It is different from type 1 and type 2 diabetes and is often under-recognised or misdiagnosed. Accurate diagnosis is important to ensure the right treatment and support.

What is Type 3c diabetes?

Type 3c diabetes occurs when the pancreas becomes damaged and can no longer produce enough insulin or digestive enzymes. Unlike type 1 diabetes, which is autoimmune, or type 2 diabetes, which is linked to insulin resistance, type 3c is secondary to a condition affecting the pancreas itself.

The pancreas has two main roles:

• Producing insulin and other hormones that regulate blood glucose
• Producing enzymes that help digest food

When it becomes inflamed, injured or partially removed, both of these functions can be disrupted.

Causes of Type 3c diabetes

The most common causes of Type 3c diabetes include:

• Chronic pancreatitis – long-term inflammation of the pancreas
• Pancreatic cancer
• Surgical removal of part or all of the pancreas (pancreatectomy)
• Cystic fibrosis
• Trauma to the pancreas
• Hereditary conditions such as haemochromatosis
• Autoimmune pancreatitis

In many cases, damage to the pancreas results in both diabetes and problems with digestion, such as malabsorption or weight loss.

Symptoms

The symptoms of type 3c diabetes are often similar to other forms of diabetes, but may also include signs of pancreatic insufficiency. Common symptoms include:

• Frequent urination
• Excessive thirst
• Fatigue
• Unexplained weight loss
• Blurred vision
• Abdominal pain
• Bloating or discomfort after meals
• Pale, greasy or foul-smelling stools (steatorrhoea)

These digestive issues occur because the pancreas is no longer producing enough enzymes to break down food properly.

Diagnosis

Type 3c diabetes is frequently misdiagnosed as type 2 diabetes, especially in people without obvious signs of pancreatic disease. A correct diagnosis is essential for effective management.

Diagnosis may involve:

• A thorough medical history, particularly noting any pancreatic conditions or surgery
• Blood tests to check glucose levels and HbA1c
• Pancreatic imaging (CT scan, MRI or ultrasound)
• Tests for pancreatic enzyme function, such as faecal elastase
• Screening for vitamin and nutrient deficiencies

One key difference is that people with type 3c diabetes often have low insulin levels and reduced pancreatic enzyme levels, whereas those with type 2 diabetes do not typically experience digestive problems.

Treatment

Treating type 3c diabetes requires a dual approach, as both blood sugar control and digestive health need to be managed.

Key aspects of treatment include:

• Insulin or other diabetes medications – to manage blood glucose levels
• Pancreatic enzyme replacement therapy (PERT) – to support digestion and nutrient absorption
• Nutritional support – often with the help of a dietitian to ensure a balanced diet and address deficiencies
• Vitamin supplementation – particularly fat-soluble vitamins (A, D, E and K)
• Regular monitoring – of blood glucose, weight and nutritional status
• A multidisciplinary team approach is often needed, involving endocrinologists, dietitians and gastroenterologists.

Living with Type 3c diabetes

Living with type 3c diabetes can be more complex than living with type 1 or type 2, due to the combination of digestive and glucose control challenges. However, with the right support, many people can manage their symptoms effectively and maintain a good quality of life.

Our platform offers:

• Access to expert advice on nutrition, medication and lifestyle changes
• Digital tools for logging meals, tracking blood sugars and monitoring symptoms
• Personalised coaching and support from qualified professionals
• Peer support from others living with diabetes

Type 3c diabetes is a lesser-known form of diabetes caused by damage to the pancreas which affects both insulin production and digestion, making diagnosis and management more complex.

If you or someone you care for has a history of pancreatic problems and has been diagnosed with diabetes, it is important to discuss the possibility of type 3c with your healthcare provider.

With the right care, support and education, people with type 3c diabetes can lead healthy and fulfilling lives.

• Support: Speak to other people with Type 3c diabetes

Type 1 diabetes is different to its more common counterpart,

type 2 diabetes

Whilst the major symptoms of diabetes are similar for type 1 and type 2, it is worth knowing the specific symptoms of type 1 diabetes as well as more

general diabetes symptoms

• Also see:
  
  Type 1 diabetes

The 4Ts – symptoms of type 1 diabetes

Some of the most noticeable and most common symptoms of type 1 diabetes are:

• 
  Excessive thirst
• 
  Unusually high levels of urination
• 
  Feeling tired all the time
• 
  Loss of muscular bulk and unexplained weight loss

The main symptoms of type 1 diabetes are often referred to as the

4Ts of type 1 diabetes

Other symptoms which may accompany the above symptoms are:

• 
  Itchiness around the penis or vagina
• 
  Blurring of vision
  (caused by dryness of the eyes)
• Unexpected cramping
• Skin infections

Emergency diabetes symptoms

Seek urgent medical attention if diabetes symptoms combine with any of the following:

• A serious loss of appetite
• Nausea and vomiting
• A temperature
• Pains in the stomach
• A fruity, chemical smell on the breath (most often likened to pear drops or nail varnish)

The symptoms above could be a sign of diabetic ketoacidosis (DKA), a dangerous condition that can be life threatening if medical treatment is not provided immediately.

Around 1 in 4 people diagnosed with type 1 diabetes are suffering with ketoacidosis at the time of diagnosis. Recognising the 4 main symptoms of type 1 diabetes can help to get a diagnosis before ketoacidosis sets in.

• Read more on
  
  ketoacidosis

Common symptoms of diabetes

Polydipsia

Polyuria

Polyphagia

Fatigue

Dizziness

Weight Loss

Blurred Vision

Slow Healing

Genital Itchiness

Nausea

How long does it take to develop type 1 symptoms?

The symptoms of type 1 diabetes in children and young adults tend to develop quickly over a few weeks or few days.

Type 1 diabetes is a dangerous condition if it is left untreated for too long. It is therefore important to seek a

diagnosis
from your doctor if you or your child is showing the symptoms of type 1 diabetes.

Type 1 diabetes can develop at any age. Adults may develop a specific form of type 1 diabetes known as

LADA (latent autoimmune diabetes of adulthood)

LADA tends to develop more slowly than type 1 diabetes in children and young adults and people with LADA may sometimes be misdiagnosed as having type 2 diabetes.

Can a blood glucose meter help to diagnose type 1 diabetes?

A blood glucose meter may be helpful in indicating whether you or a family member may have diabetes.

It is not essential to have a blood glucose meter but it may be considered useful in a family with a history of type 1 diabetes or autoimmune conditions.

A blood glucose result, taken over 2 hours after eating, of

over 7.8 mmol/l

could indicate a presence of diabetes.

If high results are being recorded 2 hours after eating for consecutive meals, contact your GP who will be able to carry out a

diagnosis

It is important that devices used to draw blood from fingers are not shared to prevent the risk of blood borne illnesses.

• See our guide on
  
  how to do a home blood glucose test
  
  
  

Type 2 diabetes symptoms will often develop gradually and may not always show symptoms at an earlier stage.

Type 2 diabetes symptoms can differ slightly from symptoms of

type 1 diabetes

Type 2 diabetes is a lifelong condition. Once

symptoms of diabetes
have developed into the condition, the body will then be unable to regulate the amount of glucose in the blood.

It is important to catch the symptoms as early as possible to limit damage to the body.

Although there are

3 main diabetes signs
shared by all people with diabetes, type 2 diabetes may sometimes exhibit some specific symptoms, such as certain skin disorders.

Symptoms of type 2 diabetes

Type 2 diabetes
often develops slowly, over a period of years, and the symptoms can therefore also develop gradually.

At diagnosis, people who have type 2 diabetes may show little or no symptoms of the condition.

Because the symptoms develop slowly, type 2 diabetes may commonly be diagnosed following routine medical examinations or screening tests for non-related conditions.

Symptoms of type 2 diabetes may include:

• 
  Feeling tired during the day, particularly after meals (fatigue)
• 
  Often feeling hungry, particularly if you feel hungry shortly after eating (polyphagia)
• 
  Urinating more often than normal, particular needing to do so during the night (polyuria)
• 
  Feeling abnormally thirsty (polydipsia)
• 
  Blurred vision
• 
  Itching of the skin, particularly itchiness around the genitals (genital itchiness)
• 
  Slow healing of cuts or wounds
• 
  Having regular yeast infections (thrush)
• Having a skin disorder such as psoriasis or
  
  acanthosis nigricans
• 
  Sudden weight loss or loss of muscle mass

Explore the most common symptoms of diabetes:

Common symptoms of diabetes

Polydipsia

Polyuria

Polyphagia

Fatigue

Dizziness

Weight Loss

Blurred Vision

Slow Healing

Genital Itchiness

Nausea

Spotting the symptoms of type 2 diabetes

The presence of type 2 diabetes prevents the body from being able to lower blood glucose levels as efficiently as in people without diabetes. For this reason, the symptoms of type 2 diabetes may be more noticeable following meals.

Measuring higher than normal levels of

blood pressure
or

cholesterol
may indicate a higher risk of type 2 diabetes, particularly if you are overweight and it is therefore wise to be aware of the symptoms of type 2 diabetes.

How long does it take for the symptoms of type 2 diabetes to develop?

Type 2 diabetes symptoms may be very minor for a long time, and suddenly become more serious.

This is why type 2 diabetes often goes unnoticed for many years. It is believed that

up to 850,000 adults could have type 2 diabetes and be unaware of it

It’s important not to disregard the symptoms of diabetes as being down to getting older.

Catching the symptoms early

It is important to catch the symptoms early so that the damage caused by type 2 damage is limited.

If type 2 diabetes is caught at a later stage, some of the

complications
may be present at diagnosis, such as:

• 
  Neuropathy
• 
  Retinopathy
• 
  Nephropathy

Type 2 diabetes can also lead to a significant loss of the cells in the pancreas that produce insulin. This is referred to beta cell turnover.

Catching and treating type 2 diabetes early can help to prevent a significant loss of insulin producing cells, which may help to prevent or delay a need to take

insulin injections.

Can I reverse type 2 diabetes?

