Diabetes And Insulin

Overview

Diabetes is a long-term condition where the level of glucose (sugar) in your blood is too high. Insulin is a hormone made by the pancreas. It works like a key that lets glucose move from your blood into your cells, where it is used for energy. In type 1 diabetes, the body stops making enough insulin. In type 2 diabetes, the body may not use insulin well and may later not make enough. Some people with diabetes need insulin as part of their treatment.

Yes. Diabetes is one of the most common long-term health conditions worldwide. Type 2 diabetes is especially common, and more people are being diagnosed at younger ages.

Diabetes can affect anyone at any age. Type 1 diabetes is often diagnosed in children and young adults, but it can start at any age. Type 2 diabetes is more common in adults, but it is also increasing in younger people. Some people develop diabetes during pregnancy, which is called gestational diabetes.

Symptoms

Common symptoms

• Feeling very thirsty
• Passing urine more often, especially at night
• Feeling tired or lacking energy
• Blurred vision
• Cuts or sores that heal slowly
• Losing weight without trying, especially with type 1 diabetes
• Repeat infections, such as thrush or skin infections
• Tingling, numbness, or pain in the feet or hands
• If you use insulin: shaking, sweating, hunger, dizziness, or confusion can be signs of low blood glucose

Symptoms in children

• Being very thirsty and needing to drink more than usual
• Wetting the bed or wetting themselves after being dry
• Needing to pass urine very often
• Losing weight or looking thinner
• Feeling very tired, irritable, or not themselves
• Tummy pain, vomiting, or deep breathing, which can be serious
• Fruity-smelling breath, which needs urgent medical help

Symptoms in older adults

• Thirst may be less noticeable, so high glucose can be missed
• Confusion, weakness, or falls may be the main sign
• Frequent infections or slow-healing wounds
• Needing to pass urine more often or new incontinence
• Low blood glucose may be less obvious and cause confusion or drowsiness

Causes

Main causes

• Type 1 diabetes: the immune system damages the cells in the pancreas that make insulin
• Type 2 diabetes: the body becomes less able to use insulin, and later may not make enough insulin
• Gestational diabetes: hormone changes in pregnancy make insulin work less well
• Other causes: damage to the pancreas from injury, infection, surgery, or some genetic conditions
• Some medicines can raise blood glucose, but your clinician will explain if this applies to you

Risk factors

• Having a parent, brother, or sister with diabetes
• Being overweight, especially around the waist
• Being physically inactive
• Getting older, although younger people can also develop type 2 diabetes
• Having had gestational diabetes or having polycystic ovary syndrome
• High blood pressure or abnormal cholesterol levels
• Family background or ethnicity that is linked with a higher risk in your region

When to see a doctor

See a doctor urgently if:

• You have severe low blood glucose symptoms, cannot keep fluids down, or have a foot wound that is red, swollen, or painful
• You have vomiting, deep breathing, fruity-smelling breath, or increasing drowsiness
• Your blood glucose is repeatedly very high or very low and you feel unwell
• You have signs of infection with fever and diabetes that make you feel very unwell

Book a routine appointment if:

• You have new or ongoing thirst, frequent urination, tiredness, blurred vision, or slow-healing wounds
• You have unexplained weight loss
• You use insulin and want to review your routine, lows, or monitoring
• You have questions about food, activity, sick days, travel, or work
• You are due a diabetes review, eye check, kidney check, foot check, or blood pressure check

Diagnosis

Diabetes is diagnosed with blood tests. Your clinician will ask about symptoms, your health history, and your family history. Sometimes a test is repeated to confirm the result. If you are very unwell, tests may be done urgently.

Tests that may be done

• Fasting blood glucose test: a blood test after not eating for a set time
• HbA1c test: a blood test that shows your average glucose over the past few months
• Random blood glucose test: a blood test taken at any time, especially if you have symptoms
• Oral glucose tolerance test: a sugary drink followed by blood tests, often used in pregnancy
• Urine or blood ketone test: used when you are unwell or have very high glucose
• Other blood tests to check for type 1 diabetes or to look at how well your pancreas makes insulin

What to expect at your appointment

You may need more than one test. After diagnosis, your team will explain what type of diabetes you have, what treatment is suitable, and how to monitor your glucose. They will also check your blood pressure, cholesterol, kidneys, eyes, and feet over time.

