Diabetes Patient Information

Diabetes is a condition that causes your blood sugar (which can also be referred to as blood glucose) level to become too high. It is caused by your body not making enough or any of a hormone called insulin, or the insulin not working properly (insulin resistance). Insulin helps your body use sugar for energy. Without it, the level of sugar in your blood becomes too high. Type 2 diabetes can go undiagnosed for years. Please use the following link for all information relating to symptoms.

Diabetes signs & symptoms | Symptoms of diabetes | Diabetes UK

If you are under the age of 40 and living with Early Onset type 2 diabetes the Your Journey Hub is there to support you. Information can be accessed via the following link: https://southyorkshire.icb.nhs.uk/your-health/your-diabetes-your-journey

Having diabetes can increase your chance of getting other health problems, including:

• Heart attack and stroke - your healthcare professional may discuss taking a medication called a statin to reduce the risk of these complications.
• Increased risk of Dementia.
• Kidney problems.
• Nerve damage and foot problems – diabetes can cause damage to nerves (peripheral neuropathy).

https://www.nhs.uk/conditions/peripheral-neuropathy/

• Sight problems – adults and children aged 12 or over will be offered diabetic eye screening every 1 to 2 years. Use the following link for all information.

https://www.nhs.uk/tests-and-treatments/diabetic-eye-screening/

• Gum disease - regular check-ups with your dentist should help to reduce this risk.
• Diabetes can cause sexual problems in all genders through damage to nerves and blood circulation.
• Increased risk of certain types of cancer. For more information follow this link - Diabetes and cancer | Diabetes UK

Diabetes does not cause any symptoms most of the time until damage to a part of body is done and is often too late. However, the chances can be minimised or prevented by keeping on top of the Diabetes control. If the diabetes is under control, you should not feel any different to anyone else.

Further information can be found via the link with Diabetes UK. https://www.diabetes.org.uk/about-diabetes/complications

We know that everyone’s experience of diabetes is different. Whether you’re living with diabetes or care for a loved one who does, Diabetes UK can support you.

Their website is packed full of trusted information, developed by experts. From advice about treatments and what to eat, to practical guidance and emotional support, we've got you covered.

https://www.diabetes.org.uk/living-with-diabetes/supporting-someone-with-diabetes

The annual diabetes review is a check-up to assess your health, monitor diabetes complications, and make sure your treatment is working. This includes blood pressure, blood sugar, and eye checks. Learn more about Annual Care Reviews.

Essential Health Checks for those with Diabetes, known as: “9 Care Processes” are below –

Exercise can include all types of physical activity and moving more, has lots of benefits for your overall health. It's also a way to manage your type 2 Diabetes. 

• It helps your body use insulin better.
• It helps you look after your blood pressure. High blood pressure means you’re more at risk of diabetes complications.
• It helps you to improve your cholesterol.
• It helps you maintain a healthy weight after you’ve lost it.
• It gives you energy and to get a good night’s sleep.
• It helps your joints and flexibility.
• It helps your mood. Exercise releases ‘happy hormones’ called endorphins.
• It helps to reduce stress levels.
• It helps you to improve your HbA1c levels.

Even moving a little more makes a big difference. Walking could be the best for you as you can do it anywhere, any time and it’s free.

A little activity after eating meals helps you to digest the food quicker and helps with stabilising your blood sugars. Even just cleaning your dishes can have a positive impact.

You can see local activities on the link below –

For me | Well Doncaster

Fit Rovers offer a range of activity courses you may want to consider –

https://clubdoncasterfoundation.co.uk/health-and-wellbeing/fitrovers

Get Doncaster Moving offer some active guides -

Active in Doncaster Guides | Get Doncaster Moving

There are different treatments available to help you manage type 2 diabetes. Everyone is different, so treatment will vary depending on your needs.

When you’re first diagnosed with type 2 diabetes, you may not need medication as lifestyle changes could be all you need. But at some point, most people with type 2 diabetes also need to take medication to keep their blood sugar levels healthy. This doesn’t mean you’ve done anything wrong, but your body just needs some help to keep blood sugar levels in a healthy range and reduce the risk of complications.

There are a number of medications you can be prescribed and below is a list with how you should be taking them. -

For more information on medication please see link below –

Diabetes tablets and medication | Diabetes UK

For more information on Metformin use link below -

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/tablets-and-medication/metformin

For more information on Insulin please see link below -

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/insulin/type-2-diabetes

Do not stop taking any medications without speaking to a Health Care Professional. You can get advice from community pharmacists as no appointments are required, and some have extended opening hours. Also:

• Order medications in good time and don’t leave it till last minute
• Most side effects if mild may settle with time, persevere for some time and seek advice if not settling. 
• Try and have a routine
• Try and synchronise all medications so that they are all issued at the same time from your GPs.
• Seek advice about storage of certain medications like insulin and injectable medications. 
• Your community pharmacist can advise on most medications. 

