Type 2 diabetes
Increasing the amount of fibre in your diet and reducing your sugar and fat intake, particularly saturated fat, can help prevent type 2 diabetes, as well as manage the condition if you already have it.
The Diabetes UK website has more information and advice about healthy eating .
If you're overweight or obese you have a body mass index (BMI) of 30 or overyou should lose weight by gradually reducing your calorie intake and becoming more physically active.
Losing 5-10% of your overall body weight over the course of a year is a realistic initial target.
You should aim to continue to lose weight until you've achieved and maintained a BMI within the healthy range, which is:
If you have a BMI of 30kg/m or more (27.5kg/m or more for people of south Asian or Chinese origin), you need a structured weight loss programme, which should form part of an intensive lifestyle change programme.
To help you achieve changes in your behaviour, you may be referred to a dietititian or a similar healthcare professional for a personal assessment and tailored advice about diet and physical activity.
Being physically active is very important in preventing or managing type 2 diabetes.
For adults who are 19-64 years of age, the government recommends a minimum of:
An alternative recommendation is to do a minimum of:
Going for a daily walkfor example, during your lunch break is a good way of introducing regular physical activity into your schedule.
If you're overweight or obese, you may need to be more physically active to help you lose weight and maintain weight loss.
Your GP, diabetes care team or dietitian can give you more information and advice about losing weight and becoming more physically active.
The Diabetes UK website has more information and advice about getting active and staying active .
Type 2 diabetes usually gets worse over time. Making lifestyle changes, such as adjusting your diet and taking more exercise, may help you control your blood glucose levels at first, but may not be enough in the long term.
You may eventually need to take medication to help control your blood glucose levels.
Initially, this will usually be in the form of tablets and can sometimes be a combination of more than one type of tablet. It may also include insulin or another medication that you inject.
Metformin is usually the first medicine used to treat type 2 diabetes. It works by reducing the amount of glucose your liver releases into your bloodstream. It also makes your body's cells more responsive to insulin.
Metformin is recommended for adults with a high risk of developing type 2 diabetes andwhose blood glucose is still progressing towards type 2 diabetes, despite making necessary lifestyle changes.
If you're overweight, it's also likely you'll be prescribed metformin. Unlike some other medicines used to treat type 2 diabetes, metformin shouldn't cause additional weight gain.
However, it can sometimes cause mild side effects, such as nausea and ankle swelling (oedema) .
You shouldn't take pioglitazone if you have
If glucose-lowering tablets aren't effective in controlling your blood glucose levels, you may need to have insulin treatment.
This can be taken instead of or alongside your tablets, depending on the dose and the way you take it.
Insulin comes in several different preparations, and each works slightly differently.
For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don't last very long (rapid-acting).
Your treatment may include a combination of these different insulin preparations.
Insulin must be injected becauseit would be broken down in your stomach like food and unable to enter your bloodstream if it were taken as a tablet.
If you need to inject insulin, your diabetes care team will advise you about when you need to do it.
They will show you how to inject it yourself, and will also give you advice about storing your insulin and disposing of your needles properly.
Insulin injections are given using either a syringe or an injection pen, also called an insulin pen (auto-injector). Most people need between two and four injections of insulin a day.
Your GP or diabetes nurse will also teach a relative or a close friend how to inject the insulin properly.
You can read more about insulin and how to inject it on the Diabetes UK website.
If you have type 2 diabetes that's controlled using insulin or certain types of tablets, you may experience episodes of hypoglycaemia .
Hypoglycaemia is where your blood glucose levels become very low.
Mild hypoglycaemia (a "hypo") can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.
If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets.
This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit.
In most cases, these measures will be enough to raise your blood glucose level to normal, although it may take a few hours.
If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness.
If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.
Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.
If you have type 2 diabetes, your risk of developing
If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months.
This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.
The HbA1c test is used to measure blood glucose levels over the previous two to three months.
HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.
A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.
Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 59mmol/mol (7.5%). However, it can be as low as 48mmol/mol (6.5%) for some people.
Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.
A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be usefulfor detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia) .
If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.
Blood glucose meters aren't currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you're unsure.
Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb) .
Regularly monitoring your blood glucose levels will ensure your blood glucose is as normal and stable as possible.
As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment you're taking.
In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood.
A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short.
A normal blood glucose level is 4-6 mmol/l before meals (preprandial) and less than 10 mmol/l two hours after meals (postprandial), although this can vary from person to person.
Your diabetes care team can discuss your blood glucose level with you in more detail.
Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. This means glucose stays in the blood and isn't used as fuel for energy.
Read about the symptom of diabetes, including feeling very thirsty, passing more urine than usual, and feeling tired all the time.
Read about the causes of type 2 diabetes, which occurs when the pancreas doesn't produce enough insulin to maintain a normal blood glucose level, or the body is unable to use the insulin that is produced.
Read about treating type 2 diabetes. Find out how to keep your blood glucose levels as normal as possible by making lifestyle changes, such as eating more healthily and taking more exercise.
Read about complications of type 2 diabetes. Without treatment, it can lead to a number of other health problems. High glucose levels can damage blood vessels, nerves and organs.
Read about living with type 2 diabetes. If you have type 2 diabetes, you'll need to look after your health very carefully.
After his victory at the 2000 Sydney Olympics, Sir Steve Redgrave became the only British athlete ever to win five consecutive Olympic gold medals.
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