The body is indeed able to ‘reverse’ or put type 2 diabetes into remission. This is acheived by reducing HbA1c to under the diagnosis threshold. However, unhealthy habits can cause this to relapse.

There are a number of major risk factors for

type 2 diabetes.
Although some diabetic risks come from our genetics,
many are preventable.

Unfortunately, many people do not know what these are or clearly understand
the signs of them. For this reason, below is a list
of top type 2 diabetes risk factors.

• Also see:
  
  the symptoms of diabetes

Obesity

Obesity is the major type 2 diabetes risk, with millions of people throughout the world facing obesity. Almost a quarter of adults in the UK are recorded as being obese.

Furthermore, the numbers continue to climb, both amongst adults and children.

The number of children being diagnosed with type 2 diabetes caused by obesity is climbing everywhere. In the UK, about one in three children are classed as obese.

• Read more on
  
  diabetes and obesity

Lack of exercise and sedentary way of life

Living a sedentary lifestyle without sufficient exercise is seriously damaging to health.

Being inactive often leads to being overweight, which can lead to pre-diabetes and type 2 diabetes.

Staying active
decreases insulin resistance and helps bodily insulin
to be more effective.

• Read more on
  
  diabetes and obesity

Eating a ‘Western’ diet

Eating unhealthily is a major cause of type 2 diabetes,
as over 90 per cent of type 2 diabetics are overweight.

A so called Western diet, with a reliance on processed foods, poor quality fats and little fibre content, is thought to be a major contributor to diabetes and

metabolic
syndrome

Eating
well, in conjunction with exercise, can prevent or reverse the development
of type 2 diabetes.

Picking a healthy diet can sometimes be confusing, with so many mixed messages, and its often not helped by so-called

diabetic food
which are not necessarily a healthier option.

High blood pressure

High cholesterol
and

blood pressure levels
are risks for many diseases, one of which is type 2 diabetes. Both are also major symptoms of

pre-diabetes

Gestational diabetes

Gestational diabetes
is another major risk, and affects about 2 to 5 per cent of women who fall pregnant.

Those women who suffer from it face greater later-life risks of developing type 2 diabetes, as do their children.

Family history

Having a close family member with type 2 diabetes can raise your own risk of developing the condition.

Unfortunately, you cannot do much about your genetic history, but you can be ready by being aware of the

symptoms of type 2 diabetes

Also, many ethnic minorities
are more prone to suffer from diabetes.

• For more on this, please read
  
  diabetes
  and ethnicity

Aging

As the population of the world ages, diabetes rates are soaring.

Unfortunately, the older we are, the greater the risk of developing type
2 diabetes is. The pancreas, according to some scientists, begins to produce
insulin less effectively as we age.

Furthermore, bodily resistance to insulin
increases with age.

Type 2 diabetes mellitus is a metabolic disorder that results in

hyperglycemia
(high blood glucose levels) due to the body:

• Being ineffective at using the insulin it has produced; also known as
  
  insulin resistance
  and/or
• Being unable to produce enough insulin

Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body.

From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison.

This is why people with diabetes are advised to avoid

sources of dietary sugar

The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need

long-term medication

Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide.

How serious is type 2 diabetes?

Type 2 diabetes is a serious medical condition that often requires the use of anti-diabetic medication, or

insulin
to keep blood sugar levels under control. However, the development of type 2 diabetes and its side effects (complications) can be prevented if detected and treated at an early stage.

In recent years, it has become apparent that many people with type 2 diabetes are able to

reverse diabetes
through methods including low-carb diets, very-low-calorie diets and exercise.

For guidance on healthy eating to improve blood glucose levels and weight and to fight back against insulin resistance, join the

Low Carb Program

Following

pre-diabetes
or

metabolic disorder, type 2 diabetes can potentially be avoided through

diet
and

exercise.

What causes type 2 diabetes?

Type 2 diabetes occurs when the hormone insulin is not used effectively by the cells in your body. Insulin is needed for cells to take in glucose (sugar) from the bloodstream and convert it into energy.

Ineffective use of insulin results in the body becoming resistant to insulin – also known as

insulin resistance, which in turn causes blood sugar levels to rise (

hyperglycemia
).

In advanced stages, type 2 diabetes may cause damage to insulin producing cells in the pancreas, leading to insufficient insulin production for your body’s needs.

Type 2 diabetes risk factors

A number of factors can increase the risk of developing type 2 diabetes.

These include:

• 
  Being overweight or obese
• 
  Having a waist size of 31.5 inches or more (women) or more than 37 inches (men)
• 
  Eating an unhealthy diet
• 
  Physical inactivity
• 
  Having a first-degree relative with type 2 diabetes
• 
  Having high blood pressure
  or raised
  
  cholesterol levels
• Being of
  
  South Asian
  and African-Caribbean descent
• 
  Smoking

The likelihood of developing type 2 diabetes is also influenced by genetics and environmental factors. For example, research shows that:

• If either parent has type 2 diabetes, the risk of inheritance of type 2 diabetes is 15%
  
  
  ^[1]
  
• If both parents have type 2 diabetes, the risk of inheritance is 75%
  
  
  ^[1]
  

Is there an age where I’m more at risk of type 2?

Type 2 diabetes used to be known as adult-onset diabetes as it was primarily seen in middle-aged adults over the age of 40.

However, in recent years, cases of type 2 diabetes have become more common in young adults, teens and children. This increase has been

connected to climbing levels of obesity

• See our guide on
  
  diabetes risk factors
  for more information.

Do you have to be overweight to get type 2 diabetes?

While being overweight is often associated with type 2 diabetes, someone who is a healthy weight can also be diagnosed with the condition

Often called ‘skinny’ type 2 diabetes, this condition can be found in individuals with low amounts of subcutaneous fat but high amounts of visceral or abdominal fat.

What is skinny type 2 diabetes?

The diagnosis experience of people with type 2 diabetes can vary quite significantly.

Some people are given a good introduction to what type 2 diabetes is and access to well run diabetes education courses.

However, we’re aware that some people newly diagnosed with type 2 diabetes have been given a prescription for tablets and been told to get on with it!

Our guide here provides important information as to what type 2 diabetes is and how you can get on top of the condition and start controlling it at an early stage.

What is type 2 diabetes?

Type 2 diabetes is a condition which develops if your body can no longer respond effectively enough to its own insulin to prevent your blood glucose levels from going too high.

The good news is that you can fight back against this and get your body to respond better to insulin.

Our

Low Carb Program
shows you how you can achieve this and, since we launched it in 2015, many thousands of people have improved their ability to control their diabetes.

Coming to terms with type 2 diabetes

Diabetes can be a tough condition to accept but the good news is that it is a condition which, with a bit of dedication, can be well controlled.

It’s fair to say that there are a good number of people with type 2 diabetes that have actually been pleased to have got a diagnosis of type 2 diabetes because it has explained why they were feeling less than well and has given them the chance to take achievable steps to feel better than they have in a long time.

The

Diabetes Forum
has thousands of posts from people with type 2 diabetes and there is no better place to find support and share your experiences.

• If you are finding the diagnosis of type 2 diabetes to be a shock, or are struggling to come to with your diagnosis, read our guide on
  
  accepting a diagnosis of diabetes

It is relatively common for people with diabetes to be also going through a period of depression.

Read more about coping with

diabetes and depression

Education to start controlling your diabetes

Knowledge is one of the best tools for managing diabetes. For this reason, there are a number of structured education courses that have been set up to help us understand and manage our diabetes.

In some cases, your GP may offer you the chance to enrol onto a structured education course whereas others may need to request their GP to enrol them onto a course. Note that availability of places on these courses may sometimes be limited depending on the level of demand and number of educators.

• Read more about
  
  structured diabetes education courses

For additional and immediate guidance, join our

Low Carb Program
which provides a step by step approach to diet that has made a huge difference to the many people that have followed the course.

Treatment for type 2 diabetes

The treatment options for type 2 diabetes can range from ‘lifestyle changes’ treatment to taking tablets or injections to help control the condition.

The type of treatment you receive can sometimes depend on how early diabetes has been diagnosed (the sooner the better) and how to resistant to insulin your body is.

It is common for your doctor to start you off on one treatment regimen and then you onto a different regimen depending on how well your blood sugar levels are responding.

Read more about treatment options for type 2 diabetes:

• 
  Lifestyle changes for type 2 diabetes
• 
  Metformin tablets
• 
  Insulin for type 2 diabetes

Diet and type 2 diabetes

Our diet is a key factor that affects our blood sugar levels and using diet changes to our advantage can be a good way of bringing type 2 diabetes under control.

If you are overweight, losing extra body weight can improve your body’s response to insulin and this helps to lower your blood sugar levels.

Read more of our diet and weight loss guides:

• 
  Type 2 diabetes and diet
• 
  Food tips
• 
  Using the plate method

Controlling type 2 diabetes

You will receive a blood test called an

HbA1c test
at regular intervals which will allow you and your doctors to review how well controlled your sugar levels are.

However, to get a detailed understanding of which factors and foods affect your blood sugar levels, and by how much,

home blood glucose testing
is a very useful tool.

See our page on

controlling type 2 diabetes
for how blood glucose testing can be used to build an understanding of your diabetes and improve blood glucose control.

Health appointments and health numbers

There are a number of health checks which people with diabetes should receive each year. These checks include:

• 
  HbA1c test
  – which measures how well controlled our blood glucose levels have been over the past few months
• 
  Blood pressure level checks
• 
  Blood cholesterol checks

For a complete list of the checks see our guide to

diabetes health checks

Key to the development of type 2 diabetes is the body’s inability to properly respond to

insulin.

Researchers from around the globe have studied data and carried out experiments to try to understand what may cause insulin resistance and

type 2 diabetes
to develop.

Risk factors for type 2 diabetes

There are a number risk factors that are closely linked to type 2 diabetes, but research is yet to provide clear answers as to how much these factors may be a cause or otherwise an association.

