Living with type 2 diabetes 

Type 2 diabetes - looking after yourself 

If you have type 2 diabetes, you'll need to look after your health very carefully.

Caring for your health will make treating your diabetes easier and minimise your risk of developing complications of diabetes.

Self care

Self care is an integral part of daily life. It means you take responsibility for your own health and wellbeing, with support from those involved in your care.

Self care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive self care support. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

Read more about self care.

Regular reviews

As type 2 diabetes is a long-term condition, you'll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns you have.

The more the team knows, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.

HbA1c test

You should be tested regularly (at least once a year) to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in the red blood cells, and gives your blood glucose levels for the previous two to three months.

The HbA1c target for most people with diabetes is below 48 mmol/mol. There's evidence that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.

An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low blood glucose level).

The Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don't need to avoid certain food groups altogether.

As long as you eat regularly and make healthy choices, you can have a varied diet and enjoy a wide range of foods.

You can make adaptations when cooking meals, such as reducing the amount of fatsalt and sugar, and increasing the amount of fibre.

You don't need to completely exclude sugary and high fat foods from your diet, but they should be limited. It's possible to achieve good blood glucose control by including sugary foods in your diet.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Read more about healthy recipes. Further dietary advice and cooking tips are also available on the Diabetes UK website.

Regular exercise

As physical activity lowers your blood glucose level, it's very important to exercise regularly if you have diabetes.

Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

However, before starting a new activity, speak to your GP or diabetes care team first. As exercise will affect your blood glucose level, your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don't smoke

If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.

As well as increasing this risk further, smoking also increases your risk of many other serious smoking-related conditions, such as lung cancer.

If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts (see below), and never drink alcohol on an empty stomach.

Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).

Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

The recommended daily alcohol limits are:

  • 3-4 units for men
  • 2-3 units for women

Keeping well

People with long-term conditions, such as type 2 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza).

A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.

Look after your feet hide

If you have diabetes, you're at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see a podiatrist or chiropodist (foot care specialist) regularly so that any problems can be detected early.

Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn't start to heal within a few days.

Read more about feet and diabetes.

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Regular eye tests show

If you have type 2 diabetes, you should have your eyes tested at least once a year to check for diabetic retinopathy.

Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). If left untreated, retinopathy can eventually cause blindness.

The Diabetes UK website has more information about diabetic retinopathy.

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Pregnancy  show

If you have diabetes and you're thinking about having a baby, it's a good idea to discuss this with your diabetes care team.

Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant.

You'll need to tightly control your blood glucose level, particularly before becoming pregnant and during the first eight weeks of your baby's development to reduce the risk of birth defects. You should also:

  • check your medications  some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections 
  • take a higher dose of folic acid tablets – folic acid helps prevent your baby from developing spinal cord problems; it's now recommended that all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription)
  • have your eyes checked  retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, it's important to treat retinopathy before you become pregnant

Your GP or diabetes care team can give you further advice.

Diabetes UK also has more information about pregnancy and diabetes

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Get educated show

You'll be best equipped to manage your diabetes day-to-day if you're given information and education when you're diagnosed and on an ongoing basis.

The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.

Structured patient education

Structured patient education means there's a planned course that:

  • covers all aspects of diabetes
  • is flexible in content
  • is relevant to a person’s clinical and psychological needs
  • is adaptable to a person’s educational and cultural background

For type 2 diabetes, there's a national patient education programme that meets all the key criteria for structured education. It's called the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND).

There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.

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Talk to others show

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition.

To find your local diabetes support group, visit the Diabetes UK website.

If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK’s care line on 0345 123 2399 (Monday to Friday, 9am-7pm), or email careline@diabetes.org.uk.

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Financial support and benefits  show

People with diabetes controlled by medication are entitled to free prescriptions and eye examinations.

Some people with diabetes may also be eligible for disability and incapacity benefits, depending on the impact that the condition has on their lives.

The main groups likely to qualify for welfare benefits are children, the elderly, those with learning disabilities or mental health problems, and those with diabetes complications.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Carers may also be entitled to some benefit, depending on their involvement in caring for the person with diabetes.

Your local Citizen’s Advice Bureau (CAB) can check whether you're getting all the benefits you're entitled to. They, as well as your diabetes specialist nurse, should also provide advice about filling in the forms.

Read more about care and support and benefits.

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Page last reviewed: 18/06/2014

Next review due: 18/06/2016

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Comments

The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Melvyn2 said on 17 October 2014

Hi Stevehessie,
The problems are that white flour and bread, and white rice, and potatoes have simple carbohydrates that quickly turn to sugar.

So the answer is to eat whole grain bread, pasta, brown rice etc. By having complete foods your health will be be greatly improved in general and the carbs are more complex, therefore not converting to sugar in the blood stream, as happens with denatured white versions.

As for fruit, the common suggestion is to eat plenty of 'fruit and vegetables'. This isn't quite correct. Lots of vegetables yes, but keep fruit intake to minimum, or moderate use.

There is the suggestion that the fibre in fruit makes the sugars acceptable, which is true to a 'certain' degree. but definitely more Veg than fruit.

Potatoes are one of the nightshade foods, so should be treated with great respect. Just occasional use maybe ok, but should never be staple food. Unfortunately there has been a switch from whole grain to potatoes in the west. that is bad news. And a big problem for our health - western diets are really not good.

As for meat, try to keep to a minimum, especially red meat, and get organic where possible, to avoid chemicals. Fish too is contaminated, so in moderation. Say twice a week.

By eating whole grain and pulses together you will get complete protein, and vegetables will provide the vitamins and minerals etc. Try adding seaweed on a daily basis which will given you a real mineral boost.

Organic food is far better for us, and recent studies have shown this to be the case. It's kind of obvious really. Yet many 'scientist' still don't get it. At least those attached to Big Food, Big Pharma and Big Agri don't get it.

I am happy to discuss further if you wish. I hope this is helpful
Regards Melvyn

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stevehessle said on 23 August 2014

I don't know about anyone else, but the advice on this site contradicts what I have been told about sources of carbohydrate. Carbohydrates are the enemy and the best way for me to keep my glucose low is abstinence from pasta, bread, rice, potatoes and fruit. This site advocates one third of meals to be carb based. I do miss them though and to ensure vitamins are not compromised, take supplements.
Just meat, fish and veg Is a bit boring and I get really tired sometimes, but the weight is dropping off and I'm getting better control.

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DaiB said on 05 March 2012

I might question the 'Eat Healthily' advice. Many T2s find that keeping carbohydrates at a sensibly, but not excessively, low level is important in blood sugar control; it's not just about sugar as carbs end-up as glucose in the body. NHS advice to base all meals around carbs is very dated and I would question what research the advice is based on?

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