Diabetes is a long-term (chronic) condition caused by too much glucose (sugar) in the blood.  It affects two million people in England and Wales. It is also thought that there are a further 750,000 people who have the condition but are unaware of it.  There are two types of diabetes: diabetes type 1 and diabetes type 2.

What is type 2 diabetes?
Type 2 diabetes occurs when not enough insulin is produced by the body for it to function properly, or when the body’s cells do not react to insulin. This is called insulin resistance.

Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body does not produce any insulin at all.  Around 95% of all people with diabetes have type 2 diabetes.

If you have type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, and monitoring your blood glucose level. However, as type 2 diabetes is a progressive condition, you may eventually need to take insulin medication, usually in the form of injections.

Type 2 diabetes is often associated with obesity. Obesity-related diabetes is sometimes referred to as maturity onset diabetes because it is more common in older people.

How can I reduce the risk of developing type 2 diabetes?
It may not be possible to prevent developing type 2 diabetes but by controlling the risk factors, you may be able to reduce your chances of getting the condition. For example, you should:

• Lose weight, if you are overweight or obese. 
• Keep your waist size under 31.5 inches (80cm) if you are a woman, 35 inches (90cm) if you are an Asian man, and 37 inches (94cm) if you are a man who is white, or black.
• Get at least 30 minutes of exercise every day. 
• Do not smoke.
• Keep your blood pressure and cholesterol levels under control.
• Only drink alcohol in moderation.

Could you be at risk of diabetes? 
Take the diabetes self-assessment test on the NHS website here.

NHS England has produced the following short animation, following a fictional character’s journey on discovering he was at risk of developing type 2 diabetes

Diabetic retinal screening
If you do have diabetes it is important that you have your eyes screened for diabetic retinopathy.

All people with diabetes aged over 12 are invited every year to have a simple test which could reduce their likelihood of losing their sight.

When diabetes affects the small blood vessels in the part of the eye called the retina this is known as diabetic retinopathy. The retina lines the inside of the eye and acts rather like the film in a camera. In the early stages diabetic retinopathy will not affect your sight. However if the changes get worse eventually your sight will be affected. Untreated diabetic retinopathy is one of the most common causes of blindness in the working age population. Screening is an effective way of detecting diabetic retinopathy and early detection means that treatment to prevent sight loss can start quickly. The screening is a very simple procedure that consists of eye drops to widen the pupil before a photograph is taken of your eyes.

So when you receive your annual screening invitation make sure you book an appointment right away.

FreeStyle Libre ®

Within the NHS East and North Hertfordshire Clinical Commissioning Group (ENHCCG) area FreeStyle Libre® is recommended for restricted use as an option for specific groups of patients with type 1 diabetes and women with type 2 diabetes on an intensive insulin regime who are pregnant or trying to get pregnant, in accordance with the East of England Priorities Advisory Committee (PAC) recommendations. Details are available in a local recommendation document and separate East of England PAC recommendation documents for adults and children and young people available below:

• FreeStyle Libre - Recommendation Document
• FreeStyle Libre - Summary Patient Groups
• FreeStyle Libre - Information For Patients 
• FreeStyle Libre - East of England PAC recommendations for adults
• FreeStyle Libre - East of England PAC recommendations for children and young people

Refer to these documents for full information on patient groups, agreed criteria, supply and funding recommendations.

FreeStyle Libre® will be initiated, managed and supplied by a hospital Trust consultant led specialist diabetes team. GP prescribing is not recommended.

Foot care for people with diabetes - How to look after your feet

Foot care for people with diabetes – Your annual foot check

Foot care for people with diabetes – What happens if you develop a diabetic foot problem

Foot care for people with diabetes – A guide for healthcare professionals