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Diabetes Management
Diabetes is serious disease but can be managed well with a combination of medicines and lifestyle changes.
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Diabetes is a health condition in which your body has difficulty converting glucose (a type of sugar) into energy. This leads to high levels of sugar in the blood (hyperglycaemia).
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Your blood glucose levels are normally controlled by a hormone called insulin, which converts glucose into energy.
Diabetes occurs when your body can’t produce insulin or when your body can’t make use of the insulin because it’s grown resistant to it.
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Early diagnosis and treatment can also help to reduce the risk of more serious complications.
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Speak to your doctor as soon as possible if you are experiencing symptoms of diabetes listed below or have concerns about your risk of diabetes.
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ARE YOU AT RISK? — Are you at risk of type 2 diabetes? Use the Risk Checker to find out.
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Types of Diabetes
There are several types of diabetes:
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Type 1 diabetes, occurs when a person’s own immune system breaks down the cells in the pancreas that produce insulin.
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Type 2 diabetes occurs when the body’s cells do not respond effectively to insulin or lose the ability to produce enough insulin in the pancreas. This causes glucose to stay in the blood, leading to a higher-than-normal level of glucose in the body.
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Gestational diabetes occurs when a woman experiences high blood glucose levels during pregnancy. It usually goes away after the baby is born. Women who experience gestational diabetes have a higher risk of developing type 2 diabetes in the future.
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Pre-diabetes is where blood glucose levels are higher than usual, but not high enough for a diagnosis of diabetes.
What are the symptoms of diabetes?
Common symptoms of diabetes include:
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excessive thirst or hunger
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passing more urine than usual
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feeling tired and lethargic
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unexplained weight loss (for type 1), or gradual weight gain (for type 2)
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having cuts that heal slowly
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itchy skin or skin infections
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blurred vision
Type 1 diabetes is usually spotted quickly, since symptoms can appear suddenly. Most people with type 1 diabetes are diagnosed before the age of 19.
Many people with type 2 diabetes, however, don’t have symptoms at all or have signs that go unnoticed for a long time.
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What causes diabetes?
There are different possible causes of diabetes according to type.
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Type 1 diabetes
Type 1 diabetes is an auto-immune condition: your body’s immune system attacks the cells in your pancreas that produce insulin. The exact cause of this reaction is still unknown, but diet and lifestyle are not factors that determine who gets type 1 diabetes. Research suggests that both genetics and the environment may play a part. While having a family history increases your risk, most people with type 1 diabetes have no family history of the condition.
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Type 2 diabetes
Type 2 diabetes develops gradually over years as your body’s insulin becomes less effective at managing your blood glucose levels. As a result, your pancreas produces more and more insulin, and eventually the insulin producing cells wear out and become ineffective. Type 2 diabetes is a combination of low insulin and ineffective insulin.
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The risk of getting type 2 diabetes increases with certain lifestyle factors:
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a family history of diabetes
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low levels of physical activity
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poor diet
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being obese or overweight, especially around the waist
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Gestational diabetes
During pregnancy, certain hormones that provide nutrition for a growing baby reduce the effectiveness of the mother's own insulin. If the pancreas is unable to produce enough insulin in response, blood glucose levels rise and gestational diabetes develops.
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How is diabetes diagnosed?
If your doctor suspects you have diabetes, you will be asked to have a blood test to check your glucose levels.
This may include:
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Fasting glucose test — testing your glucose levels after fasting for 8 hours.
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Oral glucose tolerance test (OGTT) — this involves drinking a sugary drink (after fasting), then testing your glucose levels 1 to 2 hours later to assess the effect.
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Random blood glucose test — a blood test taken without fasting.
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HbA1c test — this test doesn’t require fasting as it doesn’t test glucose levels directly, but looks for a by-product in your red blood cells that shows how your body manages glucose over time.
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If you’re pregnant, your doctor will screen for gestational diabetes as part of standard antenatal testing.
How is diabetes treated and managed?
Although there is currently no cure, diabetes can be managed with lifestyle changes and medication.
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Type 1 diabetes
If you have type 1 diabetes, you will need insulin replacement, through injections or an insulin pump. This helps control your body’s blood glucose levels. While there's nothing you can do to prevent type 1 diabetes, your lifestyle choices after your diagnosis can reduce the risk of developing more serious complications such as kidney disease, eye damage and foot problems.
Type 2 diabetes
Type 2 diabetes can sometimes be initially managed by lifestyle changes, such as following a healthy diet and being physically active. Eventually, you may need to take medicines to manage glucose levels. Your doctor may prescribe tablets or injectable medicines (insulin or others) to help keep your blood glucose in the target range.
Gestational diabetes
While every woman’s experience is different, gestational diabetes can usually be managed by keeping blood glucose levels within the range for a healthy pregnancy. This involves a healthy eating plan and regular physical activity. Medication may be needed if adequate glucose control can't be achieved with lifestyle changes alone.
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Blood glucose monitoring
Crucial to diabetes management is regular blood glucose monitoring. This helps you to understand the relationship between blood glucose, food, exercise and insulin in your body. It also helps you keep track of potential treatment side effects, such as hypoglycaemia (a sudden drop in blood sugar).
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