Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Glucose is your body’s main source of energy.
It is very common, highly manageable, and with the right knowledge, you can stay firmly in control of your health.
Diabetes occurs when your body either cannot make enough insulin or cannot effectively use the insulin it produces. Insulin is the essential hormone that acts like a key to let blood sugar into your cells for energy.
It is very common: Millions of people live with diabetes worldwide.
Often silent early on: Type 2 diabetes can develop gradually, meaning you might not notice any symptoms at first.
A chronic condition: While it is long-term, it can be successfully managed for decades.
Prevention is possible: Effective management and lifestyle changes can prevent or significantly delay long-term complications.
While all types result in high blood sugar, they have different causes and require different approaches.
| Type | What Happens | Typical Onset | Main Treatment |
| Type 1 | The body’s immune system mistakenly destroys insulin-producing cells. | Usually children/young adults | Daily insulin injections or pump |
| Type 2 | The body becomes resistant to insulin and doesn’t make enough. | Usually adults (but rising in youth) | Lifestyle, oral medications, +/- insulin |
| Gestational | High blood sugar that develops during pregnancy. | During pregnancy | Diet, monitoring, sometimes medication |
Your HbA1c test is a simple blood test that measures your average blood sugar levels over the past 2 to 3 months. It is the gold standard for monitoring diabetes control.
| Category | HbA1c (mmol/mol) | HbA1c (%) | Meaning |
| Normal | <42 mmol/mol | Below 5.7% | No diabetes |
| Prediabetes | 42–47 mmol/mol | 5.7% – 6.4% | High risk of developing Type 2 |
| Diabetes | ≥48 mmol/mol | 6.5% or higher | Diagnostic for diabetes |
Note: Target ranges can vary. For most adults with diagnosed diabetes, a general target is around 53 mmol/mol (7.0%), but your doctor will personalize this for you.
Understanding why diabetes develops helps in targeting its management.
Family History: Having a parent or sibling with diabetes increases your risk.
Weight & Inactivity: Excess body fat (especially around the abdomen) and a sedentary lifestyle are strong triggers for Type 2.
Age: The risk of Type 2 diabetes increases as you get older.
Ethnicity: People of South Asian, Black, African-Caribbean, and Middle Eastern descent have a higher risk of developing Type 2 diabetes at a younger age.
Autoimmune Factors: Type 1 diabetes is driven by an unavoidable genetic and immune response, not lifestyle.
When blood sugar levels are high, the body tries to flush out the excess glucose, leading to recognizable symptoms.
Feeling constantly thirsty
Urinating more frequently than usual (especially at night)
Feeling incredibly tired or lethargic
Unexplained weight loss (more common in Type 1)
Frequent bouts of thrush or slow-healing wounds
Blurred vision
Extreme blood sugar highs or lows can become medical emergencies. Seek immediate care if you experience:
Signs of DKA (Diabetic Ketoacidosis): Fruity-smelling breath, vomiting, deep/rapid breathing, and confusion (mostly affects Type 1).
Severe Hypoglycemia (Low Blood Sugar): Shakiness, sweating, confusion, or passing out that doesn’t improve after eating fast-acting sugar.
Severe Infections: Any foot ulcer or wound that looks infected, red, swollen, or hot to the touch.
Managing diabetes relies on keeping blood sugar steady to protect your blood vessels and vital organs.
Metformin: The most common first-line pill for Type 2; it helps your body use insulin better.
SGLT2 Inhibitors: Pills that help your kidneys flush out excess sugar through your urine. They also heavily protect your heart and kidneys.
GLP-1 Receptor Agonists: Injections (or pills) that mimic natural hormones to lower blood sugar, reduce appetite, and protect the cardiovascular system.
Insulin: Vital for Type 1 diabetes and often used in Type 2 when other medications need a boost.
Blood Pressure Pills (ACE Inhibitors/ARBs): Used to protect your kidneys from diabetes-related damage.
Statins: Cholesterol-lowering medication routinely recommended to protect your heart health.
Small, consistent daily habits make the biggest difference in managing diabetes successfully.
Follow a Balanced Diet: Focus on whole grains, lean proteins, and plenty of vegetables. Minimize highly processed foods and sugary drinks.
Stay Active: Aim for at least 150 minutes of moderate exercise (like brisk walking) per week. Physical activity naturally lowers blood sugar.
Manage Weight: Losing even 5% of your body weight can significantly improve Type 2 diabetes control.
Take Care of Your Feet: Wash and check your feet daily for cuts, blisters, or red spots, as diabetes can reduce blood flow and nerve sensation.
Quit Smoking: Smoking combined with diabetes drastically increases the risk of heart disease and stroke.
Regular checkups catch potential issues early. Ensure you receive your annual diabetes review, which covers the “Healthcare Essentials”:
HbA1c Blood Test: Checked every 3 to 6 months to monitor average blood sugar.
Blood Pressure: Checked at every visit (Target is generally under 130/80).
Kidney Function: An annual blood test (eGFR) and urine test (ACR) to check for protein leaks.
Diabetic Eye Screening: An annual photograph of your retinas to check for blood vessel damage.
Foot Check: An annual exam by a professional to check circulation and nerve sensation.
While your primary care doctor manages most diabetes care, you may be referred to a Diabetes Specialist (Endocrinologist) or specialist nurse if:
You are newly diagnosed with Type 1 diabetes.
Your blood sugar remains high despite trying multiple medications.
You experience frequent, severe low blood sugar levels (hypos) or lose your awareness of them.
You are planning a pregnancy or become pregnant.
You develop advanced complications affecting your eyes, kidneys, or nerves.
Diabetes is common, highly manageable, and does not have to control your life. By working closely with your healthcare team, keeping up with regular checks, and adopting heart-healthy daily habits, you can feel well and protect your health for the future.
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