Check if you have type 2 diabetes

Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

• peeing more than usual, particularly at night
• feeling thirsty all the time
• feeling very tired
• losing weight without trying to
• itching around your penis or vagina, or repeatedly getting thrush
• cuts or wounds taking longer to heal
• blurred vision

You're more at risk of developing type 2 diabetes if you:

• are over 40 (or 25 for south Asian people)
• have a close relative with diabetes (such as a parent, brother or sister)
• are overweight or obese
• are of south Asian, Chinese, African Caribbean or black African origin (even if you were born in the UK)

Type 2 diabetes is often diagnosed following blood or urine tests for something else.

However, you should see your GP straight away if you have any symptoms of diabetes.

To find out if you have type 2 diabetes, you usually have to go through the following steps:

1. See your GP about your symptoms.
2. Your GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back.
3. If you have diabetes, your GP will ask you to come in again so they can explain the test results and what will happen next.

If you're diagnosed with diabetes

What your GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

Generally, they'll talk to you about:

• what diabetes is
• what high blood sugar means for your health
• what medicine you'll have to take
• your diet and exercise
• your lifestyle – for example, alcohol and smoking

If you have questions about your diagnosis

It's usually difficult to take in everything the GP tells you during the appointment.

Talk to family and friends about what the GP told you, and write down any questions you have.

Then make another GP appointment and take your list of questions with you.

There's also a lot of information on diabetes available.

What happens after the diagnosis

Usually, the following things happen after your diagnosis:

1. Your GP will prescribe medicine. It might take time for you to get used to the medicine and to find the right doses for you.
2. You might need to make changes to your diet and be more active.
3. You'll have to go for regular type 2 diabetes check-ups.
4. You'll have to look out for certain signs to avoid other health problems.
5. Ask your GP about a free education course for type 2 diabetes.

Medicines for type 2 diabetes

Most people need medicine to control their type 2 diabetes.

Medicine helps keep your blood sugar level as normal as possible to prevent health problems. You may have to take it for the rest of your life.

Diabetes usually gets worse over time, so your medicine or dose may need to change.

Adjusting your diet and being active is also necessary to keep your blood sugar level down.

Getting the right medicine for you

Diabetes medicines help lower the amount of sugar in your blood.

You'll usually be offered a medicine called metformin first.

If your blood sugar levels are not lower within 3 months, you may need another medicine.

Over time, you may need a combination of medicines. Your GP or diabetes nurse will recommend the medicines most suitable for you.

Insulin is not often used for type 2 diabetes in the early years. It's only needed when other medicines no longer work.

Diabetes UK has more information about taking medicines for type 2 diabetes.

Taking your medicine

Your GP or diabetes nurse will explain how to take your medicine and how to store it.

If you need to inject insulin, they'll show you how.

Side effects

Your diabetes medicine may cause side effects.

These can include:

• bloating and diarrhoea
• weight loss or weight gain
• feeling sick
• swollen ankles

Not everyone has side effects.

If you feel unwell after taking medicine or notice any side effects, speak to your GP or diabetes nurse.

Do not stop taking medication without getting advice.

How to get free prescriptions for diabetes medicine

You're entitled to free prescriptions for your diabetes medicine.

To claim your free prescriptions, you'll need to apply for an exemption certificate.

To do this:

• fill in a form at your GP surgery
• you should get the certificate in the post about a week later – it'll last for 5 years
• take it to your pharmacy with your prescriptions

Save your receipts if you have to pay for diabetes medicine before you receive your exemption certificate. You can claim the money back.

Travelling with diabetes medicines

If you're going on holiday:

• pack extra medicine – speak to your diabetes nurse about how much to take
• carry your medicine in your hand luggage just in case checked-in bags go missing or get damaged
• if you're flying with a medicine you inject, get a letter from your GP that says you need it to treat diabetes

Staying healthy if you have type 2 diabetes

A healthy diet and keeping active will help you manage your blood sugar level.

It'll also help you control your weight and generally feel better.

You can eat many types of foods

There's nothing you cannot eat if you have type 2 diabetes, but you'll have to limit certain foods.

You should:

• eat a wide range of foods – including fruit, vegetables and some starchy foods like pasta
• keep sugar, fat and salt to a minimum
• eat breakfast, lunch and dinner every day – do not skip meals

If you need to change your diet, it might be easier to make small changes every week.

Information about food can be found on these diabetes sites:

• food for people with diabetes
• tips on eating with your family and eating out
• recipes for people with diabetes
• food and nutrition message board

Help with changing your diet

If you find it hard to change your diet, a dietitian might be able to help.

Talk to your GP or diabetes nurse to see if the cost could be covered through the NHS.

Being active lowers your blood sugar level

Physical exercise helps lower your blood sugar level. You should aim for 2.5 hours of activity a week.

You can be active anywhere as long as what you're doing gets you out of breath.

This could be:

• fast walking
• climbing stairs
• doing more strenuous housework or gardening

The charity Diabetes UK has tips on how to get active.

Your weight is important

Losing weight (if you're overweight) will make it easier for your body to lower your blood sugar level, and can improve your blood pressure and cholesterol.

To know whether you're overweight, work out your body mass index (BMI).

