Diabetes Mellitus- HbA1c of 48 mmol/mol or above
This section refers to type 2 diabetes- if you have type 1 diabetes you will be under a hospital consultant and nursing team.
If you are diagnosed with type 2 diabetes you will receive an initial appointment with our nurse to discuss the conditions, short and longterm implication and management options. The information below is taken from the Diabetes UK website.
Type 2 diabetes is high blood sugar levels due to your body not making enough of a hormone called insulin, or the insulin it makes not working properly — known as insulin resistance.
High blood sugar levels over time can cause other health problems like heart attacks and strokes, as well as problems with your eyes, kidneys, and feet. These are called diabetes complications.
So treatment includes regular health checks and getting support to be active, eat healthily, and maintain a healthy weight. You may need to take medication including insulin and check your blood sugars regularly too.
Type 2 diabetes can go undiagnosed for years if you don’t have symptoms or your symptoms are missed.
It doesn't just affect people living with overweight or obesity, although this is one of the risk factors, along with ethnicity.
There are many reasons type 2 diabetes develops but it mostly affects people over 25 often with a family history.
Many people can do things to try and prevent type 2 diabetes.
There’s no cure but some people with type 2 diabetes can put their diabetes into remission.
If you have a diagnosis of Diabetes Mellitus useful resources are available at: Homepage | Information Site (scot.nhs.uk)
https://www.diabetes.org.uk/
https://www.nhsinform.scot/illnesses-and-conditions/diabetes/type-2-diabetes/
Prediabetes- HbA1c of 43-47 mmol/mol
Your average blood glucose is assessed by checking your HbA1c. Normal is 42mmol/mol or lower. A diagnosis of Prediabetes is made when your HbA1c is 43-47mmol/mol.
If you have an HbA1c in this range you will be asked to book a nurse appointment to discuss you diagnosis, you will be referred to the NHS Lanarkshire Let's Prevent Programme and will receive an annual recall to ensure you do not develop Diabetes.
The information below is taken form the Diabetes UK Website.
What is prediabetes?
Prediabetes means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with type 2 diabetes. It also means that you are at high risk of developing type 2 diabetes. You are unlikely to be experiencing any symptoms with prediabetes.
Prediabetes is also sometimes called borderline diabetes. Higher than normal blood sugars can be detected via blood tests. The medical terms for higher-than-normal blood sugars are:
- Impaired Fasting Glucose (IFG)
- Impaired Glucose Tolerance (IGT)
- Impaired Glucose Regulation (IGR)
- Non-diabetic hyperglycaemia
These tests are a mix of fasting or non-fasting and they all help your healthcare team to understand your risk of developing type 2 diabetes. So, if you’ve been told you have any of these, knowing this is the first step to being able to do something about it. And for many people there are things you can do to reduce your risk of type 2 diabetes.
Diagnosing prediabetes
If you’re worried about prediabetes you could call your GP surgery and ask for a blood test. The most common test will be checking your HbA1c levels which is your average blood glucose (sugar) levels for the last two to three months. If your HbA1c level is between 42mmol/mol (6%) – 47mmol/mol (6.4%) this means it is higher than normal and you are at risk of developing type 2 diabetes.
Prediabetes symptoms
Prediabetes doesn’t have any symptoms. If you start to have any of the symptoms of type 2 diabetes it means you have probably already developed it.
So it’s important to know the risk factors and what support is available to help you prevent or delay type 2 diabetes.
A lot of people don’t get any symptoms when it comes to type 2 diabetes, or don’t notice them. But you may notice:
- going to the toilet more often, especially at night
- feeling more tired, because your body can't get enough glucose in to your cells for energy
- losing weight without trying
- genital itching or thrush
- cuts and wounds taking longer to heal
- blurred vision
- feeling extremely thirsty.
Causes of prediabetes
At the moment, 13.6 million people are at increased risk of type 2 diabetes in the UK. If you’ve been told you have prediabetes, this is a warning sign that you are at high risk of developing type 2 diabetes. The good news is you don’t have it yet, and with the right support up to 50% of cases of type 2 diabetes can be prevented or delayed.
Type 2 diabetes happens because insulin can’t work properly, so your blood sugar levels keep rising. This means more insulin is released. For some people with type 2 diabetes this can eventually tire the pancreas out, meaning their body makes less and less insulin. This can lead to even higher blood sugar levels.
