Pre Diabetes
PRE-DIABETES (Borderline Diabetes Type 2)
Prediabetes occurs when your blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. It also indicates an increased risk of developing type 2 diabetes. Most people with prediabetes do not experience any symptoms.
This condition is sometimes referred to as borderline diabetes. Elevated blood sugar levels can be detected through blood tests, with medical terms including:
Impaired fasting glucose (IFG)
Impaired glucose tolerance (IGT)
Impaired glucose regulation (IGR)
Non-diabetic hyperglycaemia
These tests, whether fasting or non-fasting, help healthcare professionals assess your risk of developing type 2 diabetes. If you’ve been diagnosed with any of these conditions, recognizing it is the first step toward taking action. Fortunately, many people can make lifestyle changes to lower their risk of progressing to type 2 diabetes.
The most common test for prediabetes is measuring your HbA1c levels, which reflect your average blood sugar levels over the past two to three months. An HbA1c level between 42 mmol/mol (6%) and 47 mmol/mol (6.4%) is higher than normal, indicating an increased risk of developing type 2 diabetes.
WHAT SYMPTOMS CAN SHOW THAT I HAVE PRE-DIABETES ?
Prediabetes typically has no symptoms. If you begin experiencing symptoms of type 2 diabetes, it likely means the condition has already developed.
That’s why it’s essential to understand the risk factors and explore available support to help prevent or delay type 2 diabetes.
Many people with type 2 diabetes either don’t have noticeable symptoms or may not recognize them. However, some common signs include:
Frequent urination (especially at night), increased fatigue due to the body’s inability to absorb glucose for energy, unintentional weight loss, genital itching or recurring thrush, slow-healing cuts and wounds, blurred vision, persistent thirst.
WHY WORRY ABOUT PRE-DIABETES?
If you’ve been diagnosed with prediabetes, it serves as a warning sign that you are at a high risk of developing type 2 diabetes.
Type 2 diabetes develops when insulin cannot function properly, causing blood sugar levels to rise. In response, the body produces more insulin, but over time, this can overwork the pancreas, leading to decreased insulin production and even higher blood sugar levels.
The condition often develops gradually and remains more common in people over 40. However, an increasing number of individuals under 40 are also at risk. Because symptoms can be subtle or even absent, it may take up to 10 years before a diagnosis is made.
Understanding the risk factors is crucial:
If you are white and over 40, or over 25 if you are African-Caribbean, Black African, or South Asian, your risk is higher.
You are two to six times more likely to develop type 2 diabetes if a close family member (parent, sibling, or child) has it.
People of South Asian, African-Caribbean, or Black African descent are two to four times more likely to develop type 2 diabetes.
A history of high blood pressure increases your risk.
Being overweight or living with obesity raises your likelihood of developing the condition.
Environmental factors such as poverty, deprivation, and inequality can also contribute to a higher risk.
If any of these factors apply to you, your chances of developing type 2 diabetes may be increased.
You can calculate Risk Factors on website Diabetes UK – Know Your Risk of Type 2 diabetes
CAN LIFE STYLE HELP IN PREVENTION OF PRE-DIABETES?
For some individuals, a combination of lifestyle changes—such as improving diet, increasing physical activity, and maintaining weight loss—can lower the risk of developing type 2 diabetes by approximately 50%.
Being at risk doesn’t guarantee you’ll develop type 2 diabetes. This is an ideal time to adopt healthier eating habits and increase your physical activity to help reduce your risk.
You can lower your risk of developing type 2 diabetes by setting realistic goals
Eating a balanced, nutritious diet (include healthier fats in diet: olive oil, sunflower or rapeseed oil, seeds, avocados, unslated nuts, chose drinks without added sugar…)
Staying physically active
Seeking support to lose weight, if necessary
Stop smoking if you do
Be sensible with taking alcohol
Cut down on salt
Seek for a support or help from Health Professionals or from local support groups ( Diabetes support | How we help | Diabetes UK)
Prediabetes occurs when your blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. It also indicates an increased risk of developing type 2 diabetes. Most people with prediabetes do not experience any symptoms.