Type 2 diabetes risk factors include:

• Carrying too much excess body fat
• 
  Having high blood pressure or cholesterol
• Having a close family member with type 2 diabetes
• Having previously had
  
  gestational diabetes
• Read more about
  
  risk factors
  for type 2 diabetes

Diet

Dietary factors are often viewed as a prominent cause of diabetes and often incorrect assumptions that it is the only factor linked to a cause are made.

Research indicates that

diet
can play a part in type 2 diabetes but it is still one factor amongst many others that can apply and generalisations should not be drawn without the consideration of other contributing factors.

Genetic

Research has uncovered a number of genes which are associated with an increased risk of diabetes. There are a number of factors which can influence our

blood sugar levels, including where we distribute fat on our body and how well our muscles take up glucose from the blood.

Our genes help to control each process in the body and a variation in just one gene which plays a part in

metabolism
can increase the risk of having difficulty with controlling blood sugar later in life. To date researchers have identified over 60 genes associated with type 2 diabetes.

• Read more about
  
  genetic research and type 2 diabetes

Medication

A number of

medications
have been linked with increased risks of type 2 diabetes. Some of these medications include the following:

• 
  Corticosteroids
• Thiazides
• Beta-blockers
• 
  Statins

It may sometimes be difficult to distinguish how much medications may raise the risk of type 2 diabetes in people that are already at risk and how much medications may have been the primary causal factor.

In cases where medication is thought to be the primary cause of diabetes, this may be termed as

drug induced diabetes

Stress

Stress
causes a response from the body to release hormones including the natural steroid hormone cortisol. The stress hormones prepare the body for action by raising

blood pressure, blood sugar levels and stiffening muscles but also temporarily suppress the immune system and the digestive process.

Persistently being stressed is referred to as chronic stress and this can have negative effects on health. Research indicates that there is a significant link between chronic stress and insulin resistance.

Pollution, chemicals and plastics

Type 2 diabetes has been one of the fastest growing conditions over the course of the last century and researchers have been looking at what other factors could be contributing to the steep rise in incidence.

In recent years, research has been published which indicates that pollution and other chemicals which we commonly face in our daily lives might increase the risks of type 2 diabetes.

Amongst the chemicals and pollutants that have been linked with diabetes are traffic pollution and a type of chemical, found in plastics and some make up products, called phthalates.

Read news on chemicals, pollutants and diabetes risk:

• Children are ‘particularly susceptible’ to air pollution which can alter the structure of their brain, study shows
• ‘Evidence is mounting’ that soil pollution can lead to cardiovascular disease
• Higher levels of air pollution can affect children’s academic skills, research shows

The primary aim of treating type 2 diabetes is to help control blood glucose levels, but another key aim is to help with weight loss or weight management.

Keeping blood sugar levels under control is important as high sugar levels have been shown to significantly increase the

risk of health problems (complications)
developing later in life.

Type 2 diabetes can be treated by a number of different methods, ranging from lifestyle adjustments to tablet medication and injections, through to bariatric (weight loss) surgery.

Lifestyle changes are advised for everyone with type 2 diabetes; your doctor will recommend treatment alongside these changes if your blood glucose levels are too high.

Your GP and health centre

Your GP is an important part of your healthcare and will be able to advise you treating your diabetes, refer you to diabetes education and lifestyle courses and medical specialists, where appropriate, and prescribe medication.

Your GP will also be responsible for monitoring your health and ensuring you undergo a number of important diabetes health checks each year. These will include your blood glucose control, blood pressure and cholesterol, amongst others.

Diet

When it comes to diet, weight loss is often a primary goal for those with type 2 diabetes. If you are overweight, losing weight can help to

improve insulin sensitivity
and make diabetes easier to manage.

To achieve

weight loss, your diet should be

low-calorie, and because type 2 diabetes is a lifetime condition, it is important to have a diet you are happy to commit and stick to.

In the modern world, many of us have become accustomed to eating energy-dense foods, such as bread, rice, pasta and potato-based foods. Whilst these high-energy foods are convenient they’re less good for those who aren’t regularly physically active.

Vegetables (not counting potatoes) are a strong choice because they provide a variety of nutrients whilst having a relatively low calorie count. Because vegetables are a great source of soluble fibre, they also help us to

stay full for longer

If you are at a healthy weight, aim to eat a balanced diet which allows you to keep your blood glucose levels under control.

The

Low Carb Program, an education program which won the

Positive Social Impact Award at the Lloyds Bank National Business Awards UK 2016, can help people with type 2 diabetes achieve better blood glucose levels, enable weight loss and reduce dependency on medication.

Physical activity

Physical activity
can be particularly effective in controlling blood glucose levels. When our muscles work they take in glucose from the blood, liver and muscles. After the exercise, the body will start replenishing its stores of glucose by steadily taking in available glucose from the blood.

As well as helping to lower blood sugar levels, exercising makes use of the energy we take in from our diet, meaning that if we exercise more and don’t increase calorie intake, we’re then in a better position to lose weight.

Other lifestyle changes

In addition to diet and physical activity, other lifestyle adjustments such as reducing intake of alcohol and quitting smoking will also help your diabetes and general health.

Blood glucose monitoring

Blood glucose monitoring can be a useful tool as it shows how diet and activity impacts on your blood sugar levels.

If you are on insulin you may need to regularly

test your blood glucose levels
to help prevent blood glucose levels from going too low.

Blood glucose monitoring is highly valued by some people with diabetes and has helped people achieve excellent control.

Medication

The main role of diabetes medication is to help lower blood glucose levels, although more recently developed medications can also aid weight loss.

Each form of medication has side effects and it is important to be aware of which side effects can occur from any medication you are taking. Known side effects will be detailed in the patient information leaflet in

every pack of medication

You may be put onto medication as soon you are diagnosed with type 2 diabetes or sometime after if your blood glucose levels become too high.

You can be moved onto stronger medication if your blood glucose levels remain too high, while you can also be moved onto less strong medication if your blood glucose levels improve. Whilst less common, some people may even be able to come off medication, particularly if significant weight loss is achieved.

Diabetes medication needs to be supported with diet changes and regular physical activity to keep you healthy.

Medication for type 2 diabetes includes tablets and/or injectable medication.

Tablets

There are a range of tablets available for type 2 diabetes and many of these work in different ways. For example, metformin helps the body to better respond to insulin, whereas sulphonylureas prompt the pancreas to produce more insulin.

Metformin is often the first tablet prescribed to people with type 2 diabetes and stronger-acting medication may be prescribed in addition to metformin, or in place of it, if blood glucose levels remain too high.

Injectable medication

There are now a number of different injectable medications available for treating diabetes. These fall into two main groups:

• 
  Insulin
• 
  Incretin mimetics

Insulin

Insulin is the most well-known type of injectable medication for diabetes. Insulin is the hormone which helps to move sugar out of the blood and into cells to be used as energy or to be stored as fat.

Insulin is a powerful medication for lowering blood glucose but can lead to dangerously low blood sugar levels (

hypoglycemia
) if too much is taken. For this reason it is important for people to be able to recognise the symptoms of low blood sugar levels and know how to treat hypos should they occur.

Incretin mimetics

Incretin mimetics have been used for treating diabetes since 2005. Incretin mimetics are medications which mimic the action of a hormone called glucagon-like-peptide-1. This hormone plays a number of roles in response to digestion such as increasing the amount of insulin released and decreasing the amount of

glucagon
(a hormone that helps raise blood sugar) released. A group of tablet medications, known as DPP-4 inhibitors, work in a similar way to incretin mimetics.

Compared with insulin, incretin mimetics are a new medication and their long-term effects on the body are still not so well understood. Whilst incretin mimetics have been shown to be effective in reducing blood glucose levels and helping to reduce appetite, the drug has been linked with an increased risk of pancreatitis.

Weight loss surgery

Bariatric surgery, also known as

weight loss surgery, is an option that may be considered if weight gain is leading to a high risk of suffering dangerous health conditions, which may include difficulty breathing and loss of mobility.

There are significant health risks involved in surgery, and bariatric surgery is only offered to people who are very overweight and have not had success with less dangerous weight loss methods.

Obesity is a long-term medical condition where excess body fat builds up to the point that it may have a negative effect on health.

The accumulation of an excessive amount of body fat can cause type 2 diabetes and the risk of type 2 diabetes increases linearly with an increase in body mass index.

Obesity is a complex, chronic condition influenced by genetics, behaviour, environment and social factors.

It’s typically measured using the Body Mass Index (BMI), which compares a person’s weight to their height.

A BMI of 30 or above is considered obese (or 27.5 for South Asians) while a BMI between 25 and 29.9 is classed as overweight.

However, BMI doesn’t always tell the full story — where fat is stored in the body, especially around the abdomen, can play a big role in disease risk.

How does obesity develop?

Obesity develops over time when a person consistently consumes more calories than their body uses.

These excess calories are stored as fat. Although this sounds simple, the causes of obesity are anything but. It’s not just a matter of willpower — a range of physical, emotional, environmental and social factors come into play.

Modern life makes it easy to gain weight. Many people work in sedentary jobs, spend hours in front of screens and rely on convenience foods that are high in calories but low in nutrients.

Stress, poor sleep and certain medications can also lead to weight gain.

People living in deprived areas may find it harder to access healthy food or safe places to exercise.

Genetics can influence how your body stores fat, how hungry you feel and how your metabolism works. The result is that millions of people struggle with obesity, even when they’re trying to live a healthy life.

• Body Mass Index (BMI) Calculator

Obesity in the UK

The UK has the highest level of adult obesity in Western Europe.

According to the latest Health Survey for England, around 26% of adults are classified as obese and an additional 38% are overweight.

That means nearly two-thirds of adults in the UK are carrying excess weight.

The numbers are equally concerning for children, with nearly one in three children aged 10 to 11 now classed as overweight or obese.

Forecasts suggest that by 2040, more than 70% of UK adults could be overweight or obese if action isn’t taken. Obesity is now one of the leading causes of preventable ill health and early death in the UK — and it’s also placing enormous strain on the NHS.

