Diabetes (or diabetes mellitus to give it its full name) is a lifelong condition that causes blood sugar levels (or glucose) to be too high.

There are two main types of diabetes:

Type 1 – where the body’s immune system attacks and destroys the cells that produce insulin. People diagnosed with this will need insulin injections for the rest of their lives. Type 1 diabetes can develop quickly over weeks or even days.

Type 2 – where the body doesn’t produce enough insulin, or the body’s cells don’t react to it. Controlled by diet and exercise mainly, some people may also have to take tablets and in rare cases, insulin. Many people have type 2 diabetes for years without realising because the early symptoms tend to be so general.

Type 2 diabetes is far more common than type 1, accounting for 90% of cases in the UK. And whilst type 2 is often preventable and lifestyle choices can improve it, type 1 isn’t as it’s an autoimmune disease which typically appears in childhood or early adulthood.

So what’s the relationship between insulin and glucose?

Glucose is needed by the body for energy and to function. It comes from carbohydrates like bread and potatoes which are broken down or ‘digested’ into glucose which enters the blood stream. Insulin then moves glucose out of the blood and into cells, where it’s broken down to produce energy.

In people with diabetes, the body isn’t able to break down glucose into energy because there’s either not enough insulin, or the insulin produced doesn’t work properly.


Symptoms occur because of some or all of the glucose staying in the blood, instead of being used as fuel for energy. The body tries to reduce blood glucose levels by flushing the excess glucose out of the body in the urine, so the first symptoms can be peeing a lot or excessive thirst. Other symptoms are:

  • feeling very tired
  • weight loss and loss of muscle bulk
  • itching around the penis or vagina, or frequent episodes of thrush (caused by high levels of glucose being a perfect breeding ground for the fungal infection which causes it).
  • cuts or wounds that heal slowly
  • blurred vision


Both types of diabetes can increase the risk of getting other health problems which may not start immediately, but constant high blood glucose levels can lead to:

  • heart disease and stroke
  • foot and circulation problems
  • sight problems and blindness
  • pain and loss of feeling (nerve damage)
  • kidney problems

The other 2 main complications of diabetes are Hypoglycaemia (hypos or low blood sugar levels) and Hyperglycaemia (high blood sugar levels).

A hypo happens when the blood glucose level is too low, usually measured as being below 4mmol/L.

It happens if:

  • not enough food/fuel is eaten – particularly carbohydrate
  • too much exercise is done without having enough carbohydrate or reducing the insulin dose
  • too much insulin is taken
  • drinking alcohol on an empty stomach

Hypos can come on really quickly and fast treatment is essential as left untreated, the blood sugar level will continue to drop and it can be fatal.

The most common signs are:

  • sweating
  • being anxious or irritable
  • feeling hungry
  • difficulty concentrating
  • blurred sight
  • trembling and feeling shaky

Treating a hypo

  • 3 dextrose or glucose sweets
  • 5 small sweets, like jelly babies
  • 1 glass of non-diet sugary drink (a mini can of cola is ideal)
  • 1 glass of fruit juice

Try not to eat:

  • sugary foods that contain fat, like chocolate or cake (they don’t work as well)
  • too much – or your glucose levels will go too high

Emergency hypo treatment

Some people keep ‘glucagon’ at home in case of an emergency. An injection of glucagon releases glucose which is stored in the liver into the bloodstream. People prone to hypos, or those who have a history of not responding to glucose quickly enough should train their family and friends how to administer it in case of emergencies. If someone hasn’t come round within 10 minutes of the glucagon injection, an ambulance should be called.

Hyperglycaemia (hyper) is when blood glucose levels are too high, it’s can be caused by:

  • stress
  • being generally unwell
  • being less active
  • not having enough insulin for the carbohydrate that’s been eaten

Help should be sought if there is:

  • extreme thirst
  • much more peeing than normal
  • extreme tiredness
  • extreme weight loss
  • blurred vision
  • have fruity-smelling breath (like pear drops)

Very high blood sugar levels can lead to a serious problem called diabetic ketoacidosis (DKA) where the body starts to break down fat for energy when there’s not enough insulin, leading to a build-up of acid (ketones) in the blood. It can be life threatening and hospital treatmetn should be sought.


Although there are no lifestyle changes you can make to lower your risk or improve type 1 diabetes, people with type 2 diabetes can make their diabetes much better, and in some cases pretty much disappear with a few simple choices. Type 2 is mainly associated with being overweight, and so whilst avoiding being overweight can lessen the chances of getting it, even after diagnosis, significant weight loss can reverse it.

A recent trial in Scotland and the North East of England put people on a radical diet of 850 calories a day for 3 to 5 months, followed by a 2- to 8-week period where calorie intake is slowly increased. At the end of the trail period, half of them effectively ‘cured’ their diabetes and had normal blood glucose levels. Healthy eating and exercise have also been shown to help, especially if weight loss can be maintained.

But with the right lifestyle, treatment and care, most people can live a healthy life by respecting their diabetic status.

For more information visit: https://www.diabetes.org.uk/

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