Type 2 diabetes can come on slowly, usually over the age of 40. The signs may not be obvious, or there may be no signs at all, therefore it might be up to 10 years before you find out you have it.
That’s why it’s very important to know the risk factors:
- You’re more at risk if you’re white and over 40 or over 25 if you’re African-Caribbean, Black African, or South Asian.
- You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.
- Type 2 diabetes is two to four times more likely in people of South Asian descent and African-Caribbean or Black African descent.
- You’re more at risk if you’ve ever had high blood pressure.
- You’re more at risk of type 2 diabetes if you’re carrying extra weight, especially if this weight is around your middle.
You are more at risk of developing type 2 diabetes if some or all of the risk factors apply to you. Our Know Your Risk online tool only takes a couple of minutes to complete. If your results show that you are at high or very high risk, you will need to ask your GP for a blood test.
You could be eligible for a place on the Healthier You: NHS Diabetes Prevention Programme in England.
You may also be eligible for a free NHS Health Check which will check for health conditions including type 2 diabetes.
Preventing type 2 diabetes
By making changes to diet, increasing physical activity and losing weight, about half of type 2 diabetes cases can be prevented or delayed in some people.
Being at risk doesn’t mean you will definitely develop type 2 diabetes. Now is a great time to start making healthy changes to your lifestyle to reduce your risk of type 2 diabetes. Your healthcare team can support you in making these changes.
You can also call our helpline if you have any worries about being at risk of type 2 diabetes or for help with what to do next. And you could join our online forum to share your experiences with others who are at risk or have type 2 diabetes.
Here are some steps you can take to reduce the risk of developing type 2 diabetes in the future.
Manage your weight
If you are living with overweight or obesity and are at high risk of type 2 diabetes, losing just 5% of your body weight can significantly reduce your risk. There are lots of ways you can lose weight and it’s about finding what works best for you.
Making healthier food choices and being more active are both positive ways to start making these changes. If you need help with managing your weight, a dietitian can help you. Your GP surgery may also be able to help you find weight management services in your local area.
Eat a healthy and balanced diet
There’s no one special diet for all people at high risk of developing type 2 diabetes. Everyone is individual, so there isn’t a one size fits all way of eating for everyone. But, the food and drink we have in our overall diet is linked to our risk of developing type 2 diabetes.
For example, if your overall diet is made up of food and drinks that are in high fat, have a high GI (short for glycaemic index) and low fibre content, this is linked to an increased risk of type 2 diabetes. But the good news is that by changing some of your food and drink choices, you can reduce your risk of type 2 diabetes.
But what is a healthy and balanced diet anyway? All of these ways of eating have been linked with a decreased risk of type 2 diabetes:
- Mediterranean diet — check out our handy Mediterranean meal plans
- Dietary Approaches to Stop Hypertension (DASH) diet
- vegetarian and vegan diets
- the Nordic diet
- moderately cutting down on carbohydrates.
This is because they are made up of healthy foods like fruits, vegetables, wholegrains and lean proteins and it’s the overall balance of our diet that is important in keeping us healthy.
So, to reduce your risk, aim to eat more of the foods linked with a decreased risk. Research has shown us that the following foods and drinks can be associated with a decreased risk;
- total fruit and veg intake (including specifically green leafy veg, blueberries, grapes and apples)
- wholegrains
- yogurt and cheese
- unsweetened tea and coffee
Additionally, there are some foods we recommend reducing your intake of, as these have been associated with an increased risk. These foods include:
- sugar sweetened drinks
- red and processed meats
- refined carbohydrates (like sugary snacks, white bread, sugary cereals)
- potatoes (particularly French fries)
Be more active
If you spend a lot of time sitting down, this is known as a sedentary lifestyle. Being sedentary is linked with an increased risk of type 2 diabetes.
So being active in your daily life can help to reduce your risk of type 2 diabetes. This doesn’t mean you need to take up a new sport or join the gym. You could make small changes so that you are being more active every day. Think about taking phone calls standing up, using stairs instead of the lift, and going for a walk on your lunch break.
Here are some tips on becoming more active to reduce your risk of developing type 2 diabetes
https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/move-more
Further information is available in the Live Well, Feel Well section of our website.