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Management of Diabetes

What is Diabetes?

Diabetes is a lifelong condition in which your body produces blood sugar levels that are too high. Generally, diabetes is categorised into two types: Type 1 and Type 2, as detailed below.  Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2.

Type 1 Diabetes

In people with type 1 diabetes, the pancreas does not make enough insulin, a hormone that regulates blood sugar levels. People with type 1 diabetes require insulin treatment to manage their blood sugar levels and need to check their blood sugar levels regularly. In some people, insulin treatment may be given in the form of multiple daily injections; a long acting or ‘basal’ insulin and also short-acting insulin with meals. In others, an insulin pump may be more appropriate. Increasingly, people with type 1 diabetes may benefit from glucose sensing technologies (CGM – continuous glucose monitoring), which replaces finger prick testing with a sensor that can be worn for many days, allowing the individual to view graphs of their glucose levels and respond to trends.

Our specialists have a wide range of experience in supporting people to self-manage type 1 diabetes and can discuss which insulin may be most appropriate for you, the use of pumps and CGM and also, with support from a specialist dietitian, can provide training around carbohydrate counting. In addition to helping you manage your blood sugar levels, our specialists recognise the importance of maintaining good health and will also discuss your cholesterol levels and blood pressure management and monitor for the development of complications.

Type 2 Diabetes

Type 2 diabetes develops when the body doesn’t respond to insulin appropriately (insulin resistance) and is often associated with being overweight, but not in all cases. In the initial stages, changing diet and lifestyle to induce weight loss, may be enough to reverse the condition, however medicines are usually started quite early on. With time, the medicines may also not be enough to manage blood sugars and insulin injections may need to be started. Like all forms of diabetes, type 2 diabetes is a risk factor for heart attacks and strokes, so it’s very important to manage not only blood sugar levels, but also blood pressure and cholesterol levels.

In recent years there have been a number of new medicines available to help treat type 2 diabetes, some of these have the added benefit of reducing risk of cardiovascular complications in the future. Our specialists will make an assessment of your individual needs and preferences when supporting you to self-manage your type 2 diabetes. With knowledge of all the latest developments in treatment you can be confident of a thorough assessment and specialist input.

Other types of Diabetes

Aside from type 1 and type 2 diabetes, there are many other types of diabetes including genetic forms of diabetes (MODY) and hybrid forms that don’t quite ‘fit’ with typical type 1 or type 2 diabetes. These include, LADA or adult onset type 1 diabetes, ketosis-prone types 2 diabetes and other atypical presentations.

Treatment of Diabetes at OneWelbeck

Whatever category you fall into, our specialists will use the latest diagnostic tools to help classify and manage your specific types of diabetes and where possible, provide clarity around your diagnosis. In some cases genetic testing may be necessary to identify genetic forms of diabetes and we will ensure you are consented and counselled thoroughly. We may also arrange dynamic tests to look at how your own insulin production responds to food intake. For those with rare or unusual forms of diabetes, our specialists will counsel about the best treatment and individualise decision-making specifically to you and your needs.

Type 1 Diabetes

If you have type 1 diabetes our specialists will plan carefully the best approach to your management and will discuss pros and cons of all approaches along with support from specialist diabetes nurses, dietitians and psychologists. Our specialists take a holistic approach, focusing not just on glucose control, but also your overall cardiovascular health and well-being.

Our specialists can support you in the use of technology to help self-management of your diabetes, including the use of insulin pumps and continuous and intermittent glucose sensing devices. They will also discuss the advantages of different types of insulin injection, support carbohydrate counting and advise on how to manage glucose levels in challenging situations e.g. during exercise.

Type 2 Diabetes

The management of type 2 diabetes is rapidly evolving with new medications that not only lower blood glucose levels, but also improve risk of heart attacks and strokes. Our specialists will discuss in detail the pros and cons of different medications and the ones that are best suited to you. They will support you to not only manage your glucose levels, but also your cardiovascular health and well-being. If you are keen to use technology or apps to help manage your diabetes, our Specialists can help and if you have progressed to needing insulin, they can advise on the best choice and support you with this.