This condition is sometimes referred to as borderline diabetes. Elevated blood sugar levels can be detected through blood tests, with medical terms including:
Impaired fasting glucose (IFG)
Impaired glucose tolerance (IGT)
Impaired glucose regulation (IGR)
Non-diabetic hyperglycaemia
These tests, whether fasting or non-fasting, help healthcare professionals assess your risk of developing type 2 diabetes. If you’ve been diagnosed with any of these conditions, recognizing it is the first step toward taking action. Fortunately, many people can make lifestyle changes to lower their risk of progressing to type 2 diabetes.
The most common test for prediabetes is measuring your HbA1c levels, which reflect your average blood sugar levels over the past two to three months. An HbA1c level between 42 mmol/mol (6%) and 47 mmol/mol (6.4%) is higher than normal, indicating an increased risk of developing type 2 diabetes.
WHAT SYMPTOMS CAN SHOW THAT I HAVE PRE-DIABETES ?
Prediabetes typically has no symptoms. If you begin experiencing symptoms of type 2 diabetes, it likely means the condition has already developed.
That’s why it’s essential to understand the risk factors and explore available support to help prevent or delay type 2 diabetes.
Many people with type 2 diabetes either don’t have noticeable symptoms or may not recognize them. However, some common signs include:
Frequent urination (especially at night), increased fatigue due to the body’s inability to absorb glucose for energy, unintentional weight loss, genital itching or recurring thrush, slow-healing cuts and wounds, blurred vision, persistent thirst.
WHY WORRY ABOUT PRE-DIABETES?
If you’ve been diagnosed with prediabetes, it serves as a warning sign that you are at a high risk of developing type 2 diabetes.
Type 2 diabetes develops when insulin cannot function properly, causing blood sugar levels to rise. In response, the body produces more insulin, but over time, this can overwork the pancreas, leading to decreased insulin production and even higher blood sugar levels.
The condition often develops gradually and remains more common in people over 40. However, an increasing number of individuals under 40 are also at risk. Because symptoms can be subtle or even absent, it may take up to 10 years before a diagnosis is made.
Understanding the risk factors is crucial:
If you are white and over 40, or over 25 if you are African-Caribbean, Black African, or South Asian, your risk is higher.
You are two to six times more likely to develop type 2 diabetes if a close family member (parent, sibling, or child) has it.
People of South Asian, African-Caribbean, or Black African descent are two to four times more likely to develop type 2 diabetes.
A history of high blood pressure increases your risk.
Being overweight or living with obesity raises your likelihood of developing the condition.
Environmental factors such as poverty, deprivation, and inequality can also contribute to a higher risk.
If any of these factors apply to you, your chances of developing type 2 diabetes may be increased.
You can calculate Risk Factors on website Diabetes UK – Know Your Risk of Type 2 diabetes
CAN LIFE STYLE HELP IN PREVENTION OF PRE-DIABETES?
For some individuals, a combination of lifestyle changes—such as improving diet, increasing physical activity, and maintaining weight loss—can lower the risk of developing type 2 diabetes by approximately 50%.
Being at risk doesn’t guarantee you’ll develop type 2 diabetes. This is an ideal time to adopt healthier eating habits and increase your physical activity to help reduce your risk.
You can lower your risk of developing type 2 diabetes by setting realistic goals
Eating a balanced, nutritious diet (include healthier fats in diet: olive oil, sunflower or rapeseed oil, seeds, avocados, unslated nuts, chose drinks without added sugar…)
Staying physically active
Seeking support to lose weight, if necessary
Stop smoking if you do
Be sensible with taking alcohol
Cut down on salt
Seek for a support or help from Health Professionals or from local support groups ( Diabetes support | How we help | Diabetes UK)
Type 2 Diabetes
What is Type 2 Diabetes?
Type 2 diabetes occurs when blood sugar levels are too high due to the body not producing enough insulin (a hormone that regulates blood sugar ) or because the insulin produced isn’t working effectively—this is known as insulin resistance.
It doesn’t only affect individuals who are overweight or obese, although that is a lead risk factors. It is often associated with inactivity, unhealthy eating habits, smoking and alcohol intake, high blood pressure (hypertension) or a family history of diabetes and ethnicity. Women who had Gestation Diabetes are also in risk to develop it if they do not follow instructions from specialist.
Type 2 diabetes is a significant health condition that increases the risk of serious problems affecting the eyes, feet, heart, and nerves. It’s a long-term condition that can impact daily life and may require dietary changes, medications, and regular medical check-ups.
What are the first symptoms of Type 2 Diabetes?
