What Does my Blood GFR and Urine ACR Mean?
May 8, 2026
What does my blood GFR and urine ACR mean – and how are they connected? Glomerular filtration rate (GFR) This is a blood test that measures kidney function – the higher the GFR, the b...
Diabetes is a long-term condition where your blood sugar levels become too high. This happens because your body either cannot make enough insulin, or the insulin it does make isn’t working properly.
Insulin is a vital hormone that acts like a key, letting the sugar from your food enter your cells to be used for energy.
When that process breaks down, sugar builds up in your blood instead, which can cause health problems over time if it isn’t managed.
In the UK: Over 5.6 million people are currently living with diabetes, and that number is growing every year.
Type 1 Diabetes: Around 8% of people with diabetes have this type. It is an autoimmune condition that is usually diagnosed in children and young adults.
Type 2 Diabetes: This is by far the most common type, accounting for about 90% of cases. It is closely linked to lifestyle, weight, and family history.
Other Types: The remaining 2% includes Gestational Diabetes (which happens during pregnancy) and a few rarer, inherited forms.
Knowing exactly which type of diabetes you have is incredibly important because it changes how your medical team will help you look after your health.
| Feature | Type 1 Diabetes | Type 2 Diabetes |
| What is happening? | The body’s immune system mistakenly attacks and destroys the cells that make insulin. The body now makes zero insulin. | The body still makes insulin, but the cells have become resistant to it, or there just isn’t quite enough to keep up. |
| When does it start? | It usually appears quickly, often during childhood, teenage years, or early adulthood. | It develops very gradually and is most common in adults over 45, though it is becoming more common in younger people. |
| Body Weight | Most people are a healthy weight or quite lean when they are diagnosed. | It is often (but not always) linked to carrying extra weight, especially around the tummy. |
| Urgent Risks | High risk of a dangerous condition called DKA if an insulin dose is missed. | Low risk of DKA, but very high blood sugars can cause severe dehydration. |
| Main Treatment | You must take insulin every single day for the rest of your life, using injections or a pump. | Started with healthy lifestyle changes and tablets. Injectable medications or insulin may be needed later on. |
Anyone can get diabetes, but your genetics and your background can significantly change your baseline risk.
Family History: Your genes play a huge role. Interestingly, Type 2 diabetes runs in families even more strongly than Type 1. If a parent or sibling has Type 2, your own risk is much higher.
Your Ethnicity: Background matters a lot when it comes to Type 2. People of South Asian, African-Caribbean, and Black African descent are 2 to 4 times more likely to get Type 2 diabetes. They also tend to develop it up to 10 to 12 years earlier, and at a lower body weight, than White Europeans.
Carrying Extra Weight: Carrying excess weight, particularly around your waist, creates a physical barrier that makes it much harder for your natural insulin to do its job.
Medical Conditions: Women with Polycystic Ovary Syndrome (PCOS) naturally struggle more with how their body uses insulin. Also, if you developed diabetes while pregnant (Gestational Diabetes), you have a 50% chance of developing permanent Type 2 diabetes within the next 5 to 10 years.
Catching diabetes early protects your long-term health. With Type 1 diabetes, these symptoms can come on incredibly fast—sometimes over just a few days.
With Type 2, they can be so slow and mild that people live with the condition for years without noticing anything at all.
Always look out for the 4 Ts:
Toilet: Going to the loo much more often than usual, especially waking up multiple times in the night. When there is too much sugar in your blood, your kidneys try to flush it out through your urine, which drags lots of extra water out of your body.
Thirsty: A severe, unquenchable thirst. Because you are losing so much fluid on your trips to the toilet, your brain sends strong signals telling you to drink to avoid dehydration.
Tired: Feeling completely exhausted and wiped out for no obvious reason. Because your body doesn’t have the insulin it needs to unlock your cells, the food you eat can’t be turned into energy. Your muscles and brain are effectively running on empty.
Thinner: Losing weight quickly without trying. This is especially common with Type 1. Because your cells can’t get energy from glucose, your body goes into survival mode and starts rapidly breaking down its own fat and muscle for fuel.
Doctors look at specific blood tests to find out if you have diabetes. The most common markers are:
HbA1c Test: 48 mmol/mol (6.5%) or higher. This is a brilliant test because it doesn’t require you to skip breakfast. It measures how much sugar has been sticking to your red blood cells. Since these cells live for about 3 months, the test gives your doctor a steady, reliable picture of your average blood sugar levels over the last 8 to 12 weeks.
Fasting Blood Glucose: 7.0 mmol/L or higher. This test measures the sugar in your blood after you have had nothing to eat or drink (except water) for at least 8 hours overnight.
Random Blood Glucose: 11.1 mmol/L or higher. This is a quick test done at any time of day, regardless of when you last ate.
Prediabetes (“The Amber Light”): This means your HbA1c is between 42 and 47 mmol/mol (6.0% to 6.4%). Your blood sugars are higher than normal, but not quite in the diabetes range yet. Think of this as a crucial warning light—it is your best opportunity to make changes and turn things around before it becomes full Type 2 diabetes.