If you need to lose weight, try to do it slowly over time. Aim for around 0.5 to 1kg a week.

The charity Diabetes UK has more information on healthy weight and weight loss.

Type 2 diabetes check-ups help to make sure your condition doesn't lead to other health problems.

Every 3 months

Blood sugar checks (HbA1C test)

Checks your average blood sugar levels and how close they are to normal.

You have these checks every 3 months when newly diagnosed, then every 6 months once you're stable.

This can be done by your GP or diabetes nurse.

Once a year

Feet

Checks if you've lost any feeling in your feet, and for ulcers and infections.

This can be done by your GP, diabetes nurse or podiatrist.

Speak to your GP immediately if you have cuts, bruises or numbness in your feet.

Eyes

Checks for damage to blood vessels in your eyes.

Speak to your GP immediately if you have blurred vision.

Blood pressure, cholesterol and kidneys

Checks for high blood pressure, heart and kidney disease.

This can be done by your GP or diabetes nurse.

Why it's important to have these check-ups.

You need to keep an eye on your health and have regular check-ups if you have type 2 diabetes because it can lead to:

• heart disease and stroke
• loss of feeling and pain (nerve damage) – causing problems with sex
• foot problems – like sores and infections
• vision loss and blindness
• miscarriage and stillbirth
• problems with your kidneys

Controlling your blood sugar level and having regular diabetes check-ups is the best way to lower your risk of complications.

Getting your heart checked

You should have your cholesterol (blood fats) and blood pressure checked at least once a year. Diabetes increases your risk of heart disease and stroke, so it's important that high blood pressure and high cholesterol are spotted and treated early.

If you're already being treated for high cholesterol and high blood pressure, keep taking your medicine.

Diabetes also worsens the effects of smoking on your heart. Get help to quit smoking.

Loss of feeling

You should let your GP or diabetes nurse know if you notice any changes in your body.

Diabetes can damage your nerves (neuropathy). This usually affects your feet, but it can affect other parts of your body, causing:

• numbness
• pain or tingling
• problems with sex
• constipation or diarrhoea

Early treatment can prevent nerve damage getting worse.

Looking after your feet

You should check your feet every day. Diabetes can reduce the blood supply to your feet and cause a loss of feeling.

This means foot injuries don't heal well and you may not notice if your foot is sore or injured. These problems can lead to ulcers and infections.

Simple things are important, like:

• keeping feet clean and dry to avoid infection
• trying not to go barefoot outside to avoid nicks and cuts
• wearing shoes that fit well

Speak to your GP or diabetes nurse if you notice any changes in your feet, including:

• cuts, cracks or blisters
• pain or tingling
• numb feet

Diabetes UK has advice on how to check your feet.

Your feet should also be checked every year by your GP, diabetes nurse or podiatrist.

Sores or infections that aren't treated early can lead to gangrene. More than 135 amputations resulting from diabetes are carried out every week in the UK.

Checking your eyes

Your eyes should be checked every year for damaged blood vessels, which can cause sight problems (diabetic retinopathy) and blindness.

Eye checks can detect damage before it affects your sight. Treating damaged blood vessels early can prevent sight problems.

Speak to your GP immediately if you notice changes to your sight, including:

• blurred vision, especially at night
• shapes floating in your vision (floaters)
• sensitivity to light

Pregnancy and diabetes

Speak to your GP or care team if you're thinking of having a baby.

You can have a safe pregnancy and birth if you have type 2 diabetes. But you will need to take extra precautions and have more appointments before and during pregnancy.

There is a lot of information and support available for type 2 diabetes. Some of the support depends on the area you live in.

Take a course to help you manage your diabetes

There are free education courses to help you learn more about and manage your type 2 diabetes.

Your GP will need to refer you, but you can phone your GP surgery to get a referral letter, so you don't need to make an appointment.

Read more information about education courses for type 2 diabetes.

Telling DVLA you have type 2 diabetes

If you're taking insulin for your type 2 diabetes, you will need to tell DVLA. This is because of the risk of low blood sugar (hypoglycaemia). You can be fined if you don't tell DVLA.

Support groups for type 2 diabetes

The charity Diabetes UK runs local support groups.

These can help with things like managing your diabetes on a daily basis, diet, exercise or dealing with emotional problems, such as depression. They offer a place to talk and find out how others live with the condition.

Blogs, forums and apps

• Diabetes.co.uk forum – discussions about living with and managing diabetes
• Diabetes UK blogs – a collection of blogs on work and diabetes, food, eyes and more
• Diabetes Chat – scheduled chats with healthcare professionals or just the chance to talk to others
• NHS Apps Library – find apps and tools to help you manage your diabetes, including some that link you to a lifestyle coach

Telling others can be difficult

It can be difficult to tell others you have diabetes, but it can help for certain people to know:

• family can support you – especially as you will need to make changes to what you eat
• it's important your colleagues or employer know in case of an emergency
• being diagnosed with diabetes can affect your mood – telling your partner will help them understand how you feel

Carry medical ID in case of an emergency

Some people choose to wear a special wristband or carry something in their wallet that says they have diabetes, in case of an emergency.

If it's known that you have diabetes, this can make a difference to the treatment you'll receive.

Search the internet for "medical ID" to find websites that sell them.