Many people with type 2 diabetes don’t experience noticeable symptoms or may not recognize them but possible symptoms (most common ones) include:
Frequent urination, especially at night
Excessive thirst
Increased tiredness
Unintentional weight loss
Genital itching or recurring thrush
Slow-healing cuts and wounds
Blurred vision
You can find more about Diabetes Symptoms on video link created by Diabetes UK
https://youtu.be/bIhy-Rb2xp4
Do you need to be obese to develop Type 2 Diabetes?
No. While type 2 diabetes is often associated with being overweight, individuals at a healthy weight can also develop the condition. This form, sometimes called “skinny” type 2 diabetes, occurs in those with minimal subcutaneous fat but a high amount of visceral or abdominal fat.
Visceral fat is found surrounding vital organs like the liver, pancreas, and intestines, and is commonly linked to insulin resistance. The term TOFI (Thin Outside, Fat Inside) describes individuals who may not appear overweight but have a significant amount of abdominal fat. Those with TOFI are considered at greater risk of developing insulin resistance.
How do you treat Diabetes Type 2?
The initial treatment for type 2 diabetes typically focuses on dietary changes combined with regular, appropriate exercise. A diet high in fibre and low-glycaemic-index (low-GI) carbohydrates is recommended, offering flexibility to suit different preferences. Diets such as low-carb or low-calorie can be followed while including plenty of low-GI foods.
Your Doctor or Diabetes Nurse may be prescribed oral medications or injectable treatments if needed.
People with type 2 diabetes, especially those who have had the condition for years, may eventually need insulin injections.
Who is responsible for the care of Diabetic patients?
You will be invited for Diabetes review at least once pear year. It will include: blood test, urine check, BP and BMI check, foot check, checking of smoking and alcohol intake.
Advanced Nurse Practitioner / Practice Nurse
Routine diabetes checks can be carried out by any nurse or doctor. They can provide advice on diabetes management and diet, conduct essential health checks, and adjust medications when necessary.
Practice nurses can also provide free glucometers for home blood sugar monitoring and offer self-management plans to support diabetes care.
General Practitioner (GP)
GPs focus on more complex cases, working to improve diabetes management and adjust medications as needed.
Diabetic Nurse Specialist
Specialist nurses can see patients with poorly controlled diabetes. They offer detailed advice and can initiate insulin treatment if required.
Dietitian
Dietitians offer detailed dietary advice. All new diabetic patients and those with poorly controlled diabetes can be referred to the dietitian.
Chiropody
Annual foot exams are conducted at the clinic by the diabetic nurse.
Retinal Eye Screening
Patients are referred for annual retinal eye screenings to monitor eye health.
Can Diabetes Type 2 be cured?
While there’s no cure for type 2 diabetes, some individuals can achieve remission.
What can I do to prevent Type 2 Diabetes?
Main advice will always be :
Eat well (for more information follow link 10 tips for healthy eating | Type 2 diabetes risk | Diabetes UK)
Exercise – regular walking is always recommended !
Lose weight if needed
Stop smoking and do not use large amounts of alcohol
You can join and start Low Carb program
Low Carb Program – Sustainable Weight Loss and Blood Glucose Control
You can join and follow Healthier You guidelines
Healthier You | Diabetes Prevention Programme
Type 2 diabetes occurs when blood sugar levels are too high due to the body not producing enough insulin (a hormone that regulates blood sugar ) or because the insulin produced isn’t working effectively—this is known as insulin resistance.
It doesn’t only affect individuals who are overweight or obese, although that is a lead risk factors. It is often associated with inactivity, unhealthy eating habits, smoking and alcohol intake, high blood pressure (hypertension) or a family history of diabetes and ethnicity. Women who had Gestation Diabetes are also in risk to develop it if they do not follow instructions from specialist.
Type 2 diabetes is a significant health condition that increases the risk of serious problems affecting the eyes, feet, heart, and nerves. It’s a long-term condition that can impact daily life and may require dietary changes, medications, and regular medical check-ups.
What are the first symptoms of Type 2 Diabetes?
Many people with type 2 diabetes don’t experience noticeable symptoms or may not recognize them but possible symptoms (most common ones) include:
Frequent urination, especially at night
Excessive thirst
Increased tiredness
Unintentional weight loss
Genital itching or recurring thrush
Slow-healing cuts and wounds
Blurred vision
You can find more about Diabetes Symptoms on video link created by Diabetes UK
https://youtu.be/bIhy-Rb2xp4
Do you need to be obese to develop Type 2 Diabetes?