Because people with Type 1 diabetes cannot make any insulin at all, the goal of treatment is to safely copy what a healthy pancreas would do naturally.
Daily Injections: The traditional method involves using a long-acting insulin once or twice a day to keep your background blood sugar steady. You then take a rapid-acting insulin dose right before you eat, counting the carbohydrates in your meal to figure out the exact dose you need.
Continuous Glucose Monitors (CGMs): Gone are the days of constant, painful finger-prick tests. Modern care uses a tiny sensor worn on the arm or belly that reads your sugar levels through the skin 24/7. It sends the numbers straight to your smartphone, shows you if your sugar is rising or falling, and sounds an alarm if you are heading towards a “hypo” (low blood sugar).
Insulin Pumps: These are small, electronic devices that stay attached to your body and deliver a steady trickle of rapid insulin all day and night. This replaces the need for separate background injections.
The “Artificial Pancreas” (Closed-Loop Systems): This is the gold standard of modern care. It uses clever computer software to connect your CGM sensor directly to your insulin pump. The system reads your sugar levels and automatically adjusts or pauses your insulin doses while you sleep or go about your day, taking away a massive amount of the daily guesswork.
Treating Type 2 diabetes is no longer just about forcing blood sugar numbers down. Modern medicine focuses on an all-round approach that protects your heart, looks after your kidneys, and helps you manage your weight.
Metformin: This is almost always the first tablet doctors prescribe. It is a highly trusted, safe medicine that works by stopping your liver from dumping excess stored sugar into your blood, while helping your muscles use your natural insulin much better.
SGLT2 Inhibitors (The “-gliflozin” tablets): These are clever tablets (like dapagliflozin) that tell your kidneys to stop reabsorbing sugar. Instead, they filter the extra sugar out of your blood and flush it completely out of your body when you pass urine. Doctors love these because they also provide incredible protection for your heart and slow down kidney disease.
GLP-1 Medications: These are newer weekly injections or daily tablets (like semaglutide) that work by copying your gut’s natural hormones. They slow down how fast your stomach empties, tell your pancreas to release insulin when you eat, and act on your brain to curb your appetite. They are famous for providing fantastic weight loss and heart protection.
Putting Type 2 into Remission: We now know that Type 2 diabetes does not have to be a permanent, lifelong sentence. Major medical studies have proved that if people who are newly diagnosed manage to lose a significant amount of weight (usually 10 to 15 kg), they can clear the fat out of their liver and pancreas. This allows the body to start making its own insulin properly again, putting the condition into complete remission without needing any medication.
Persistent high blood sugar behaves like a slow irritant inside your body, damaging the delicate blood vessels that supply your vital organs. Doctors divide these problems into two main areas:
Damage to Small Blood Vessels:
Your Eyes (Retinopathy): High blood sugars can damage the tiny, fragile blood vessels at the back of your eye, causing them to leak or bleed. Left unchecked, this can severely damage your eyesight.
Your Kidneys (Nephropathy): The kidneys act as the body’s filters. Constant high sugar clogs these filters, causing important proteins to leak out into your urine. Over many years, this can lead to chronic kidney disease (CKD; and, in some, kidney failure.
Your Nerves (Neuropathy): Sugar can starve your nerves of oxygen, leading to a loss of feeling, a burning pain, or numbness, usually starting in your toes and feet. Because you can’t feel pain properly, you could walk on a blister or a stone without realizing, creating a silent wound that can lead to severe infections.
Damage to Large Blood Vessels: Over time, high blood sugars harden the main arteries in your body, which significantly increases your risk of suffering a heart attack, a stroke, or poor circulation in your legs.
Dangerous Emergencies:
DKA (Diabetic Ketoacidosis): This is a severe medical emergency mostly seen in Type 1 diabetes. If your body runs out of insulin completely, it has to burn fat for energy at a dangerous, uncontrolled speed. This produces acidic waste called ketones. Symptoms include vomiting, heavy breathing, severe tummy pain, and a distinct, fruity smell on your breath.
HHS: An emergency mostly seen in older people with Type 2 diabetes, where blood sugars climb to extreme levels, leading to life-threatening dehydration.
Up to 80% of Type 2 diabetes cases can be completely delayed or prevented by making practical, everyday adjustments to your habits.
Moving Your Body: Aiming for about 150 minutes of moderate exercise a week (like a brisk daily walk, swimming, or cycling) does wonders for your metabolism. If you add in a couple of strength sessions a week, you build muscle that acts like a natural sponge, soaking up excess sugar from your blood and keeping your insulin working beautifully for up to two days after you finish your workout.
Smart Eating Habits: You don’t need to go on a miserable, restrictive diet. Focus on swapping highly processed foods and sugary drinks for whole, real foods. Choosing foods high in fiber (like vegetables, beans, and whole grains) slows down how quickly your gut absorbs sugar, preventing sudden spikes after meals and giving your pancreas an easier job.
Using Your “Amber Light”: If you have been told you have prediabetes, see it as an incredible opportunity to take action rather than a guarantee of illness. Making simple, sustainable changes to your weight and daily activity during this window can cut your risk of ever developing Type 2 diabetes by more than half—often working much better than any prescription medication.
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