• Preadolescent obesity risk in offspring reduced by breastfeeding
• Research shows weight loss doubles with early use of anti-obesity medication
• New fat cell subtypes could transform obesity care

Symptoms and signs of obesity

Obesity doesn’t always present immediate symptoms, but it can gradually affect how you feel and function.

Many people with obesity experience:

• Breathlessness
• Tiredness
• Low energy
• Joint pain or
• Sleep problems like snoring and sleep apnoea.

Emotionally, obesity can take a toll too, often leading to low self-esteem, anxiety, or depression. Over time, the physical effects of obesity can lead to much more serious health complications.

Diagnosis and measuring obesity

Common methods of assessment include:

Body Mass Index (BMI)

• 18.5–24.9: Healthy weight
• 25–29.9: Overweight
• 30–34.9: Obese (Class I)
• 35–39.9: Obese (Class II)
• 40+: Obese (Class III or severe obesity)

Waist circumference

Risk is increased in men with >94 cm (37 inches) and in women with >80 cm (31.5 inches).

Body fat

Body fat percentage is assessed with body composition tools.

Blood tests

Blood tests to assess metabolic health, insulin resistance or prediabetes.

Link between obesity and type 2 diabetes

Obesity is the most significant modifiable risk factor for type 2 diabetes.

In fact, around 80–85% of people with type 2 diabetes are overweight or obese.

When there’s too much fat — particularly around the belly — the body’s cells can become resistant to insulin, the hormone that helps regulate blood sugar.

This condition, known as insulin resistance, means glucose builds up in the bloodstream, eventually leading to type 2 diabetes if not managed.

Research shows that people with obesity are up to 80 times more likely to develop type 2 diabetes than people with a BMI under 22.

Central obesity where one carries excess fat around the waist is particularly high risk.

Even before type 2 diabetes develops, many people pass through a stage called prediabetes, where blood sugar levels are raised but not high enough to be classed as diabetes. Prediabetes is often reversible, especially with early intervention and weight loss.

Other health risks associated with obesity

Obesity increases the risk of a wide range of serious conditions. These include:

• Type 2 diabetes with a 3–7x higher risk
• Cardiovascular disease (CVD) due to increased risk of stroke, hypertension, heart attack
• Breast, bowel, pancreatic, liver, and endometrial cancer
• Osteoarthritis due to increased wear and tear on joints
• Infertility, especially in women (linked to PCOS)
• Sleep apnoea, due to fat deposits around the neck
• Mental health disorders such as depression, anxiety, and low self-esteem

Can obesity be treated?

Yes — obesity is treatable and even modest weight loss can have a major impact on your health.

A 5% reduction in body weight can significantly improve insulin sensitivity, reduce blood pressure and lower cholesterol levels.

This in turn reduces your risk of developing type 2 diabetes by more than 50%, according to NHS data.

Lifestyle changes

Treatment starts with lifestyle changes.

A healthy, balanced diet that is lower in processed foods and refined sugars, combined with regular physical activity, forms the foundation.

Behavioural strategies — like tracking your meals, setting goals and managing emotional eating — can also help.

Structured digital tools like the Gro Health app can support these lifestyle changes by providing personalised support, education and motivation.

• Mediterranean Diet and 7 Day Meal Plan
• Low Carb Diet: Beginner’s Guide
• Intermittent Fasting: Guide to Fasting and How it Works

Weight loss medication

In some cases, medications such as GLP-1 receptor agonists may be prescribed including:

• Semaglutide (Wegovy)
• Tirzepatide (Mounjaro)

These medications help regulate appetite and have shown significant weight loss results in clinical trials. For those with severe obesity or related health complications, bariatric surgery may be considered.

Obesity in children and young people

Obesity is no longer an adult-only issue.

Worryingly, it’s becoming increasingly common in younger age groups.

Nearly a third of children aged 2 to 15 are now classed as overweight or obese and children from more deprived communities are disproportionately affected.

Obesity during childhood is likely to continue into adulthood and increases the risk of developing health problems earlier in life, including type 2 diabetes, heart disease and mental health issues.

Prevention through healthy eating, physical activity and education is critical — not only for the child but for the entire family.

Tackling obesity

Obesity prevention requires action on multiple fronts.

This includes education around healthy eating and physical activity, creating supportive environments in schools and communities and ensuring that people can access affordable, healthy food.

Local councils and healthcare providers are increasingly offering weight management services tailored to different cultural backgrounds and life stages.

The government and NHS also recommend routine screening for obesity and associated conditions.

Many GPs and local health services can refer people to weight management programs, including structured education, dietitian support and digital tools.

What is the cost of obesity?

Obesity costs the NHS an estimated £6.5 billion each year — and this figure is expected to rise to over £9.7 billion per year by 2050 if trends continue.

Much of this cost is related to treating obesity-related diseases, including:

• Type 2 diabetes
• Kidney disease
• Amputations
• Heart disease
• Cancers linked to obesity

Preventing obesity, or treating it early, can dramatically reduce the burden on the NHS and improve quality of life for millions.

Research highlights and new findings

Recent studies have shown that habits like late-night snacking, poor sleep during adolescence and maternal obesity during pregnancy can increase the risk of obesity in children and teens.

Sleep, in particular, plays a vital role in regulating hunger hormones and metabolism.

Studies also suggest that reducing screen time — even by just a few hours a week — can have a measurable effect on children’s waistlines.

• Preadolescent obesity risk in offspring reduced by breastfeeding
• Whole milk associated with reduced risk of obesity
• Countries with highest obesity levels revealed

Obesity is complex but it’s not inevitable.

The more we understand the contributing factors, the better equipped we are to support individuals and families on their journey toward healthier living.

People with type 2 diabetes that are able to get their HbA1c below 42 mmol/mol (6%) without taking diabetes medication are said to have reversed or resolved their diabetes. This also known as putting diabetes into remission.

Loss of body weight can be particularly beneficial in helping to reverse the progression of diabetes.

With time and dedication, type 2 diabetes can be reversed and the results can be very rewarding, with less tiredness and better all-round health.

If you think you need to come off your diabetes medication, ensure you speak to your healthcare team before doing so.

Understanding how diabetes progresses

The most common cause of type 2 diabetes is obesity-related, which generally follows a vicious cycle pattern:

• Diet high in calories – particularly if high in refined carbohydrates.
• Insulin levels in the bloodstream rise to cope with the high- and quick-acting carb intake.
• Weight is gained around the belly (central or truncal obesity).
• Consistently high insulin levels lead to the body’s cells becoming resistant to insulin and commonly lead to weight gain.
• High insulin levels also increase weight gain.
• Insulin resistance leads to an increase in blood sugar levels, particularly after meals.
• The pancreas produces more insulin to cope with
  rising blood sugar levels
• High sugar levels lead to feelings of lethargy and high insulin levels lead to increased hunger.
• Hunger often leads to overeating and lethargy, with less physical activity being taken.
• Overeating, less activity and high insulin levels all lead to further weight gain and more insulin resistance.
• Consistently high demand on the pancreas to produce extra insulin leads to damage of the pancreas’ insulin-producing beta cells.
• Beta cell damage results in the body struggling to produce enough insulin, and steeper rises in blood sugar levels leads to more recognisable symptoms of diabetes, such as thirst and a frequent need to urinate

Breaking the progressive cycle of type 2 diabetes

To reverse diabetes, you need to be able to break this cycle by taking the strain off your insulin-producing cells.

Research indicates that effective ways to reverse diabetes include:

• Low-carbohydrate diets
• Very low calorie diets
• Exercise
• Bariatric surgery

Low-carbohydrate diets

Low-carbohydrate diets are known for lowering the amount of insulin the body needs to produce, resulting in less insulin resistance.[175]

A study by the Second University of Naples showed that a low-carbohydrate Mediterranean diet was able to achieve significant rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, 5% had achieved remission on the diet – a stunning achievement.

By comparison, low-fat diets were not as effective in the study. After one year, 4% of participants on a low-fat diet had achieved remission and, after six years, 0% of participants had achieved remission.

Dr David Unwin, a UK GP, has run studies that have demonstrated reversal of diabetes in a number of his patients after following a reduced-carbohydrate diet.

The Low Carb Program is a digital weight loss program that was made with Dr David Unwin that provides a 12-week programme supporting members to reduce the amount of carbohydrates in the diet. The programme has been clinically validated in 6 peer-reviewed, published studies to support weight loss, improvements in HbA1c and remission of prediabetes and type 2 diabetes.

Low-carbohydrate diets and remission in the news:

• Low carb diet shown to reduce high blood pressure
• Man puts type 2 diabetes into remission 23 years since diagnosis
• Diabetes remission app saves NHS thousands in diabetes medication costs, latest evidence shows

Low-carb success stories from the forum:

Read other people’s success stories and see how others have managed to reverse their type 2 diabetes:

• Down from 9.9 to 6.7 in 10 weeks
• Type 2 and normal HbA1c with just diet/exercise
• Down from 23.5 to 5.9 in 8 weeks
• Latest HBA1C – stunned!
• After 9+yrs of Metformin no more meds!
• Lower carb diet and Fatty Liver Gone
• Hba1c down from 86(12.3) to 38(5.6) in 3 months diet and exercise only and the love of this forum

Very low-calorie diets

Very-low-calorie diets (VLCD) have been shown to achieve significant weight loss, reduce insulin resistance and allow people with type 2 diabetes to come off their diabetes medication.

A study was published by researchers at Newcastle University showing that an 8-week 800 kcal per day diet was able to achieve remission from diabetes in seven of the 11 participants that took part. The diet included around 600 kcal from meal shakes and around a further 200 kcal from non-starchy vegetables. [174]

The trial used MRI scans and showed that the reversal of diabetes appeared to be correlated with significant reductions in fat storage within the liver and pancreas.

Newcastle University ran a study involving 32 participants. The participants were put on a similar diet for a similar length of time and then followed a low calorie weight maintenance diet.