No. While type 2 diabetes is often associated with being overweight, individuals at a healthy weight can also develop the condition. This form, sometimes called “skinny” type 2 diabetes, occurs in those with minimal subcutaneous fat but a high amount of visceral or abdominal fat.
Visceral fat is found surrounding vital organs like the liver, pancreas, and intestines, and is commonly linked to insulin resistance. The term TOFI (Thin Outside, Fat Inside) describes individuals who may not appear overweight but have a significant amount of abdominal fat. Those with TOFI are considered at greater risk of developing insulin resistance.
How do you treat Diabetes Type 2?
The initial treatment for type 2 diabetes typically focuses on dietary changes combined with regular, appropriate exercise. A diet high in fibre and low-glycaemic-index (low-GI) carbohydrates is recommended, offering flexibility to suit different preferences. Diets such as low-carb or low-calorie can be followed while including plenty of low-GI foods.
Your Doctor or Diabetes Nurse may be prescribed oral medications or injectable treatments if needed.
People with type 2 diabetes, especially those who have had the condition for years, may eventually need insulin injections.
Who is responsible for the care of Diabetic patients?
You will be invited for Diabetes review at least once pear year. It will include: blood test, urine check, BP and BMI check, foot check, checking of smoking and alcohol intake.
Advanced Nurse Practitioner / Practice Nurse
Routine diabetes checks can be carried out by any nurse or doctor. They can provide advice on diabetes management and diet, conduct essential health checks, and adjust medications when necessary.
Practice nurses can also provide free glucometers for home blood sugar monitoring and offer self-management plans to support diabetes care.
General Practitioner (GP)
GPs focus on more complex cases, working to improve diabetes management and adjust medications as needed.
Diabetic Nurse Specialist
Specialist nurses can see patients with poorly controlled diabetes. They offer detailed advice and can initiate insulin treatment if required.
Dietitian
Dietitians offer detailed dietary advice. All new diabetic patients and those with poorly controlled diabetes can be referred to the dietitian.
Chiropody
Annual foot exams are conducted at the clinic by the diabetic nurse.
Retinal Eye Screening
Patients are referred for annual retinal eye screenings to monitor eye health.
Can Diabetes Type 2 be cured?
While there’s no cure for type 2 diabetes, some individuals can achieve remission.
What can I do to prevent Type 2 Diabetes?
Main advice will always be :
Eat well (for more information follow link 10 tips for healthy eating | Type 2 diabetes risk | Diabetes UK)
Exercise – regular walking is always recommended !
Lose weight if needed
Stop smoking and do not use large amounts of alcohol
You can join and start Low Carb program
Low Carb Program – Sustainable Weight Loss and Blood Glucose Control
You can join and follow Healthier You guidelines
Healthier You | Diabetes Prevention Programme
Gestational Diabetes
GESTATIONAL DIABETES
Gestational diabetes is a condition where blood sugar levels become elevated during pregnancy but typically return to normal after childbirth.
It can occur at any point in pregnancy but is most frequently diagnosed in the second or third trimester.
This happens when the body is unable to produce sufficient insulin—a hormone responsible for regulating blood sugar—to meet the increased demands of pregnancy.
If left unmanaged, gestational diabetes can pose health risks for both the mother and baby. However, early detection and proper management can significantly reduce these risks.
What are the symptoms of Gestational Diabetes?
Gestational diabetes often does not cause noticeable symptoms.
In most cases, it is only detected through routine blood sugar testing during pregnancy screening.
However, some women may experience symptoms if their blood sugar levels become too high (hyperglycaemia), including:
Increased thirst
More frequent urination
Dry mouth
Fatigue
Blurred vision
Genital itching or thrush
Many of these symptoms are also common in pregnancy and may not necessarily indicate gestational diabetes. If you have any concerns, speak with your midwife or doctor for reassurance and guidance.
How Gestational Diabetes Can Affect Your Pregnancy
Most women with gestational diabetes go on to have healthy pregnancies and babies.
However, the condition can lead to certain complications, including:
Excessive foetal growth – Your baby may grow larger than usual, which can make delivery more difficult and increase the chances of needing induced labour or a caesarean section.
