diabetes self care basics

Overview

Diabetes is a condition where your body cannot keep your blood sugar (glucose) at a healthy level. Glucose is the main energy source for your body's cells. In diabetes, glucose builds up in the blood because the body either doesn't make enough insulin, or can't use insulin well. Insulin is a hormone that helps glucose enter cells. Over time, high blood sugar can cause problems.

Yes. Diabetes is one of the most common long-term conditions in the world. In the UK, for example, more than 4 million people have the condition, and many more are at risk.

Diabetes can affect people of all ages and backgrounds. Type 1 diabetes often starts in childhood or young adulthood. Type 2 diabetes is more common in adults, especially those who are overweight or have a family history, although it is increasingly seen in younger people. Gestational diabetes happens during pregnancy.

Symptoms

Common symptoms

• Feeling very thirsty
• Urinating more often than usual
• Feeling tired and weak
• Blurred vision
• Losing weight without trying
• Slow-healing cuts and bruises
• Numbness or tingling in hands or feet

Symptoms in children

• Bedwetting after they have been dry at night
• Feeling very thirsty and drinking more than usual
• Weight loss despite normal or increased appetite
• Lack of energy and mood changes

Symptoms in older adults

• Feeling confused or unusually sleepy
• Numbness or pain in the legs
• Recurrent infections, such as urinary tract infections
• Blurred vision
• Feeling dizzy when standing up

Causes

Main causes

• Type 1 diabetes: The body's immune system attacks the cells in the pancreas that make insulin. The exact cause is still unknown.
• Type 2 diabetes: The body becomes resistant to insulin, or the pancreas stops making enough insulin. This is linked to genes and lifestyle factors.
• Gestational diabetes: Hormones during pregnancy can make the body less responsive to insulin.

Risk factors

• Being overweight, especially around the waist
• A parent, brother, or sister with type 2 diabetes
• Being age 40 or older (for type 2 diabetes)
• Being from a South Asian, Black African, or Caribbean family (these groups are at higher risk)
• High blood pressure or high cholesterol
• Having had gestational diabetes before
• Not being physically active

When to see a doctor

See a doctor urgently if:

• If you have symptoms of very high blood sugar (extreme thirst, frequent urination, feeling sick) and can't bring levels down
• If you have repeated episodes of low blood sugar (hypoglycaemia) despite following your care plan
• If you have signs of an infection, such as a high temperature, chills, or a red, hot, painful area on your foot

Book a routine appointment if:

• If you feel your blood sugar is often out of target range, even if you have no severe symptoms
• For your regular diabetes check-ups (foot, eye, kidney, and blood pressure checks)
• If you have numbness or tingling in your feet, changes in your vision, or chest pain

Diagnosis

A doctor diagnoses diabetes using blood tests. They measure your blood sugar (glucose) levels to see if they are too high. There is no need to be afraid: the tests are quick and simple.

Tests that may be done

• Fasting blood sugar test: measures your blood glucose after you have not eaten for at least 8 hours.
• HbA1c test: gives an average of your blood sugar levels over the past 2 to 3 months.
• Oral glucose tolerance test: checks how your body handles a sugary drink over a couple of hours.
• Random blood sugar test: a blood sample taken at any time, regardless of when you last ate.

What to expect at your appointment

If your test results show diabetes, your doctor will talk about treatment and support. You may be referred to a diabetes education programme. The goal is to help you manage your blood sugar, feel well, and reduce the risk of complications.

Treatment

Treatment for diabetes is about keeping blood sugar as close to a healthy target as possible. For type 1 diabetes, you will need insulin every day. For type 2 diabetes, lifestyle changes can make a big difference, and you may also need medicines. Treatment is personalised to your needs, so always talk to your doctor before making any changes.