Diabetic Ketoacidosis which can be referred to as DKA is a rare, but serious and sometimes life-threatening condition that can happen when you have diabetes. DKA happens when your body is lacking insulin and cannot use sugar for energy and starts burning fat instead, producing acidic ketones that build up in your blood making it dangerously acidic. It is more commonly seen with Type 1 Diabetes, but you can still be affected with Type 2.  This can happen if you become unwell whilst taking any of these medications:

• Jardiance (Empagliflozin)
• Forxiga (Dapagliflozin)
• Invocana (Canagliflozin). 

If you feel unwell whilst taking these medications, contact a doctor or 111 straight away.

If you develop any of the following symptoms, it is a medical emergency, and you must ring 999 / attend A&E:

• Feeling sick or being sick
• Stomach / abdominal pain
• Feeling very thirsty
• High level of ketones in the blood (1.5 mmols or higher) - if you have access to a blood ketone meter
• Shortness of breath or rapid breathing
• Confusion
• Feeling sleepy or unusually tired
• Rapid weight loss
• A sweet smell to your breath

More information on this can be found here –

Diabetic ketoacidosis (DKA) | Ketosis symptoms and treatment | Diabetes UK

Information Prescriptions offer personalised advice on managing diabetes based on your latest test results. These include tips on improving diet, exercise, and lifestyle changes. Learn more about this below –

Information Prescriptions for people with diabetes | Diabetes UK

If you are taking any medication for diabetes, please speak to a health care professional if you become unwell with any of the following –

• Vomiting.
• Diarrhoea.
• Fever.
• Not able to eat or drink.
• Symptoms of a urinary or genital tract infection.
• Abdominal pain.
• Feeling very tired or breathless.

For more information on medications with sickness here –

A5_T2Illness_TREND_FINAL.pdf

Taking certain medicines when dehydrated or very unwell can result in you developing a more serious illness. If you are unwell (i.e. too unwell to go to work or carry out normal daily activities) and especially if you have vomiting, diarrhoea, or fever, you should temporarily stop the medication lists below –

• Metformin.
• SGLT2 (Empagliflozin, Dapagliflozin, Canagliflozin).
• GLP1 (Mounjaro, Ozempic, Trulicity).

Once you are better and can drink normally you should re-start your medicine(s). If you remain unwell after 48 hours, or are unsure about restarting, seek medical advice from your GP/Pharmacy/NHS 111/Specialist Nurse.

The main treatment for managing blood sugar levels if you have type 2 diabetes is weight loss and full information on weight loss management can be located via the below links through Diabetes UK.

Weight loss and diabetes | Diabetes UK

You can also access a free 12-week weight management programme using the link below -

Better Health - NHS

Moving more can help you lower your blood sugar levels long term. This is because when your muscles move, they use up sugar – also known as glucose – in the blood, bringing your blood sugar levels down. 

The following link provides information and resources on exercise via Diabetes UK.  

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise/resources

Medical advice should be sought prior to changes to physical activity if you’re on insulin or medication that can increase risk of hypoglycaemia such as Gliclazide / Glimepiride and also in light of foot care advice. 

Get Doncaster Moving offer some active guides -

Active in Doncaster Guides | Get Doncaster Moving

Healthy Eating can help maintain your Diabetes and with the right support there are some things that you can change, but others you can’t. By following the link below information on all aspects of healthy eating can be found: - https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/preventing/ten-tips-for-healthy-eating

If you’re a smoker with Diabetes giving up the habit is one of the most positive things you can do to the improve your health an reduce your risks of long-term complications.      

Further information is available via the following link.

https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/help-with-giving-up-smoking

You can also self-refer using the following link -

NHS Stop Smoking Service - Yorkshire Smokefree

It can be harmful to drink alcohol to excess. It can impact negatively on your diabetes management, your weight and general health.

The recommendation is to drink no more than 14 units of alcohol per week and to have at least 2 days alcohol free per week. 

If you drink alcohol whilst taking certain medications for your diabetes such as Gliclazide / Glimepiride or Insulin, it can cause life threatening low blood glucose levels particularly in the night (hypos) and it can reduce your awareness and warning signs that the blood sugar level is dropping too low. 

Please see more information below –

https://www.diabetes.org.uk/living-with-diabetes/eating/what-to-drink-with-diabetes/alcohol-and-diabetes?gad_campaignid=15219795760&gad_source=1

https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/

www.drinkaware.co.uk

The Podiatry Foot Protection Service in Doncaster (Rotherham Doncaster and South Humber NHS Foundation Trust) has some helpful and useful information on. This includes advice videos from the Podiatry Service:

Diabetes foot health – Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH)

Diabetes UK also has a helpful guide – “Diabetes and looking after your feet” which is available on their website to download or order a free copy. The guide provides information on:

•            Why am I at risk?

•            How to check your feet

•            Your annual foot check

•            Signs of a serious foot problem

•            Reducing your risk of a serious foot problem

https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications/feet

When to Access Care

Keep your regular appointments that are planned by your doctor/nurse.

Seek advice if you have:

• • Significant changes in diet or weight.
  • Any side effects from any of the medications.
  • If you have not heard at a time when you are due a review. 
  • If you have been hospitalised or any of the medications are added or removed.
  • If you are going to take up a new exercise or sports routine.
  • If you are using a glucose monitor and experience any low blood sugar levels (less than 4).