Polyhydramnios – An excess of amniotic fluid in the womb, which may lead to premature labour or delivery complications.
Preterm birth – Giving birth before 37 weeks of pregnancy.
Pre-eclampsia – A condition characterized by high blood pressure during pregnancy, which can lead to complications if untreated.
New-born health issues – Your baby may have low blood sugar or jaundice (yellowing of the skin and eyes) after birth, sometimes requiring hospital treatment.
Stillbirth – Though rare, gestational diabetes can increase the risk of pregnancy loss.
Additionally, having gestational diabetes increases your likelihood of developing type 2 diabetes later in life.
What is needed for screening ?
At your first antenatal (booking) appointment* , typically between weeks 8 and 12 of pregnancy, your midwife or doctor will ask questions to assess your risk of developing gestational diabetes.
If you have one or more risk factors, you will be offered a screening test.
The oral glucose tolerance test (OGTT) is used to diagnose gestational diabetes and takes about two hours. It involves:
A blood test in the morning after fasting (no food or drink for 8 to 10 hours, though water is usually allowed—check with your hospital if unsure).
Drinking a glucose solution.
A second blood test two hours later to see how your body processes the glucose.
This test is usually performed between 24 and 28 weeks of pregnancy. If you’ve had gestational diabetes before, you’ll have an earlier OGTT after your booking appointment, followed by another at 24 to 28 weeks if the first result is normal.
*Please visit NHS link to learn more about antenatal bookings Your antenatal appointments – NHS
What is being tested with OGTT?
When we consume carbohydrates, they are broken down into glucose and other simple sugars, which are then absorbed by the small intestine and transported through the bloodstream.
Glucose is vital for energy production in most cells, but it is especially crucial for the brain and nervous system, which depend on a steady supply to function properly.
The body’s ability to utilize glucose relies on insulin, a hormone produced by the pancreas. Insulin helps transport glucose into cells for energy, signals the liver to store excess glucose as glycogen for short-term energy, and promotes fat storage for long-term energy reserves.
After eating, blood glucose levels naturally rise, triggering insulin release to bring them back down. The amount of insulin produced depends on the meal’s size and composition. When blood sugar drops—such as between meals or after intense exercise—the pancreas releases glucagon, another hormone that prompts the liver to release stored glucose, stabilizing blood sugar levels.
A well-functioning glucose-insulin system keeps blood sugar within a healthy range. However, imbalances can lead to hyperglycaemia (high blood sugar) or hypoglycaemia (low blood sugar), both of which can strain the body. Sudden, severe fluctuations may result in organ failure, brain damage, coma, or, in extreme cases, death.
Prolonged high blood sugar can damage vital organs, including the kidneys, eyes, blood vessels, heart, and nerves. In pregnancy, gestational diabetes can lead to complications, such as larger-than-average babies who may experience low blood sugar at birth.
Treatment for Gestational Diabetes Mellitus?
If you have gestational diabetes, managing your blood sugar levels can help lower the risk of complications during pregnancy.
You will receive a blood sugar testing kit to track how well the treatment is working.
Making changes to your diet and increasing physical activity, if possible, can help lower blood sugar levels. Activities like walking, swimming, and prenatal yoga are beneficial, but be sure to consult your doctor or midwife before starting any new exercise routine.
If these lifestyle adjustments don’t sufficiently control your blood sugar, medication will be necessary. This could include either tablets or insulin injections.
You will also be closely monitored throughout your pregnancy and labour to check for any potential issues.
If you have gestational diabetes, it’s generally recommended to deliver before reaching 41 weeks. If labour hasn’t started naturally by then, an induced labour or a caesarean section may be suggested.
Earlier delivery may also be recommended if there are concerns about your or your baby’s health, or if your blood sugar levels have been difficult to manage.
* Please visit NHS link to learn more about treatments of Gestational diabetes – Treatment – NHS
What are the long term effects of gestational diabetes?
Gestational diabetes typically disappears after childbirth. However, women who experience it are at a higher risk of developing:
Gestational diabetes again in future pregnancies
Type 2 diabetes, which is a lifelong condition
It’s important to have a blood test 6 to 13 weeks after delivery to check for diabetes, and annually thereafter if the results are normal. Please contact your GP Surgery if you do not get invitation once per year.
If you notice symptoms of high blood sugar, such as increased thirst, frequent urination, or a dry mouth, see your GP right away—don’t wait for your next test.
