Living with diabetes

Overview

Diabetes is a long-term condition that affects how your body uses energy from food. When you eat, your body breaks down carbohydrates into glucose (blood sugar), which enters your bloodstream. A hormone called insulin, made by the pancreas, helps glucose get into your cells for energy. In diabetes, your body either doesn't make enough insulin, or can't use it properly, so glucose builds up in your blood to unhealthy levels.

Yes. Diabetes affects millions of people worldwide. In the UK, around 4 million people have a diabetes diagnosis, and many more are at risk.

Diabetes can affect people of all ages. Type 1 is often diagnosed in children and young adults. Type 2 is more common in people over 40, those living with overweight, and people with a family history. Gestational diabetes can occur during pregnancy.

Symptoms

Common symptoms

• Feeling very thirsty
• Urinating more often, especially at night
• Feeling very tired
• Blurred vision
• Slow-healing cuts or sores
• Tingling, burning, or numbness in the hands or feet

Symptoms in children

• Extreme thirst and dry mouth
• Bedwetting (if they were previously dry at night)
• Losing weight without trying
• Being very tired or irritable
• Fruity-smelling breath (a warning sign that needs urgent care)

Symptoms in older adults

• More frequent urination, including at night
• Feeling unusually tired or weak
• Confusion or memory problems
• Blurry vision
• Infections that heal slowly or you get ill often

Causes

Main causes

• Type 1 diabetes is an autoimmune condition where the immune system mistakenly attacks the cells in the pancreas that make insulin.
• Type 2 diabetes develops when the body's cells stop responding to insulin properly (insulin resistance) and the pancreas cannot make enough insulin to keep blood sugar stable.
• Gestational diabetes happens during pregnancy due to hormonal changes that make cells more resistant to insulin.

Risk factors

• A family history of diabetes
• Living with overweight or obesity
• Being over 40 years old
• Having high blood pressure or high cholesterol
• Being physically inactive
• Having had diabetes during a previous pregnancy

When to see a doctor

See a doctor urgently if:

• New or worsening symptoms like extreme thirst, frequent urination, or unexpected weight loss
• Blood sugar readings that are consistently above the target range your doctor gave you
• Signs of an infection, such as a fever, or redness around a cut, that does not improve quickly

Book a routine appointment if:

• A regular diabetes review (usually every 3–12 months) to check your A1C, blood pressure, cholesterol, feet, eyes, and kidneys
• A conversation with a diabetes educator or dietitian whenever you want help with meal planning or medication timings
• If you feel unsure about what to do when you are ill or when you are planning to travel

Diagnosis

Diabetes is diagnosed with a blood test. A nurse or phlebotomist takes a small sample of blood, usually from a vein in your arm. The test may be done after fasting (not eating for at least 8 hours) or at any time, depending on the reason.

Tests that may be done

• HbA1c test — reflects your average blood sugar over the past 2 to 3 months
• Fasting blood glucose test — measures sugar after an overnight fast
• Oral glucose tolerance test — compares blood sugar before and 2 hours after a sugary drink
• Random blood glucose test — a sample taken without fasting

What to expect at your appointment

The test itself is quick and painless. If the result is high enough, your doctor may ask you to repeat it on another day to confirm. After diagnosis, you will be offered appointments to learn about monitoring your blood sugar, taking medicines safely, and planning meals. You won't be left alone to figure it out.

Treatment

Treatment for diabetes is highly individualised. Your care plan will depend on the type of diabetes you have, your lifestyle, your preferences, and your other health conditions. The aim is to keep your blood sugar within a healthy range, protect your heart, kidneys, eyes, and feet, and help you feel your best.

Self-care at home

• Check your feet daily for blisters, cuts, red spots, or swelling — and report any changes to your foot care team.
• Take your medicines exactly as prescribed, even when you feel well.
• Learn to recognise your own signs of a high or low blood sugar and how to respond.
• Keep a sick-day plan ready for times when you have an infection or vomiting.
• Bring your glucose meter or record book to appointments so your team can see how things are going.

Medical treatments

Medical therapy may include tablets, non-insulin injectable medicines, or insulin replacement (given by injection or pump). Some medicines increase the amount of insulin the pancreas releases; others help the body use insulin more effectively or slow the release of sugar from the liver. Many people need a combination. A doctor will prescribe the safest and most appropriate treatment for you — never take diabetes medicines without professional advice.

When is surgery considered?

Surgery is not usually needed to treat diabetes itself. However, for some people with type 2 diabetes and severe obesity, weight-loss (bariatric) surgery may be considered as part of a wider management plan. This decision is made carefully with your specialist team and is never rushed.

Living with this condition

Living with diabetes means adding a few new habits to your daily routine, but you can still do everything you love. The key is to build a simple, sustainable plan: eat well, move regularly, take your medicines, and keep your check-up appointments. Over time, these routines become second nature.

Lifestyle tips

• Eat a wide variety of vegetables, fruit, whole grains, and lean proteins.
• Take at least 30 minutes of moderate activity like brisk walking on most days.
• Maintain a healthy weight, or aim to lose a little if advised by your healthcare professional.
• Keep a consistent schedule for meals and medicines to help stabilise blood sugar.
• Get enough sleep — poor sleep makes blood sugar harder to control.

Diet and exercise

There is no single 'diabetes diet'. The right approach is the same one recommended for everyone: lots of vegetables, whole grains, beans, fish, poultry, and healthy fats, with limited refined sugar and processed foods. Physical activity also helps your body use insulin better. Try to move for 30 minutes a day — even 10-minute walks after each meal can help. If you need personalised advice, a registered dietitian can design a plan that fits your preferences and budget.

Mental health and emotional wellbeing

It is completely normal to feel frustrated, anxious, or burned out by diabetes. This is sometimes called diabetes distress. Talk to your diabetes team, a counsellor, or someone you trust. If you ever feel overwhelmed to the point of having thoughts of self-harm, get help immediately — contact a crisis line or call your local emergency number. Your mental health is as important as your blood sugar.

Prevention

Type 1 diabetes cannot be prevented. Type 2 diabetes can often be prevented or delayed. Losing even 5–10% of your body weight (if you live with overweight), increasing physical activity, and following a balanced diet can lower your risk. In some cases, a doctor may also recommend a screening test to catch early warning signs before diabetes develops.

Vaccines

If you live with diabetes, staying up to date with recommended vaccinations is important because infections and illnesses can cause blood sugar to rise rapidly and lead to serious complications. This includes the annual flu vaccine and other standard immunisations. Ask your healthcare provider which ones are recommended for you.

Screening programmes

If you are at high risk — for example, with a family history of diabetes or high blood pressure — your healthcare provider may offer blood tests to detect prediabetes or undiagnosed diabetes. This simple blood test can make a big difference to your long-term health.

Complications

If left untreated

• Heart disease and stroke
• Kidney damage that can lead to kidney failure
• Nerve damage, especially in the feet and legs
• Foot ulcers and infections that may become serious
• Eye damage and vision loss

Long-term outlook

It's natural to worry about complications, but the future is not fixed. Many people with diabetes live long, active lives without serious complications. The key is consistent care: keep blood sugar, blood pressure, and cholesterol in a healthy range, see your healthcare team regularly, and ask for help early. Every step you take to care for yourself today is an investment in a better tomorrow.

Find support

International organisations

• International Diabetes Federation (IDF) ↗

Local organisations

• Diabetes UK ↗ · United Kingdom

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