A Patient Journey for Diabetes

The amount of glucose (sugar) in the blood is controlled by insulin, a hormone produced by the pancreas. When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce energy.

If you have diabetes, your body is unable to break down the glucose, either because there’s not enough insulin to move the glucose or the insulin produced doesn't work properly.

There are two main types of diabetes:

Type 1 Diabetes - where the body's immune system attacks and destroys the cells that produce insulin. Type 1 diabetes can develop quickly over days or weeks.

Type 2 Diabetes - where the body doesn't produce enough insulin, or the body's cells don't react to it. Many people have type 2 diabetes for years without realising because the early symptoms tend to be general. In the UK, around 90% of all adults with diabetes have type 2.

A third type – Gestational Diabetes - has the same symptoms as type 1 and type 2 diabetes and can occur at any stage of pregnancy, but is more common in the second half and goes away after the baby is born.

What are the symptoms?

Common symptoms include:

  • Feeling very thirsty, particularly when combined with some of the following symptoms
  • Urinating more frequently than usual, particularly at night
  • Feeling very tired
  • Weight loss and loss of muscle bulk
  • Itching around the vagina, or frequent episodes of thrush
  • Cuts or wounds that heal slowly
  • Blurred vision
  • Female sexual dysfunction

Visit your GP as soon as possible if you experience any of these symptoms.

Treatments and living with diabetes

If you're diagnosed with diabetes, you'll need to eat healthily, take regular exercise and carry out regular blood tests to ensure your blood glucose levels stay balanced.

Type 1 diabetes

As type 1 diabetes is a long-term condition, you'll be in regular contact with your diabetes care team.

You will probably need insulin injections usually given by an injection pen and, when you're first diagnosed, your diabetes care team will help you with them, before showing you how and when to do it yourself, how to store your insulin and dispose of needles properly. They may also teach close friends or relatives to inject the insulin correctly.

An alternative is an insulin pump - a small device attached to you by a thin piece of tubing and a needle and is inserted under your skin, allowing insulin to continuously flow into your bloodstream at a rate you can control.

They will also check your eyes, feet and nerves regularly, all of which can be affected by diabetes.

Type 2 diabetes

If you have type 2 diabetes, you'll need to look after your health for the rest of your life, making changes where necessary. Your GP will explain how your diabetes care team will be able to give you support and advice, including three key areas:

Eating a balanced diet is very important. The good news is you don't need to avoid certain foods altogether, just have a varied diet and make healthy choices.

  • Aim to reduce the amount of fat, salt and sugar you eat, while increasing the amount of fibre.
  • Eat regularly, include starchy carbohydrates e.g. pasta, and have plenty of fruit and vegetables.

A well-balanced diet means you will be able to achieve a satisfactory level of health and maintain a healthy weight. Any woman can develop gestational diabetes during pregnancy, but there is an increased risk if your body mass index (BMI) is above 30.

Regular moderate aerobic activity totalling two and a half hours a week e.g. cycling or fast walking, will lower your blood glucose level. Before starting a new activity, your GP will want to discuss it with you first. Exercise affects your blood glucose level and they may decide to adjust your insulin treatment or diet.

In addition to diet, your GP will want to discuss other lifestyle issues:

Smoking and alcohol

If you have diabetes, your risk of developing a cardiovascular disease is increased if you are a smoker.

Women with diabetes are advised not to regularly drink more than 14 units a week.

If you’re pregnant or are thinking about having a baby

Whether a woman has diabetes or not, the UK’s Chief Medical Officer’s advice is that, if you're pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all.

If you have diabetes and you're thinking about having a baby, you should discuss this with your diabetes care team. You will need to manage your blood glucose level to reduce the risk of birth defects, particularly before becoming pregnant until the first eight weeks of your baby's development.

You should also:

  • Check your medications, some of which may harm your baby and you may have to switch to insulin injections.
  • Take a higher dose of Folic acid, which helps prevent your baby developing spinal cord problems. Women with diabetes are advised to take 5mg each day (only available on prescription).
  • Have your eyes checked. Diabetic eye screening is important because the risk of serious eye problems is greater in pregnancy.
  • Talk to your GP about giving birth with the support of a consultant-led maternity team in a hospital.

Your GP or diabetes care team can give you further advice on all these topics and further information and advice can be found on talkhealth:

Online Clinic on Diabetes

talkhealth diabetes blog

talkhealth supports the charity Diabetes UK

Sources used in writing this article are available on request.

Information written by the talkhealth team

Last revised: 20 September 2017

Next review: 20 September 2020