diabetes follow up care

Overview

Diabetes is a condition that affects how your body manages sugar (glucose) in the blood. Diabetes follow-up care is the regular check-up, monitoring, education and treatment review you receive after being diagnosed. It helps you keep blood sugar levels as close to target as possible, prevent problems, and adapt your plan as your life and body change.

Diabetes is very common. More than 1 in 10 adults worldwide live with diabetes, and the number is rising. It is one of the most common conditions managed in long-term care.

Diabetes affects people of all ages. Type 1 diabetes is often diagnosed in children and young adults, while type 2 diabetes usually appears later in life, although it is increasingly seen in younger people. It is more common in people who have a family history, are above a healthy weight, or are over the age of 40 (or younger in some ethnic groups).

Symptoms

Common symptoms

• Feeling much thirstier than usual
• Urinating more often, especially at night
• Feeling very tired or lacking energy
• Blurred vision
• Cuts or wounds that heal slowly
• Losing weight without trying

Symptoms in children

• Wetting the bed after having been dry at night
• Extreme thirst and constant hunger
• Tiredness, irritability or mood changes
• Weight loss or poor weight gain
• Breath that smells sweet or fruity

Symptoms in older adults

• Increased confusion, drowsiness or changes in behaviour
• Falls, dizziness or feeling weak
• Difficulty doing everyday tasks due to tiredness
• More frequent or slow-healing infections, especially urinary or skin infections
• Dry mouth, dehydration or ongoing thirst

Causes

Main causes

• Diabetes occurs when the body does not make enough of the hormone insulin, or cannot use insulin effectively. Insulin moves sugar from the blood into cells for energy. When this is disrupted, sugar builds up in the blood.
• Type 1 diabetes is an autoimmune condition where the body attacks the cells that make insulin.
• Type 2 diabetes develops when the body becomes resistant to insulin and, over time, does not produce enough.
• Some other forms of diabetes can be caused by pregnancy, certain medicines, illness, or damage to the pancreas.

Risk factors

• Having a close family member with diabetes
• Being above a healthy weight or carrying extra weight around the waist
• Being physically inactive
• Getting older — especially over 40, or over 25 in some South Asian, Black African and Caribbean populations
• Having high blood pressure, high cholesterol, or polycystic ovary syndrome (PCOS)
• Having had diabetes during pregnancy (gestational diabetes) or having given birth to a large baby

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.
• If you have vomiting or diarrhoea and cannot keep fluids down, contact your care team the same day.
• If you have a foot wound, blister, bruise or dark patch, especially if it is warm, painful or smelly, get same-day medical help.

Book a routine appointment if:

• At least every 3 to 6 months for blood tests (such as HbA1c), blood pressure, weight and medication review
• At least once a year for a full foot check, eye test, kidney function test and cholesterol test
• Whenever you need a repeat prescription, ask for a review of your medicines at the same time
• Before planning pregnancy, or as soon as you know you are pregnant

Diagnosis

A healthcare professional diagnoses diabetes through blood tests that measure the amount of sugar in your blood. If a result is high, the test is usually repeated on another day to confirm the diagnosis, unless symptoms are severe.

Tests that may be done

• HbA1c test — measures your average blood sugar over the past 2 to 3 months
• Fasting plasma glucose — a blood sugar test after not eating or drinking overnight
• Oral glucose tolerance test — blood sugar checked before and 2 hours after a sugary drink
• Random blood glucose — a blood sugar test taken at any time of day

What to expect at your appointment

Diagnosis is usually made by a doctor or nurse with a simple blood test. You may need to fast beforehand. After diagnosis, you will be given clear instructions, learning materials and a follow-up plan. You will likely meet a diabetes specialist team, including a doctor, nurse, dietitian and sometimes a pharmacist or podiatrist.

Treatment

Diabetes treatment focuses on keeping blood sugar, blood pressure and cholesterol in a healthy range. Your follow-up plan will become more personal over time, based on how well your treatment is working and how your needs change.

