Introduction

Diabetes is a serious condition where blood glucose levels are too high. Type 1 diabetes occurs when your body doesn't produce insulin and Type 2 is when your body does not produce enough.

Type 1 is an autoimmune condition where you don’t produce any insulin. It is treated with insulin only.

In Type 2 diabetes, which is the most common, the insulin you make either can’t work effectively, or your body can’t produce enough of it. It is treated with tablets and/or injections including insulin. 

Type 1 and Type 2 diabetes are different conditions, but they are both serious. 

There are other types of diabetes such as Gestational diabetes, which is first recognised during pregnancy, and other subtypes of diabetes such as Type 3c diabetes secondary to pancreatic disease and Monogenic diabetes. Diabetes may also develop as a complication of other endocrine conditions or can be associated with some types of medication such as steroids. In all types of diabetes glucose levels in the body become elevated which, if left untreated, can lead to short and longer-term health problems.

These divide into acute short-term and chronic long-term complications. Eyesight complications, kidney complications, sexual dysfunction, heart complications, pregnancy complications and feet and leg complications.

Diabetic ketoacidosis (DKA)

Diabetic ketoacidosis (DKA) is a very serious complication of diabetes usually seen in patients with Type 1. It is caused by a lack of insulin and elevation of blood glucose and ketone levels. If glucose levels are high and you feel unwell, you are vomiting, have abdominal pain or are short of breath then seek urgent medical assistance.

DKA is a medical emergency and requires urgent medical assessment. Do not delay, seek help by calling 999.

Hypoglycaemia (Low blood glucose)

Hypoglycaemia (hypos) happen if there is an imbalance of insulin with the food you eat or physical activity you do. Some symptoms include feeling shaky, feeling confused, being pale, tiredness and palpitations.

When you have a hypo stop what you are doing and treat the hypo immediately. Fast-acting carbohydrates are needed, for example five glucose or dextrose tablets, four jelly babies, small glass of a sugary drink (not diet), or a small carton of pure fruit juice. After treating your hypo, your blood sugar levels should return to normal. You may need to eat some slow-acting carbohydrates which can include a sandwich or a piece of toast, a piece of fruit, a small bowl of cereal or drink a glass of milk. If you drive, make sure you have fast-acting carbohydrates in your car, wait until your blood sugar levels are greater than 5mmol/L and you have waited at least 45 minutes. Never ignore symptoms.

Prolonged severe hypoglycaemia is life-threatening and can lead to complications such as multiple organ failure, cardiac arrest, brain damage, coma and death, Timely action and keeping your blood sugars between an acceptable range is important. Your Consultant and Diabetes Nurse Specialist (DNS) can help and support you understand what is right for you.   

Learn more about hypos on the Diabetes UK website.

Diabetes and driving

It is your legal responsibility to inform the DVLA about your diabetes and to notify the DVLA of any other diabetes problems. You need to inform the DVLA if you are on insulin, you will generally be issued with a licence which lasts up to three years. The DVLA will send you a letter at the end of that three years to check your fitness to drive. It is your responsibility to comply with the letter. You should notify the DVLA if you; have had laser treatment in one eye, if you have lost sight in the other, if you are unable to read a car number plate at 20.5 metres or if you develop circulation problems or nerve damage affecting your sensation.

Always have the ability to monitor glucose levels if you are driving. This can be via glucose sensor or a glucose meter in your vehicle. Always carry fast-acting carbohydrates, always check your blood sugars before your journey and, if you are travelling long distances, you need to check every two hours. Do not drive if your blood sugars are between four to five. Take corrections and reset before driving.

Living well with diabetes

• Eat regular meals
• Eat your five a day
• Eat healthier carbohydrates
• Eat fewer fatty foods
• Reduce salt intake
• Eat more fish and fibre
• Stay hydrated

Keep active

Aim to do at least 30 minutes of moderate activity five times a week. Wear suitable footwear and check feet before and after each activity, stay hydrated and drink regular fluids throughout your day. A brisk walk also counts towards your target.