diabetes overview for patients

Overview

Diabetes is a condition where the amount of glucose (sugar) in your blood is too high. Glucose is the body's main fuel, and the hormone insulin helps glucose enter your cells. In diabetes, the body either doesn't make enough insulin, or it can't use insulin properly. As a result, glucose builds up in the blood instead of being used for energy.

Yes, diabetes is very common. Millions of people around the world live with diabetes. It is one of the most frequently diagnosed long-term health conditions.

Diabetes can affect people of any age, gender, or background. Type 1 diabetes most often starts in children and young adults. Type 2 diabetes is more common in adults over 40, but it is increasingly seen in younger people too.

Symptoms

Common symptoms

• Being very thirsty
• Having to urinate a lot, especially at night
• Feeling very tired
• Losing weight without trying
• Blurred vision
• Cuts or sores that heal slowly

Symptoms in children

• The same common symptoms may appear suddenly, including increased thirst and frequent urination.
• A child may start wetting the bed again after being dry.
• They may seem more tired or irritable than usual.

Symptoms in older adults

• Symptoms can be less obvious and may develop slowly.
• An older adult might feel confused or unusually sleepy.
• They may have frequent infections, such as urinary tract infections, or slow-healing sores.

Causes

Main causes

• Type 1 diabetes happens when the body's immune system attacks the cells that make insulin. The exact cause is not fully known.
• Type 2 diabetes happens when the body does not make enough insulin or can no longer use insulin properly.
• Gestational diabetes occurs during pregnancy and usually improves after the baby is born, though it increases risk for type 2 later.

Risk factors

• Family history of diabetes
• Being overweight or having excess fat around the waist
• Being physically inactive
• High blood pressure or high cholesterol
• Being older (especially for type 2 diabetes)
• For gestational diabetes: having a family history, being overweight, or having had gestational diabetes before

When to see a doctor

See a doctor urgently if:

• If you have emergency symptoms such as confusion, severe weakness, or fruity-smelling breath, call your local emergency number immediately.
• If you are already diagnosed and have very high or very low blood sugar readings with symptoms, contact your diabetes team or seek urgent care.

Book a routine appointment if:

• If you have any of the common symptoms listed above, make an appointment with your GP (doctor).
• If you have a family history of diabetes or other risk factors, ask about testing during a routine check-up.
• If you are pregnant, you should be offered screening for gestational diabetes by your maternity team.

Diagnosis

Diabetes is diagnosed with a simple blood test that measures your blood glucose level. Your doctor will usually take a sample of blood from your arm. Sometimes the blood test is done after you have been fasting (not eating or drinking anything except water) for at least eight hours. In some cases, a urine test may also be used to check for sugar, but a blood test is the standard way to confirm the diagnosis.

Tests that may be done

• Fasting blood glucose test: measures your blood sugar level after fasting.
• HbA1c test: shows your average blood sugar level over the past two to three months.
• Oral glucose tolerance test: used for gestational diabetes and sometimes for type 2. You drink a sweet glucose drink, and your blood is checked over a few hours.
• Random blood glucose test: can be used if you have severe symptoms and need a quick result.

What to expect at your appointment

If you are being tested for diabetes, the test itself is quick and simple — just a blood sample. After the test, your healthcare provider will talk through your results with you. If you are diagnosed, they will explain what the diagnosis means, what type of diabetes you have, and the next steps for treatment and support. You are not alone: a whole team of nurses, dietitians, and doctors can help you.

Treatment

Treatment for diabetes aims to keep your blood sugar levels as close to the normal range as possible. The exact treatment depends on the type of diabetes, your health, and your lifestyle. A diabetes specialist or nurse will work with you to create a plan that fits you. Treatment usually involves making healthy lifestyle changes and, for many people, taking medicines. All options will be discussed fully with your healthcare team.

Self-care at home

• Monitor your blood sugar if your healthcare team advises it — they will teach you how.
• Take all prescribed medication exactly as your doctor advises.
• Eat regular meals with balanced portions of carbohydrates, proteins, and vegetables.
• Stay physically active most days of the week — even a short walk helps.
• Check your feet daily for any cuts, blisters, or red spots.
• Attend regular eye, foot, and kidney screening appointments.