Self-care at home

• Check your blood sugar at home as often as your team advises
• Take your medicines at the times prescribed and do not stop or change them without talking to your team
• Check your feet daily for cuts, blisters, redness, swelling or nail problems
• Attend every scheduled follow-up appointment and bring your blood sugar diary if you keep one
• Ask for help if you are struggling with diet, exercise, costs or mental health

Medical treatments

Your healthcare team may prescribe medicines to lower blood sugar. These can be tablets, liquids, or injectable medicines. Some people also take an injectable hormone to help control blood sugar. The right choice depends on your type of diabetes, kidney function, weight, other health conditions, and personal preference. Your team will review and adjust your treatment regularly at follow-up visits. Never change or stop your medicines without medical advice.

When is surgery considered?

Surgery is not part of routine diabetes care. However, if you develop a serious complication such as an infection or a foot wound that does not heal, a specialist may discuss surgery to protect the limb or improve your health. If you are planning any surgery, tell your diabetes team so they can help you prepare.

Living with this condition

Living with diabetes is a daily balancing act, but routine makes it easier. It helps to keep regular meal times, stay active, take medicines consistently, and bring your blood sugar meter and any medicines when you travel. Over time, checking blood sugar, eating well and caring for your feet become natural parts of your day.

Lifestyle tips

• Move your body regularly — walking, swimming, cycling and everyday tasks all count
• Eat regular meals and include vegetables, whole grains, lean protein and healthy fats
• Drink plenty of water and limit sugary drinks
• Get good sleep and find healthy ways to manage stress
• Limit alcohol and do not smoke
• Take care of your feet and teeth — both can be affected by high blood sugar

Diet and exercise

You do not need a special separate meal. A balanced diet — with plenty of vegetables, whole grains, beans, nuts, fish, lean meat and fruit in sensible amounts — works well for most people with diabetes. Try to keep meals consistent and avoid large amounts of food at one sitting. Aim for about 30 minutes of moderate activity most days. If you are overweight, losing 5% to 10% of your body weight can make a meaningful difference to blood sugar and blood pressure.

Mental health and emotional wellbeing

Diabetes can feel overwhelming, and many people experience stress, diabetes burnout, guilt or depression at some point. These feelings are common and treatable. Talk to your GP, diabetes nurse, or a mental health professional. You do not have to cope alone, and asking for support is a sign of strength, not weakness.

Prevention

Type 1 diabetes cannot be prevented. Type 2 diabetes can often be delayed or prevented by keeping a healthy weight, moving more, eating a balanced diet and avoiding smoking. If you already have diabetes, good follow-up care and reaching your treatment targets are the most powerful way to prevent complications and protect your long-term health.

Vaccines

People with diabetes have a higher risk of complications from infections. Stay up to date with recommended vaccines, including the flu vaccine, pneumococcal vaccine and any other vaccines your local health service advises. Ask your pharmacist, GP or local clinic about what is available to you.

Screening programmes

Screening is built into diabetes follow-up. Regular checks include HbA1c blood tests, blood pressure checks, urine and blood tests for kidney function, annual eye examinations with dilated pupils to check for damage, and foot screening to check nerve feeling and circulation. Tell your care team if you notice any changes in vision, feet, skin, urination or energy.

Complications

If left untreated

• Damage to blood vessels and nerves, leading to heart attack, stroke or poor circulation
• Kidney disease, which can progress to kidney failure
• Eye damage, including diabetic retinopathy, which can affect vision
• Nerve damage, causing pain, tingling, numbness or loss of feeling, especially in the feet
• Foot ulcers and infections that can, in severe cases, lead to amputation
• Higher risk of gum disease and dental infections

Long-term outlook

With regular follow-up, most people with diabetes can live long, full and active lives. Reaching your individual targets for blood sugar, blood pressure and cholesterol significantly lowers the risk of complications. Diabetes is serious, but it is manageable. Your outlook often depends less on perfect numbers and more on staying engaged with your care team, learning about your condition, and taking small consistent steps every day.

Find support

International organisations

• International Diabetes Federation ↗

Local organisations

• Diabetes UK ↗ · United Kingdom

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