Having diabetes doesn't have to rule your life. It can feel overwhelming, but no matter how long since your diagnosis, you can benefit from support. It’ll help you manage your diabetes. Ask your doctor or nurse about free diabetes education courses such as XPERT.

X-PERT Health Diabetes Education and Weight Loss Programmes

People who go on these courses often feel more confident about managing their diabetes, making healthier food choices, looking after themselves and meeting other people with diabetes. If you're supporting someone with diabetes, you can usually go along on a face-to-face course with them.

For more information on courses use the link below -

Diabetes education courses | Diabetes UK

This programme supports people with Type 2 diabetes to achieve remission through weight loss. It offers structured plans and guidance, potentially helping reduce or even stop diabetes medications. Learn more about the Remission Programme or find out if you are eligible NHS Remission Programme Overview. There's no guarantee your diabetes will go into remission but the only way to know if it's possible for you is to try it.

Continuous glucose monitors also known as CGM let you check your blood sugar levels without having to prick your finger. CGM is a small sensor that sits under the skin at all times that reads your blood sugar levels, and the information is shared with your phone or reader. However, the CGM is not offered to everyone. You can find more information on this below –

What are continuous glucose monitors? | Diabetes UK

However, many type 2 patients are not eligible for CGM, but some are eligible for self-monitoring of blood sugar using test strips and lancets. More information on self-monitoring blood sugars can be found below –

How to check your blood sugar levels | Diabetes testing | Diabetes UK

Finger Pricking is how you find out what your blood sugar levels are at that moment in time. Your health care team will show you how to use the tests and it is important to do this properly or you could get the wrong results.

For more information on finger prick testing please see below –

How to check your blood sugar levels | Diabetes testing | Diabetes UK

For more people with diabetes driving isn’t a problem and you can carry on driving. But diabetes can affect your ability to drive safely. The three main things that can affect driving are –

• If you treat your diabetes with certain medications or insulin you are more at risk of having a hypo (where your blood sugar levels drop below 4mmol/l).
• Being unable to recognise the warning symptoms of hypos.
• If you develop diabetic complications.

For more information, please follow the link below –

Driving when you have diabetes | Diabetes UK

You also need to make DVLA know that you have Diabetes, follow the link below for more information –

Diabetes and driving - GOV.UK

Information for drivers with diabetes - GOV.UK

Living with diabetes shouldn't be a barrier to taking trips or holidays at home or abroad it just means there are a few more things to think about before you set off.  You should plan to take 2-3 times the amount of insulin or other diabetes medication and equipment you’d normally use in case you unexpectedly stay for longer than expected.

If you’re travelling abroad, a little extra planning can go a long way to help you relax and enjoy yourself.

A doctor's letter and travel insurance maybe required if you are carrying sharp objects like needles or syringes, liquids in excess of 100ml, medical devices like Continuous Glucose Monitor (CGM’s), international travel, if you’re travelling with large number of supplies or if you require special assistance. However, it is always good to check this with your airline or travel company.

You may find the following links useful when organising future travel.

Travelling with diabetes | Managing your diabetes | Diabetes UK

Having family members diagnosed with Diabetes can be tough on everyone and Diabetes UK can offer support to you and your family members. Use the link below for more information –

Support for newly diagnosed families | Diabetes UK

If a loved one or friend can’t manage without your help with their diabetes — and you are unpaid — you’re seen as a carer. This is different to providing support as and when needed. Often, the person you’re caring for will have other health conditions too. 

If you’re finding it hard to manage practically and financially, you may need help. Find out where and how to get help in the Social care and support guide on the NHS website. The charity Carers UK is also there to help you.

As a carer you are entitled to go on a diabetes education course with the person you’re supporting – however long they’ve had diabetes. This will help you feel better informed about helping them look after their diabetes. 

If you have diabetes and are thinking of getting pregnant you will need advice on this, and it is important to speak to a Health Care Professional.

Most women with diabetes have a healthy baby but planning for pregnancy with diabetes is really important as you and baby are at more risk of serious health complications during pregnancy and childbirth. The good news with planning ahead is that you can get support from your GP and Diabetic Team, and this will reduce health risks.

More information on pregnancy and diabetes can be found below –

Pregnancy and diabetes | Diabetes UK

In some religions fasting is an important spiritual aspect but it can lead to major health problems for someone with Diabetes. If you have any symptoms of illness such as cold, Covid-19 or flu, it is best not to fast. More information can be found on this below –

Religious fasting and diabetes | Enjoy food | Diabetes UK

Ramadan is one of the longest periods of fasting, further information on this can be found below Diabetes and Ramadan | Fasting | Diabetes UK

Talking Therapies are to support adults who may experience stress, depression, or anxiety in the context with their long-term conditions. This is available for patients with Diabetes. More details of talking therapies can be found below -

https://www.rdash.nhs.uk/services/nhs-talking-therapies-for-long-term-conditions/