Self-care at home

• Monitor your blood sugar regularly as advised by your team and keep a record.
• Take your medicines or insulin exactly as prescribed – never skip a dose without talking to your doctor.
• Check your feet daily for cuts, blisters, or red spots.
• Keep your diabetes review appointments, including eye checks and foot checks.
• Carry a supply of fast-acting glucose (like glucose sweets or a sugary drink) in case of low blood sugar – as recommended by your team.
• Wear a medical ID or carry a card that says you have diabetes.

Medical treatments

Medical treatment may include tablets that help lower blood sugar, injectable medicines that help your body use insulin better, or insulin therapy using a syringe, pen, or pump. Some people also need medicines to control blood pressure and cholesterol. Your doctor will decide the best plan for your type of diabetes. Never change or stop your medicine without speaking to your healthcare team.

When is surgery considered?

Surgery is not a standard treatment for diabetes. However, for some people with severe obesity and type 2 diabetes, weight-loss surgery (bariatric surgery) may be offered. This can sometimes lead to much better blood sugar control, but it is not a 'cure' and is not right for everyone.

Living with this condition

Living with diabetes means paying attention to what you eat, staying active, checking your blood sugar, and taking medicines as directed. It might feel overwhelming at first, but many people find a routine that works for them. Your healthcare team will help you set realistic goals and adjust your plan when needed.

Lifestyle tips

• Eat regular meals and don't skip breakfast – this helps keep blood sugar steady.
• Choose foods with fibre, like whole grains, beans, and vegetables.
• Limit sugary drinks and processed snacks.
• Aim for at least 150 minutes of activity a week, like walking, cycling, or swimming. Check with your team if you have other health issues.
• Sleep matters – getting enough rest helps with blood sugar control.
• If you smoke, ask for support to quit. Smoking raises the risk of complications.

Diet and exercise

A balanced diet for diabetes is very similar to what everyone should eat: lots of fruit and vegetables, whole grains, lean protein (like fish, poultry, and beans), and healthy fats like olive oil and nuts. Physical activity helps insulin work better and lowers blood sugar. You don't need to run a marathon – just being active for 30 minutes a day, in chunks if easier, can help. Always carry a small snack if you take medicine that can cause low blood sugar.

Mental health and emotional wellbeing

Living with a long-term condition can sometimes feel heavy. You may feel worried, stressed, or down. These feelings are common. Unmanaged stress can also raise blood sugar, so it is worth finding ways to relax, like deep breathing, talking to a friend, or doing something you enjoy. If low mood or anxiety lasts for more than a couple of weeks, speak to your doctor. In a crisis, contact your local emergency number or crisis support line.

Prevention

Type 1 diabetes cannot be prevented. Type 2 diabetes can be prevented or delayed in many people by keeping a healthy weight, being physically active, eating a balanced diet, and not smoking. If you are at high risk, your doctor can give specific advice.

Vaccines

People with diabetes are advised to get the flu vaccine, the pneumonia vaccine, and other vaccines that your doctor recommends. Diabetes can make it harder to fight off infections, and infections can raise blood sugar. Ask your doctor or pharmacist about annual flu vaccination.

Screening programmes

If you have diabetes, regular screening is important to catch complications early. This includes an eye examination (using a special camera) every year, a foot check at your diabetes review, a kidney function blood and urine test, and blood pressure checks. Talk to your doctor about when your next check is due.

Complications

If left untreated

• High blood sugar over time can damage blood vessels and nerves, increasing the risk of heart attack and stroke.
• Eye damage (diabetic retinopathy) can lead to vision loss.
• Kidney damage can lead to kidney failure needing dialysis or transplant.
• Nerve damage can cause pain, numbness, and foot ulcers that may become infected. In severe cases, amputation may be needed.
• Poor blood flow to the feet and skin can delay healing of cuts and wounds.

Long-term outlook

A diagnosis of diabetes is not a life sentence the way it used to be. With good self-care, there is strong hope. Many people with diabetes live into their 70s, 80s, and beyond. The key is to keep blood sugar, blood pressure, and cholesterol in a healthy range, and to attend regular check-ups. Every step you take toward better control makes a difference. You are not alone, and your healthcare team is there to help you.

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