to help people at risk of type 2 diabetes reduce that risk
  • access to information and appropriate support for people with type 1 diabetes and type 2 diabetes, including access to a structured education programme, such as the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) or X-PERT Health
  • an agreed care plan to help all people with diabetes to manage their care and lead a healthy lifestyle, including a named contact for their care
  • information, care and support to enable all people with diabetes to optimise their blood glucose level, maintain an acceptable blood pressure and minimise other risk factors for developing complications
  • access to services to identify and treat possible complications, such as screening for diabetic retinopathy and specialised foot care
  • effective care for all people with diabetes admitted to hospital, for whatever reason

You can read more about diabetes care on the Diabetes UK website.

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Published Date
2014-09-18 14:17:23Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
ACE inhibitors,Black people,Clinical trials and medical research,Diabetes,Diabetes clinics,Diabetes drugs,Diabetes UK,Diabetic,Getting active,Healthy eating,Hormone and metabolism specialists,Hyperglycaemia,Hypoglycaemia,Insulin,Type 1 diabetes,Type 2 diabetes,Urinary problems,Weight gain,Weight loss,Weight management






NHS Choices Syndication


Non-insulin-dependent diabetes

Type 2 diabetes – looking after yourself

Look after your feet

If you have diabetes, you’re at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn’t start to heal within a few days.

Read more about feet and diabetes.

Regular eye tests

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

Pregnancy

If you have diabetes and you’re thinking about having a baby, it’s a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You’ll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby’s development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it’s now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it’s important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

Get educated

You’ll be best equipped to manage your diabetes day-to-day if you’re given information and education when you’re diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there’s a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there’s a national patient education programme that meets all the key criteria for structured education. It’s called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

Talk to others

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

Financial support and benefits

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you’re getting all the benefits you’re entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

Published Date
2014-07-23 13:19:06Z
Last Review Date
2014-06-17 00:00:00Z
Next Review Date
2016-06-17 00:00:00Z
Classification
Diabetes,Diabetes UK,Diabetic,Disability (living with),Disabled people,Education,Getting active,Healthy eating,Hyperglycaemia,Hypoglycaemia,Long-term management,Type 2 diabetes


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