Initial results show that 40% of participants had achieved and maintained remission from type 2 diabetes six months after completing the diet.

A VLCD is regarded as an extreme form of diet and therefore should be undertaken with care. If you are interested in following a VLCD, it is important that you first speak with your doctor to ensure the diet is safe for you to follow.

In addition to the results seen in clinical trials, a number of anecdotal reports from patients show VLCDs to be successful at reversing diabetes to varying degrees.

Read more on the low calorie diet forum 

VLCDs and reversal of diabetes in the news:

• Low calorie liquid diet recommended as NHS obesity treatment by researchers
• Very low-calorie diet can reverse type 2 diabetes for six months
• Type 2 diabetes can be reversed by eating 600 calories a day

Low-calorie success stories from the forum:

There are many success stories in the forum:

• Reversed T2 in 3 months diet only!
• “Complete diabetic remission!”
• My hba1c today

Exercise

Commitment to exercise has allowed a number of people to successfully reverse their type 2 diabetes.

Exercise helps the body to become more sensitive to its insulin. In combination with a healthy diet, exercise can reduce the demand for insulin in the body and therefore help reverse diabetes.

There is a phrase that says ‘you can’t outrun a bad diet’ and there is a lot of truth in this. The people that have used exercise to reverse their diabetes have done so by combining exercise with healthy eating.

There have been a number of anecdotal accounts showing exercise to be linked with diabetes remission.

A study published in 2015 showed that 67% of participants were able to achieve partial remission of their type 2 diabetes having taken part in a six-month diet and exercise program. The participants in this study were newly diagnosed with type 2 diabetes.

Bariatric surgery

Bariatric surgery has shown significant results in reversing type 2 diabetes, with gastric bypass surgery, leading to particularly impressive remission rates.

A study showed that, three years after gastric bypass surgery, 72% of participants with type 2 diabetes had achieved remission [176], and another study reported that 24% of participants with type 2 achieved remission six years after receiving gastric bypass surgery.[177]

Gastric bypass surgery delivers the most impressive long-term remission rates but carries a risk of complications during and following surgery. It is a permanent procedure and necessitates a change to how you eat meals.

During gastric bypass surgery, the stomach is made much smaller, and only small meals can eaten following surgery. Additionally, nutritional supplements will need to be taken for the rest of one’s life.

Is it possible to reverse type 1 diabetes?

At the moment, type 1 diabetes cannot be reversed

Type 1 diabetes is an autoimmune disease, and reversing it would require a method of preventing the body’s immune system from attacking its own insulin-producing cells.

Being a parent of a child with diabetes can bring an awful lot to consider and the responsibility can be demanding. Remember, you are not alone.

What diet should my son or daughter have? How will I manage his or her blood sugar levels? Will they get the right level care at school? How will my son or daughter cope with their own diabetes?

We answer these questions and more and if you need more advice we have a specific

Diabetes Forum for Parents and Children

Parenting Guides:

Children and Diabetes

Diabetes at School

Managing Your Child’s Diabetes

Emotional Issues

Free from Diabetes

Explaining Type 1 Diabetes to Your Child

Explaining Type 2 Diabetes to Your Child

Having Hypos as a Parent

Don’t forget to take a look at the dedicated

Diabetes and Kids
section.

Coming to terms with your child’s diabetes diagnosis

As a parent of a child with diabetes, the diagnosis can often be a much harder blow for the parent than for the child. Your child’s diagnosis will likely come as a great shock and it can be difficult to recognise just how much of an effect it can have on you.

Read about

coping with diabetes diagnosis

What diet should my child have?

A child with diabetes need not be prescribed a particular

diabetic diet
as such.

However, through blood glucose testing you may find that some foods are better for your child’s blood glucose control than others. Testing before and around 2 hours after meals is a good way to see how different meals affect your child’s blood sugar.

As with dietary advice for people in general, your child should have a balanced diet to include plenty of vegetables.

Managing your child’s blood sugar control

Watching out for hypos, being aware of hyperglycemia, monitoring and recording blood glucose levels and making sure they’re taking their doses are all involved as part of

managing your child’s blood sugar
It can be a tall order at times but a little extra knowledge can go a long way.

Should my diabetic child take part in sports?

Sports are a great activity for your child to take part in. They’ll help your child to stay fit and healthy and they’re good for the social aspects. Playing sports will lower your child’s blood sugar so they will need to test their blood before playing sports.

If a pre-sport sugar level is low or high they should not start until the level has returned to normal, as hypoglycemia could result from a low and

ketones
could be produced if exercising when too high.

Children and diabetes at school

To help you ensure your child gets the best education out of school, we’ve prepared advice on

children with diabetes at school

Coping with emotional issues

Growing up can be an emotional time in itself and diabetes can emphasise these emotions. Read more about the

emotional issues diabetic children may have

Diabetic children and social life

It can be a temptation to be protective of your child when it comes to their social life but bear in mind that being overprotective in limiting their social life could lead to

emotional difficulties
later in life.

If you’re unsure where to draw the line, it may help to speak to other parents with diabetes.

Talking to other parents of children with diabetes

Sometimes knowing what’s best for your child can be very confusing.

Connecting with other parents who have children with diabetes can help to determine the best course of action. You can discuss diabetes with other parents on our

diabetes youth club forum

Type 1 diabetes may sometimes be referred to as juvenile diabetes, however, this term is generally regarded as outdated as, whilst it is commonly diagnosed in children, the condition can develop at any age.

Insulin dependent diabetes is another term that may sometimes be used to describe type 1 diabetes.

Because type 1 diabetes causes the loss of insulin production, it therefore requires regular insulin administration either by injection or by insulin pump.

Type 1 diabetes symptoms

Type 1 diabetes symptoms should be acted upon immediately, as without treatment this type of diabetes can be deadly.

Symptoms include:

• Above average thirst
• Tiredness during the day
• Needing to pee regularly
• Unexplained weight loss
• Genital itchiness

Type 1 diabetes tends to develop more slowly in adults than it does in children and in some cases type 1 diabetes in adults may be misdiagnosed as type 2 diabetes.

Type 1 diabetes in adults over 35 years old will sometimes be referred to as Latent Autoimmune Diabetes of Adulthood (LADA).

• See more information on recognising the signs of type 1 diabetes

Type 1 causes

Type 1 diabetes is caused by a fault in the body’s immune response in which the immune system mistakenly targets and kills beta cells, the cells in the pancreas responsible for producing insulin.

As more insulin producing cells in the pancreas are killed off, the body can no longer control its blood glucose levels and the symptoms of diabetes begin to appear.

What causes the initial fault in the immune system is yet to be discovered, however, research suggests that the condition results from a combination of genetic predisposition with an environmental trigger.

What triggers the immune system to behave this way is yet to be conclusively identified. To date, the strongest evidence points towards a virus as being the most likely trigger.

• Read more about the causes of type 1 diabetes

Diagnosis

If you show signs of having diabetes, your doctor may use blood or urine tests to diagnose diabetes. Your doctor should consider which type of diabetes you have as this can affect how your diabetes is treated. If the type of diabetes is unclear, your doctor may decide to carry out one or more of the following tests:

• Ketone test
• GAD autoantibodies test
• C-pepide test

Because type 1 diabetes can develop quickly within children and young adults, a diagnosis of type 1 diabetes should be followed by same day referral to a multidisciplinary paediatric diabetes care team.

Treatment for type 1 diabetes

The impairment of the pancreas’ ability to produce insulin in type 1 diabetes means that insulin treatment is necessary.

Most people will take insulin by injection with insulin pens. Insulin can also be delivered by wearing an insulin pump. Use of an insulin pump will be considered in people that express an interest in having one and that meet certain eligibility criteria.

It is important that you are given education on how to balance insulin doses with dietary intake and physical activity and how to use blood glucose testing to help you control your diabetes.

Staying physically active and exercising regularly and eating a healthy diet are also important towards maintaining good blood glucose control and minimising the risk of long term diabetes complications. Although diet and exercise have a role to play in type 1 diabetes management, they cannot reverse the disease or eliminate the need for insulin.

• How to test your blood glucose
• How to treat a hypo
• How to inject insulin
• If you have recently been diagnosed, see our newly diagnosed with type 1 diabetes guide.

Type 1 diabetes and complications

Type 1 diabetes is a serious condition which can carry a significant risk of both short term and long term complications.

Short term complications

Short term complications can occur if blood glucose levels go too low or if insulin injections are missed. The short term complications that can occur are:

• Hypoglycemia – too low blood sugar levels
• Ketoacidosis – which can occur if insulin doses are missed or blood glucose levels become too high

Long term complications

Type 1 diabetes can lead to the development of the following long term diabetes complications:

• Heart disease
• Stroke
• Retinopathy
• Kidney disease
• Neuropathy

Whilst the list of complications is a scary prospect, the chances of developing these can be significantly reduced by maintaining good control of your blood glucose levels and ensuring you attend all your diabetic complication screening appointments.

Prevention

In the future, research may find a way to halt the development of type 1 diabetes but, to date, no intervention has successfully prevented type 1 diabetes in humans.

Type 1 diabetes research

Researchers from around the globe are looking for ways to improve type 1 diabetes treatment and to investigate possible cures. Important research areas include:

• Artificial pancreas
• Encapsulated islet cells
• Diabetes vaccines

Type 1 diabetes facts

The risk of developing type 1 diabetes can be affected by your genetics ; i.e. if your parents or siblings have type 1 diabetes.

• In terms of inheritance of type 1 diabetes – there is a 2% risk if the mother has type 1 diabetes, 8% risk if the father has type 1 diabetes; and a 30% risk of the child developing type 1 diabetes if both parents are type 1 [5]
• Within 20 years of diagnosis of type 1 diabetes, nearly all of those diagnosed have some degree of retinopathy [1]

There is also a sub-type of type 1 diabetes known as brittle diabetes.