Treatment

Treatment aims to keep your blood glucose in a safe range and reduce the risk of long-term problems. Your plan may include healthy eating, activity, glucose monitoring, and medicines. Insulin is used when your body needs more insulin than it can make. Your team will tailor the plan to your type of diabetes, age, health, and daily life.

Self-care at home

• Follow your agreed monitoring plan and write down results if asked
• Learn the signs of low and high blood glucose and what to do
• Keep a sick-day plan and ask your team what to do when you are ill
• Check your feet daily and seek help early for any wound or redness
• Carry ID or wear a medical alert item that says you have diabetes
• If you use insulin, keep a fast-acting sugar source with you as advised by your team
• Attend regular reviews for eyes, kidneys, feet, blood pressure, and cholesterol

Medical treatments

Treatment may include insulin given by injection or pump, other glucose-lowering medicines, and medicines for blood pressure and cholesterol. Your team will choose what is suitable and adjust it over time. Never change or stop insulin without medical advice — in type 1 diabetes, stopping insulin can be very dangerous. Ask your clinician or pharmacist to explain any treatment in plain words.

When is surgery considered?

Surgery is not a routine cure for diabetes. Some people with type 2 diabetes and obesity may be offered weight-loss (metabolic) surgery by a specialist team. Any surgery or illness can affect blood glucose, so you will be given a plan for adjusting treatment around procedures.

Living with this condition

Living with diabetes often means building routines: taking medicines as agreed, checking glucose when advised, eating regular meals, staying active, and keeping appointments. Plan ahead for travel, work, and sick days. A diabetes team can help you make the plan fit your life.

Lifestyle tips

• Eat regular meals and choose foods that suit your culture, budget, and preferences
• Move more in ways you enjoy, such as walking, gardening, or home workouts
• Aim for consistent sleep and manage stress where possible
• Avoid smoking and limit alcohol as advised
• Keep up with routine checks for eyes, feet, kidneys, and heart health

Diet and exercise

There is no single perfect diabetes diet. A balanced way of eating with plenty of vegetables, fibre, and regular meals works well for many people. Activity helps your body use insulin better. Start gently and ask your team what is safe for you, especially if you use insulin or have other health conditions.

Mental health and emotional wellbeing

Diabetes can feel like a lot to manage. It is common to feel worried, tired, or frustrated, and some people develop low mood or diabetes distress. These feelings matter and help is available. If you feel unsafe or in crisis, contact your local emergency services or a crisis support service in your area.

Prevention

Type 1 diabetes cannot currently be prevented. Type 2 diabetes can often be delayed or prevented with healthy eating, regular activity, and weight support where needed. Gestational diabetes usually goes away after birth, but it raises the risk of type 2 diabetes later, so follow-up checks matter.

Vaccines

Recommended vaccines vary by country and age. People with diabetes are often advised to keep up with routine vaccines, including flu vaccines where offered. Ask your clinician or pharmacist what is right for you.

Screening programmes

Regular checks can find problems early. These may include blood glucose tests, eye checks, kidney tests, foot checks, and blood pressure and cholesterol checks. Screening for gestational diabetes is offered in pregnancy in many health systems.

Complications

If left untreated

• Very high blood glucose can lead to serious emergencies, such as diabetic ketoacidosis or severe dehydration
• Very low blood glucose from insulin can cause confusion, seizures, or passing out if not treated
• Long-term high glucose can damage nerves, leading to numbness or pain
• It can damage the kidneys and eyes
• It raises the risk of heart attack and stroke
• It can cause foot ulcers and infections, which may become serious

Long-term outlook

With support and regular care, many people with diabetes live long, full lives. Modern monitoring, insulin, and education help people manage safely. Small steps matter, and your plan can change as your needs change.

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