Medical treatments

Medical treatment for diabetes includes different groups of medicines, such as tablets that help the body use insulin better or reduce sugar production, and insulin injections that replace the insulin the body cannot produce. Some newer injectable medicines may also be used for certain types of diabetes, often with diet and exercise. The choice of medication is individual, and your doctor will explain the reasons for your particular plan. In emergency situations, some people need prompt intravenous fluids and insulin, which is given in a hospital setting.

When is surgery considered?

Surgery is not a standard treatment for most types of diabetes. For a small number of people with type 2 diabetes and very high obesity, weight-loss (bariatric) surgery may be offered as part of specialist care. Pancreas or islet transplantation is rare and only considered for complex cases. Your healthcare team will tell you if any surgical option is relevant for you — it is not a common decision.

Living with this condition

Day-to-day life with diabetes requires some awareness, but it becomes a routine. You may need to check your blood sugar, take medication, and think more carefully about food and activity. Many people use a diary or an app to keep track. Your diabetes team will teach you how to adjust for exercise, sickness, and travel. Over time, you will learn what works best for your body.

Lifestyle tips

• Eat a balanced diet with whole grains, lean proteins, vegetables, fruits, and healthy fats.
• Limit sugary drinks, sweets, and highly processed foods.
• Aim for at least 150 minutes of moderate activity, like brisk walking, each week — but start slowly if you are new.
• Keep a healthy weight, or aim for small weight loss if you are overweight.
• Stop smoking, if you smoke.
• Limit alcohol, and never drink on an empty stomach if you take certain diabetes medicines.

Diet and exercise

Diet and exercise are central to diabetes management. Eating regular meals with a consistent amount of carbohydrates can help keep blood sugar steady. Choose high-fibre foods like beans, lentils, oats, and whole grains. Exercise helps your body use insulin more effectively, which lowers blood sugar. Always carry a fast-acting carbohydrate (like a small juice box or glucose tablets) in case your blood sugar goes too low during activity. Your healthcare team or a dietitian can give you personalised advice.

Mental health and emotional wellbeing

Living with diabetes can sometimes feel stressful, frustrating, or overwhelming. It is normal to feel this way. The constant self-care can be tiring. Talk to your doctor or diabetes nurse if you feel down or anxious. They can offer support, including counselling if needed. You are not weak for needing help — mental health is just as important as physical health.

Prevention

Type 1 diabetes cannot be prevented — no lifestyle choice can change the immune system's response. Type 2 diabetes, however, can often be prevented or delayed. Even if you have risk factors, healthy eating, regular physical activity, and maintaining a healthy weight can greatly reduce your chances of developing type 2 diabetes. Gestational diabetes may also be less likely if you stay active and eat well during pregnancy, but some risk factors are outside your control.

Vaccines

There is no vaccine that prevents diabetes itself. However, people with diabetes are recommended to have certain routine vaccines, like the flu vaccine and other immunisations, because high blood sugar can make infections harder to fight. Ask your doctor or pharmacist which vaccinations are recommended for you.

Screening programmes

Screening for diabetes is routine in many healthcare systems, especially if you have risk factors such as high blood pressure, a family history, or being overweight. Your GP or local health service may offer a blood test during a health check-up. If you are pregnant, you will usually be offered gestational diabetes screening between 24 and 28 weeks.

Complications

If left untreated

• High blood sugar over many years can damage blood vessels and nerves.
• It can lead to heart disease, stroke, and kidney problems.
• It can cause vision loss due to damage to the retina of the eye.
• It can lead to foot ulcers and, in very severe cases, amputation if infections are not treated.
• Severe high blood sugar can cause a dangerous condition called diabetic ketoacidosis (DKA) — a medical emergency.

Long-term outlook

With good care and daily management, people with diabetes can live long and full lives. Modern treatments, regular check-ups, and healthy habits are very effective at preventing or delaying complications. Many people successfully manage diabetes for decades without major problems. The key is to stay in touch with your healthcare team and take part in your own care. There are always new treatments and technologies being developed. Looking after your blood sugar is the most powerful thing you can do — and it is never too late to start.

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