Famous people with type 1 diabetes include:

• Young pop-rock sensation Nick Jonas
• Actress Sharon Stone
• From the UK, extreme snowboarder Chris Southwell

We know there’s a huge amount to take in when you’re newly diagnosed with type 1 diabetes so we’ve put together this guide to help make sense of it all.

Contained within this guide are links to some of our most important guides which help to get you in control of your diabetes from today.

Coming to terms with diabetes

A diagnosis of type 1 diabetes is usually a big shock and some of us wonder how we’re going to cope with the condition.

Diabetes can be a struggle to come to terms with and we each will come to terms with having diabetes in our own way and at own pace.

Some of us may adjust quickly, but for many of us it can take years to truly come to terms with this important part of our lives.

• Read more on
  
  coming to terms with a diagnosis of diabetes

You may wish to consider joining the

Diabetes Forum
as this is a great source of support – not only during your diagnosis, but also for when you wish to ask questions and share your experiences.

Having diabetes

One of the questions which often strikes us around the time of diagnosis is what effect diabetes will have on our daily lives? Will it prevent us from taking part in activities? Will it affect our present or future career? Will we have diabetes for life?

• Read answers to all of these questions and more in our guide to
  
  having diabetes

Getting to grips with injections and blood tests

Some of us adjust to injections and blood tests better than others. Although in reality, injections and blood tests are a pain for us all.

Blood testing guides

Blood glucose testing is the main way you will be able to identify what your blood glucose levels are. You will most likely be given a blood glucose meter by your doctor or healthcare team.

If you are new to blood glucose testing, the following guides will prove useful.

• 
  How to test blood glucose levels
• 
  Pain free blood glucose testing
• 
  Blood glucose meter comparison

Injection guides

Many people are scared of needles. However, injecting insulin is not as painful as you’d think.

Watch our video on how to inject insulin and read our guide on how to manage injection sites and needle phobia.

• 
  How to inject insulin
• 
  Dealing with a fear of needles
• 
  Diabetes and injection sites

Keeping diabetes under control

Diabetes control does take some dedication to get right. Insulin doses need to be carefully balanced with the amount of carbohydrate you take in and we need to remember to take in other factors including exercise.

• Hit the ground running with our guide to
  
  controlling type 1 diabetes

Many of us with type 1 diabetes will still be producing a certain amount of our own insulin. This is useful as it means that our pancreas is still able to give us a bit of a hand in helping to control our sugar levels.

This period is referred to as the ‘

honeymoon phase
’ and usually lasts anywhere from a few months up to a couple of years.

Carbohydrate counting and diabetes education courses

One of the most important aspects of type 1 diabetes is to be able to assess how much carbohydrate is in each meal and therefore to balance your carbohydrate and insulin intake.

• 
  Carbohydrate counting

Carbohydrate counting can be a challenge for some of us. Fortunately, there is help at hand and there are diabetes education courses which can be attended for free on the NHS. The courses are often very popular with people with type 1 diabetes. Ask your GP or diabetes team about which courses are available in your area.

• 
  Diabetes education courses

Spotting high and low sugar levels

If your diabetes is kept under good control, you should be able to reduce the number of times your blood sugar levels goes too high or too low.

If your sugar levels do go too high or low, it helps if you can spot this early and do a test to find out how high or low your sugar levels are.

There are some common symptoms that may be experienced at high or low levels, although the symptoms can sometimes vary from time to time.

• See our list of symptoms of
  
  high and low sugar levels

Preparing for hypos

Low blood glucose, known as hypos, can be disorientating and can become more dangerous if they’re not treated soon enough.

We have a number of guides to help you with treating and preventing hypos from happening:

• 
  How to treat a hypo
• 
  Preventing hypos
• 
  What is a severe hypo?

Avoiding ketoacidosis

At the other end of the blood sugar spectrum is diabetic ketoacidosis which is a dangerous condition which can occur if our blood glucose levels go very high.

• Read more about
  
  diabetic ketoacidosis

Health appointments and health numbers

People with diabetes should receive a number of important

diabetes health checks
each year.

It is important that these checks are carried out once each year.

The exception is children under 12 who will not usually need retinopathy (eye damage), nephropathy (kidney damage) or neuropathy (nerve damage) tests to be carried out.

Prediabetes, also commonly referred to as borderline diabetes, is a metabolic condition and growing global problem that is closely tied to

obesity.

If undiagnosed or untreated, prediabetes can develop into type 2 diabetes; which whilst treatable is currently not fully reversible.

What
is prediabetes?

Prediabetes is characterised by the presence of

blood glucose levels that are higher than normal
but not yet high enough to be classed as diabetes.

For this reason, prediabetes is often described as the “gray area” between normal blood sugar and diabetic levels. In the UK, around

7 million people are estimated to have prediabetes
and thus have a high risk for developing type 2 diabetes.


^[17]

Prediabetes may be referred to as

impaired fasting glucose (IFT), if you have higher than normal sugar levels after a period of fasting, or as

impaired glucose tolerance (IGT), if you have higher than normal sugar levels following eating.

The increasing number of new cases of prediabetes presents a global concern as it carries large scale implications towards the future burden on healthcare. Between 2003 and 2011, the prevalence of prediabetes in England alone more than tripled, with 35.3% of the adult population, or

1 in every 3 people

having prediabetes.


^[106]

Learn more about prediabetes

Prediabetes is a critical stage in the development of diabetes, for it is at this point that lifestyle choices can be made to turn it around. Early, decisive action can slow down or even halt the

development of type 2 diabetes

Explore Prediabetes

Diabetes Risk Factors

Tests for Pre-Diabetes

Metabolic Syndrome

Insulin Resistance

Glucose Intolerance

Diabetes and Ethnicity

Diabetes and Obesity

Waist Size Risk

Impaired Fasting Glycemia

Impaired Glucose Tolerance

What are the symptoms of prediabetes?

Many people have prediabetes but are completely unaware of it. This is because the condition often develops gradually without any warning signs or symptoms. In many cases, the sufferer only learns of their

borderline diabetic

state once the

symptoms of type 2 diabetes
start to appear. Therefore, being aware of the risk factors is essential.

What are the risk factors for prediabetes?

You should be tested for prediabetes if you:

• 
  Are overweight or obese
• 
  Have a close relative (parent or sibling) who currently has or has had diabetes
• 
  Have high blood pressure,
  
  low HDL (‘good’ cholesterol)
  or high triglycerides
• 
  Are over the age of 40
• 
  Have given birth to a baby who weighed over 9 pounds

While pre-diabetes may affect anyone, of any age, gender or racial type, some groups are genetically more prone. These include:

• Afro-Caribbean
• South Asian
• Native American

Testing for prediabetes

Either a

fasting plasma glucose test
or an

HbA1c test
may be used to diagnose type 2 diabetes or prediabetes.

The following results indicate the presence of prediabetes:

• 
  Fasting plasma glucose:
  
  5.5 mmol/L to 6.9 mmol/L
• 
  HbA1c:
  
  42 to 47 mmol/mol (6.0 to 6.4%)
  
  
  ^[361]
  

If your results are above the upper limits for prediabetes, your GP may either diagnose you with type 2 diabetes or take another test in the near future to confirm whether you have diabetes. If you have symptoms of diabetes but have an HbA1c of below 42 mmol/mol (6.0%), you may be given an

oral glucose tolerance test
(OGTT).

If you are diagnosed with prediabetes, your doctor should clearly set out the steps you need to take to lower your risk of developing type 2 diabetes.

Can I stop prediabetes developing into type
2 diabetes?

The good news is that cases of prediabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes. Each year in the UK, 5% to 10% of people diagnosed with prediabetes go on to develop type 2 diabetes.

The two principle factors for consideration are:

• 
  Making changes to your diet
  and
• 
  Appropriate physical exercise to your lifestyle

By making these changes, blood sugar levels can be returned to normal.

In fact, the recently completed

Diabetes Prevention Program
study conclusively showed that people with borderline diabetes can prevent the development of type 2 diabetes by making dietary changes and increasing their level of physical activity.

For a comprehensive and individual plan, speak to your doctor.

Type 1 diabetes belongs to a group of conditions known as autoimmune diseases. Autoimmune diseases are when the body incorrectly identifies its own useful cells as an attacking organism.

In type 1 diabetes, it is the

beta cells
in the pancreas which produce insulin that are wrongfully targeted and killed off by specific antibodies created by the body’s

immune system

Researchers have been investigating what may cause the immune system to act in this way but to date researchers have theories but no concrete proof.

Genetic predisposition

Researchers have uncovered a number of genetic regions that are linked closely with type 1 diabetes. Each of these is denoted with a name such as IDDM1.

At least 18 different regions have been discovered and some of the genetic areas include an increased susceptibility for other autoimmune diseases such as rheumatoid arthritis and

coeliac disease

Whilst genetics offers clues as to why some people are more susceptible to type 1 diabetes, it doesn’t explain why some people with these genes develop type 1 diabetes and why others with these genes don’t.

For example, having an identical twin with type 1 diabetes gives you a statistically higher risk but it doesn’t necessarily mean you will develop the condition.

Genetics does not explain either why people will develop type 1 diabetes at different ages. Type 1 diabetes is most commonly diagnosed in 10 to 14 year olds but can be diagnosed at any age.

• Read more on
  
  diabetes and genetics

Type 1 diabetes triggers

Researchers have hypothesised that whilst some people are have a genetic predisposition to type 1 diabetes, there is likely to be an environmental factor that triggers the initial development of type 1 diabetes.

Some of the possible triggers that have been suggested include:

• 
  Viral infection
• 
  Vaccines
• 
  Low levels of vitamin D
• 
  Increased insulin demand

Viral infection

Associations have been found between type 1 diabetes and a number of different viruses. Of these, enteroviruses have attracted the most interest from researchers. Studies have shown that enterovirus antibodies have been recorded at higher levels in pregnant mothers of

children
that gone on to develop type 1 diabetes. Higher frequencies of enterovirus infections have also been detected in children which develop type 1 diabetes when compared with siblings that have not developed the condition.

Vaccinations

Another theory put forward is that childhood vaccinations could increase the chances of developing type 1 diabetes. One researcher, Dr J B Classen has investigated incidences of type 1 diabetes in the human population as well as in animals. Dr Classen’s research indicates there could be a link between type 1 diabetes and childhood vaccinations such as smallpox, tuberculosis and Hib vaccines.

The research has yet to be accepted as conclusive enough to change vaccination schedules.

Vitamin D

A link between

vitamin D
and type 1 diabetes has been drawn.

Researchers have noted that countries with the highest incidences of type 1 diabetes tend to be located further from the equator. Countries such as the UK, Canada, Australia and the countries of Scandinavia all have notably high rates of type 1 diabetes.

Studies have also shown that people with lower levels of vitamin D had a higher incidence rate of developing type 1 diabetes. A number of studies, including the EURODIAB Substudy 2, have shown that supplementation of vitamin D appears to lower the risk of developing type 1 diabetes.

Increased insulin demand

Increased demand on insulin has also been put forward as a contributing factor. A study, carried out by the University of Colorado and published in 2008, showed that a diet with high

glycaemic index
foods could speed up the progression to type 1 diabetes in children with signs of islet autoimmunity.

The growth phase that children go through in teenage years increases the amount of

insulin
released and could lead to extra stress on beta cells, raising the risk of the immune system attacking the insulin producing cells.

Pre-diabetes will usually be diagnosed by a doctor using either an HbA1c or a fasting plasma glucose (FPG) test.
However, in some cases, an OGTT test may also be carried out.

Oral Glucose Tolerance Test (OGTT)

The OGTT is a screening test that involves testing the individual’s plasma glucose level following a glucose-rich drink (a beverage containing 75 grams of glucose).

An OGTT may be used in people that show symptoms of diabetes but have not recorded diabetic levels with the HbA1c or fasting plasma glucose tests.

The OGT test may be used for diagnosis, instead of the HbA1c in people with certain blood disorders such as shortened red blood cell life.

People who have impaired glucose tolerance (IGT) or pre-diabetes will have a plasma glucose level of

less than 11.0 mmol/L (200 mg/dl)

but

equal to or greater than 7.8 mmol/L (140 mg/dl)

• Read more about the
  
  Oral Glucose Tolerance Test

Those people who have a plasma glucose level over or

equal to 11.0 mmol/l (200 mg/dl)

after two hours will be asked to have a fasting plasma glucose test to confirm diabetes diagnosis.

The fasting plasma glucose test is used to diagnose diabetes, however.

Fasting Plasma Glucose Test (FGT)

The FGT test works by measuring the level of glucose in an individual’s blood after a period of fasting.

Anyone who is at a high risk of pre-diabetes should be given the FPG test. This includes those who are severely overweight or obese, people of South Asian or African-Caribbean descent, or anyone with a family history of diabetes.

The fasting plasma glucose test is performed after a person fasts for at least 8 hours.

Individuals who have a blood glucose level

greater than or equal to

7.0 mmol/L


(126 mg/dl) will be retested and
,

if the results are consistent
,

diagnosed with diabetes.

If the results are



less than 7.0 mmol/L



(126 mg/dl) but

greater than 6.1 mmol/L



(110 mg/dl) the individual will be diagnosed as having impaired fasting glucose, or pre-diabetes.

Central to the treatment of type 1 diabetes is to keep a balance of the right amount of insulin to keep blood glucose levels from being either too high or too low.

In type 1 diabetes the body’s immune system kills off the insulin-producing cells leaving the pancreas unable to produce enough insulin to keep blood glucose levels at healthy levels.

As a result,

insulin
needs to be taken by injection or another delivery means such as by infusion with an insulin pump. Insulin is a hormone in the body that helps to move glucose out of the blood and into cells for energy.

Your health team

Your diabetes health team are an important part of your diabetes treatment. Your GP and consultants, between them, will be able to offer you advice on controlling diabetes and refer you to any medical specialists you may need to see.

Your health team will also be responsible for making sure you get all the diabetes health checks that are recommended for people with diabetes. The

health checks will help you health team to spot any signs of damage caused by diabetes
and ensure these are treated to prevent the damage becoming more serious.

Insulin injections

When you are diagnosed with type 1 diabetes you will be put onto insulin injections. The thought of injecting each day can be a big shock at first but once you get the hang of it, it becomes a manageable part of life.

Over the last few decades some big steps have been made to reduce the hassle involved in injecting and insulin injections can now be done quickly, discretely and often painlessly.

Insulin pumps

An alternative way of taking insulin is to use an insulin pump. An alternative name for insulin pump therapy is continuous insulin infusion therapy because

insulin pumps
work by continuously delivering small amounts of insulin into the body.

Insulin pumps have a small tube called a cannula that is inserted just under the skin and is kept in place for a few days at a time until they need changing. The cannula allows insulin to be delivered into the layer of fat we have just under the skin, from where it can be absorbed by the blood.

The insulin pump itself is worn outside of the body, often near to your waist, and electronic controls on the pump or a separate handheld device allow you to control how much insulin is delivered.

Keeping blood glucose at the right level

As mentioned above, key to treating type 1 diabetes is to ensure

blood glucose levels
are not too high and not too low. There are specific blood glucose targets that we should aim to keep our blood glucose levels within.

The balancing act of keeping sugar levels not too high and not too low is not easy but with a good understanding of how our body works and how diabetes behaves, you can build up experience to gain good control of type 1 diabetes.

Everyone with type 1 diabetes will experience some blood sugar levels that are too high or too low at some point. If our blood glucose levels become either very high or very low, it can put up us at risk of immediate dangerous health so it is important to know how to

recognise the signs of high and low blood glucose levels

Another reason for keeping sugar levels at the recommended levels is that regularly having blood glucose levels that are too high raises the risk of suffering

health difficulties (diabetes complications)
later in life.

Read more:

• 
  High blood glucose levels (hyperglycemia)
• 
  Low blood glucose (hypoglycemia)

The honeymoon phase

When you are diagnosed with type 1 diabetes, your body will often be producing a significant amount of its own insulin which means your pancreas helps out to make managing sugar levels slightly easier. The time period when your body is producing a useful amount of insulin is known as the honeymoon phase of type 1 diabetes.

After a number of months and sometimes up to a few years, your body will stop being able to produce as much insulin and you will find you need to take more insulin than you have been. When this happens you may also find that your blood glucose results may become higher or sometimes lower than previously.

If you ever find that your diabetes has become more difficult to manage than previously, speak to your health team who will be able to find time to advise you on how you can best cope with managing your sugar levels.

Blood glucose monitoring

Blood glucose monitoring, also known as

blood glucose testing, is an important part of type 1 diabetes and we need to test our blood sugar levels at least a few times each day in order to control our blood sugar levels and reduce the chance of having dangerously high or low sugar levels.

Blood glucose testing involves pricking fingers to take a sample of blood. It can be painful but, like with injecting, it does get easier over time. Many of us don’t like testing blood sugar levels through the day but the benefits of testing is that it helps us to avoid unpleasant high and low sugar levels which can make us tired and uncomfortable as well as being potentially dangerous in the short and long term.

Regularly getting high or low sugar levels can become demoralising but it is important to not let that put you off. If you respond to high or low levels by testing slightly more often and spending a bit of extra time thinking why you might be high or low each time, then after a few days or so, you will start to get more understanding and confidence in managing your diabetes. Put simply, setbacks can be overcome in the longer term with a bit of dedication.

Diet and sugar levels

Whilst insulin helps to lower sugar levels by allow cells to take in glucose from the blood, the food we eat raises sugar levels. When we eat, carbohydrate in food gets broken down into glucose during digestion and gets absorbed into the blood stream.

Our diet therefore plays a significant role in the control of our blood sugar levels.

Carbohydrate counting and insulin dose adjustment

Because the carbohydrate in food raises blood sugar levels, it is important that we balance the amount of insulin we take at meals in proportion with the amount of carbohydrate we eat.

This therefore involves two skills:

• Ability to count or estimate the amount of carbohydrate in the food we eat
• Ability to calculate how much insulin is needed for that amount of carbohydrate

Carbohydrate counting and insulin dose adjustment are key skills to learn in order to best control type 1 diabetes. Learning to balance carbohydrate intake takes a combination of knowledge and experience.

One of the best ways to learn how to count carbohydrate and adjust insulin doses is to go on a carbohydrate counting course. If you have type 1 diabetes and have not been on a carbohydrate counting course, or need a refresher course, ask your GP whether he or she will be able to refer you onto a course.

One popular type of carbohydrate counting courses is called

DAFNE
which stands for dose adjustment for normal eating.

Type 1 diabetes and transplantation

Another form of treating type 1 diabetes is to have an injection of insulin producing cells. This procedure, known as

islet cell transplantation, allows the transplanted insulin producing islet cells to produce insulin inside your body.

Islet cell transplantation can help to reduce the amount of insulin you need to take and can make managing your diabetes easier but it is an expensive procedure and has drawbacks as well. For these reasons, islet cell transplants are only given to a small number of people each year.

Preference is given to people that experience

severe hypoglycemia
on a regular basis.

There’s only so much you can do to reduce your risk of gestational diabetes – some women will develop it regardless of how healthy their lifestyle is.

However, most people can make it less likely through:

• Maintaining a healthy weight before pregnancy
• Following the right diet
• Staying active

Gestational diabetes occurs when your body becomes resistant to the
insulin it produces. This happens as a result of the increased insulin demands imposed by the hormonal changes that occur during

pregnancy.
^[155]

Gestational diabetes causes
blood glucose levels to run higher than they normally would.

Maintain a healthy weight before pregnancy

If you have made a decision to try to have a baby, try to maintain a healthy weight before becoming pregnant. If you are overweight, that doesn’t necessarily mean you will develop gestational diabetes, but it does increase the risk. Having a

body mass index (BMI)
of more than 30 makes you three times more likely to develop gestational diabetes than having a BMI of 25 or less.

^[156]

If your BMI is higher than 30, you will be offered an

oral glucose tolerance test
in order to assess your blood glucose levels.

This should be offered before you are 16 weeks into your pregnancy – in women with a BMI of 25 and under, an oral glucose tolerance test should be offered between 24 and 28 weeks of the pregnancy.

If you have high blood glucose levels, some of the glucose may be transferred to your baby. This can cause excessive growth, leading to a condition called macrosomia.

It’s important to lose any weight you need to lose

before

becoming pregnant. Generally, losing weight

while


pregnant
is discouraged. Weight gain during pregnancy is entirely expected – even in obese women.

^[157]

Follow the right diet

There are several reasons it’s important to follow a healthy diet during pregnancy, one of which is to lower the risk of gestational diabetes.

To lower your risk of gestational diabetes, follow a diet that doesn’t raise your blood glucose levels too much to begin with.

There’s no

special diet
for gestational diabetes. General principles of healthy eating apply. The most important thing is that you eat few

processed foods, because they contain empty

calories, and eat plenty of

vegetables
and “natural” foods.

Speak to your doctor about the best diet for you.

Stay active

It’s very important to get plenty of

exercise
while pregnant. If you can, aim for 30 minutes of physical activity per day. Suitable exercises include brisk

walking,

bike riding
and

swimming

Many people believe that strenuous exercise during pregnancy harms the baby, but recent evidence suggests that this isn’t the case. However, because pregnant women have more blood in their bodies, strenuous exercise can put more stress on your

heart
Just to be on the safe side, it’s often best to stick to moderate exercise.

Besides, you might find strenuous exercise a bit too physically demanding during pregnancy.

^[154]

If you struggle to fit 30 minutes of exercise into your day, don’t blame yourself. The important thing is that you do something, even if it’s just getting off the bus one stop early or walking a journey you would usually

drive.

Preventing diabetes after pregnancy

Studies have shown that women who go through gestational diabetes are more likely to develop

type 2 diabetes
later in life.

^[158]

[160]

Preventing type 2 diabetes is similar to preventing gestational diabetes: you have to follow a healthy diet, stay active and maintain a healthy weight.

A study published in 2015 indicates that mothers who breast-feed their children are less likely to develop type 2 diabetes than those mothers who don’t.

The researchers argue that, because breast-feeding uses up glucose and fat in the bloodstream by transferring them to the baby, the mother’s pancreas has to produce less insulin in order to bring down high blood glucose levels. This reduces the risk of

insulin resistance.

^[159]

If you develop

gestational diabetes, it’s important to get plenty of

exercise
However, exercising during pregnancy can be a tricky balance – especially when you have gestational diabetes – and you may well have questions.

Why do women with gestational diabetes need to exercise?

Gestational diabetes occurs when your body becomes

resistant to the insulin it produces
during pregnancy. This happens as a result of the increased

insulin
demands imposed by pregnancy. When you have gestational diabetes, your

blood glucose levels
run higher than they normally would.

One way to lower blood glucose levels is to exercise. When we exercise, our

muscles
take in more glucose. When this effect wears off, our muscles remain more sensitive to insulin for some time.


^[152]

The end result is lower blood glucose levels.

Along with following a healthy diet, getting plenty of exercise is an important part of managing gestational diabetes.


^[153]

How much exercise should I be getting?

If you can, aim for 30 minutes of moderate physical activity per day – that’s the ideal. If you can’t fit that into your schedule, not to worry – the important thing is that you get some exercise, even if it’s as small an activity as getting off the bus a stop early and walking the rest of the way.

If you weren’t particularly active before you got pregnant, 30 minutes per day might be a bit of a stretch. It might be more sensible to start with 15 minutes of exercise, and work your way up slowly as you feel more comfortable.

Your personal targets may be different, and your exercise targets might change during the pregnancy. Speak to your doctor about it.

The exercise you do should always be moderate, not too strenuous. Think of moderate exercise as the kind that leaves you slightly out of breath, with a faster heart rate, and sweating.

Avoiding hypoglycemia

Different types and durations of exercise can have different effects on

blood glucose levels
The specifics can be quite complicated. Generally speaking, moderate exercise does not raise blood glucose levels, it lowers them. If you are on certain

glucose-lowering medications
such as

insulin, for example, prolonged moderate exercise can cause

hypoglycemia

If you take any medication to lower your blood glucose levels, speak to your doctor. They can tell you if you are at risk of hypoglycemia.

Blood sugar levels

Strenuous exercise can

raise

blood glucose levels in the short term, because the body may release stored glucose to keep up with the body’s heightened demand for energy. In most cases, blood sugar levels should back down during or shortly after exercise, unless you exercised in a very short burst.

The only way to know for sure is by trial and error.

Test your blood
glucose levels before and after you exercise. If you have high blood glucose levels after exercising, you can decrease the intensity of the exercise next time, and maybe increase the duration.


^[153]

For example, you may spend 15 minutes jogging on a treadmill, with some short, intense sprints. Afterwards, if you find that your blood glucose levels are too high, this is likely to be because the sprints are too intense. To prevent high blood glucose levels, you could try cutting out the sprints, and increasing the duration of your jogging to 30 minutes.

Test your blood and try things out. Eventually you’ll find an exercise regimen that works for you.

Does exercising while pregnant harm the baby (or the mother)?

Moderate exercise certainly doesn’t. Many people think that strenuous exercise can harm the baby, but most studies indicate that it doesn’t.


^[154]

Of course, certain activities aren’t suitable for pregnant women – you can read about this a little further down the page.

In most cases, exercise won’t harm the mother, either. In fact, it should make her healthier. Strenuous exercise, however, puts a lot more strain on a woman’s

heart
while she’s pregnant. This is because women have more blood in their bodies when they’re carrying a baby, so the heart has to pump more of it during exercise.

What are some good (and bad) exercises for women with gestational diabetes?

Aerobic exercises are good for women with gestational diabetes. That includes:

• 
  Walking
• Stationary
  
  cycling
• 
  Swimming

30 minutes per day of any of these activities should raise your heart rate and leave you sweating.

Exercise that strengthens your stomach can prevent backache as your baby grows. Many activities, however, are not suitable for pregnant women.

These include:

• Exercises that involve lying down on your back, particularly after 16 weeks
• Contact sports, especially martial arts
• Any sports that involve a high risk of falling. Pregnancy changes your centre of gravity, and that affects your balance. Avoid exercises that involve a high risk of falling. That includes any sports that involve a lot of changes in directio, such as badminton and
  
  tennis
• Scuba diving

Speak to your doctor about exercising with gestational diabetes. With their help, you can work out an exercise regimen that’s right for you.

Women who develop gestational diabetes during pregnancy are more likely to develop

type 2 diabetes
later on in life.

Finding
out you have gestational diabetes can be very frightening as not only do
you have to deal with all the emotions (the ups and the downs) and the
questions that come with being

pregnant, but also the uncertainty of this
new-found condition.

Fortunately, as with all types of diabetes, there
are many well-informed

health professionals
to help answer your questions
and to guide you through this very important time in your life.

The more
you know, the easier it is to accept and make the necessary changes for
a successful and happy pregnancy.

How did I get gestational diabetes?

Somewhere

between 24 and 28 weeks

into your pregnancy your doctor most likely sent
you to be screened for the presence of gestational diabetes.

If you were
at greater risk for getting gestational diabetes, your doctor may have
sent you for a screening test before you reached 16 weeks.

You may think this is too late in your
pregnancy to be finding out about such a problem, but in most cases, screening
before this time would be of little value.

Hormonal changes and insulin

It is the hormonal changes (hormones
made by the placenta that resist insulin) in the second and third trimesters
of pregnancy, along with the growth demands of the foetus, that increase
a pregnant woman’s insulin needs by two to three times that of normal.

Insulin
is needed to take the sugar from your blood and move it into your
cells for energy.

If your body cannot make this amount of insulin, sugar
from the foods you eat will stay in your blood stream and cause high blood
sugars.

This is gestational diabetes.

How common is gestational diabetes?

Gestational
diabetes means

diabetes mellitus
(high blood sugar) first found during
pregnancy.

It occurs in

3-5% of all pregnancies

(in other
words, 1 in 20 pregnant women will develop gestational diabetes); so,
you can take comfort in the fact that you are not alone.

In most cases, gestational diabetes is managed by diet and

exercise
and
goes away after the baby is born.

Very few women with gestational diabetes
require insulin to control this type of diabetes.

If you do need insulin,
it will ensure

blood glucose
stays in the acceptable range, thereby reducing
the risks to you and your baby.

Gestational
diabetes should not be taken lightly. Immediate risks to the mother and fetus are very real; however, these risks can be minimized with good care
and follow up.

Ante-natal
care

Ante-natal care should be hospital-based, from a multi-disciplinary
team.

• Individualise insulin regimens and recommend 4-times daily glucose
  monitoring.
• Aim to maintain glucose 4-7 mmol/L and
  
  HbA1c
  within the normal
  non-diabetic range.
• Remember insulin requirements increase progressively from the
  2nd trimester until the last month of gestation, when a slight fall-off
  may be noted
• Hypoglycemia and loss of awareness is common in early pregnancy.
  Hypoglycemia does not appear to have long-term adverse effects on fetal
  development

Ketoacidosis
can cause fetal death at any stage. All women should
test urine for ketones if blood glucose is high, if vomiting occurs or
if they are unwell.

Delivery

The timing of delivery is individualised; in women with good diabetes
control and no complications, the pregnancy may be continued to 39-40 weeks. Caesarian section rates are often higher than in non-diabetic
women.

Post-natal care

Insulin requirements fall dramatically after you have given birth, therefore
reduce insulin doses immediately to pre-pregnancy levels, to avoid

hypoglycemia

• Encourage slightly higher blood glucose levels than during pregnancy.
• In breast-feeding mothers, reduce insulin dose further once lactation
  is established.
• Discuss contraception while the patient is still in hospital.

All women should be seen by the diabetes pregnancy care team six weeks
after delivery.