Even if you feel fine, it’s essential to get tested since many people with diabetes don’t experience noticeable symptoms.
Your healthcare provider will also offer guidance on how to reduce the risk of developing diabetes, such as maintaining a healthy weight, eating a balanced diet, and staying active.
Some studies suggest that children born to mothers with gestational diabetes may be at higher risk for developing diabetes or obesity later in life.
What if you had Gestational Diabetes In previous pregnancy and now planning new pregnancy?
If you’ve had gestational diabetes in the past and are planning to become pregnant, it’s important to get tested for diabetes. Your GP can help arrange this.
If you are diagnosed with diabetes, your GP will advise you and possibly refer you to a specialist (pre-conception diabetes clinic) for guidance and support to ensure your condition is well managed before pregnancy.
If you have an unplanned pregnancy, it’s important to inform your GP that you had gestational diabetes in a previous pregnancy.
If tests show that you don’t have diabetes, you will be offered early screening during pregnancy, shortly after your first midwife appointment, and another test between 24 and 28 weeks if the first test is normal.
Alternatively, your midwife or doctor may recommend that you monitor your blood sugar levels at home using a finger-pricking device, just as you did during your previous gestational diabetes.
Gestational diabetes is a condition where blood sugar levels become elevated during pregnancy but typically return to normal after childbirth.
It can occur at any point in pregnancy but is most frequently diagnosed in the second or third trimester.
This happens when the body is unable to produce sufficient insulin—a hormone responsible for regulating blood sugar—to meet the increased demands of pregnancy.
If left unmanaged, gestational diabetes can pose health risks for both the mother and baby. However, early detection and proper management can significantly reduce these risks.
What are the symptoms of Gestational Diabetes?
Gestational diabetes often does not cause noticeable symptoms.
In most cases, it is only detected through routine blood sugar testing during pregnancy screening.
However, some women may experience symptoms if their blood sugar levels become too high (hyperglycaemia), including:
Increased thirst
More frequent urination
Dry mouth
Fatigue
Blurred vision
Genital itching or thrush
Many of these symptoms are also common in pregnancy and may not necessarily indicate gestational diabetes. If you have any concerns, speak with your midwife or doctor for reassurance and guidance.
How Gestational Diabetes Can Affect Your Pregnancy
Most women with gestational diabetes go on to have healthy pregnancies and babies.
However, the condition can lead to certain complications, including:
Excessive foetal growth – Your baby may grow larger than usual, which can make delivery more difficult and increase the chances of needing induced labour or a caesarean section.
Polyhydramnios – An excess of amniotic fluid in the womb, which may lead to premature labour or delivery complications.
Preterm birth – Giving birth before 37 weeks of pregnancy.
Pre-eclampsia – A condition characterized by high blood pressure during pregnancy, which can lead to complications if untreated.
New-born health issues – Your baby may have low blood sugar or jaundice (yellowing of the skin and eyes) after birth, sometimes requiring hospital treatment.
Stillbirth – Though rare, gestational diabetes can increase the risk of pregnancy loss.
Additionally, having gestational diabetes increases your likelihood of developing type 2 diabetes later in life.
What is needed for screening ?
At your first antenatal (booking) appointment* , typically between weeks 8 and 12 of pregnancy, your midwife or doctor will ask questions to assess your risk of developing gestational diabetes.
If you have one or more risk factors, you will be offered a screening test.
The oral glucose tolerance test (OGTT) is used to diagnose gestational diabetes and takes about two hours. It involves:
A blood test in the morning after fasting (no food or drink for 8 to 10 hours, though water is usually allowed—check with your hospital if unsure).
Drinking a glucose solution.
A second blood test two hours later to see how your body processes the glucose.
This test is usually performed between 24 and 28 weeks of pregnancy. If you’ve had gestational diabetes before, you’ll have an earlier OGTT after your booking appointment, followed by another at 24 to 28 weeks if the first result is normal.
*Please visit NHS link to learn more about antenatal bookings Your antenatal appointments – NHS
What is being tested with OGTT?
When we consume carbohydrates, they are broken down into glucose and other simple sugars, which are then absorbed by the small intestine and transported through the bloodstream.
Glucose is vital for energy production in most cells, but it is especially crucial for the brain and nervous system, which depend on a steady supply to function properly.
The body’s ability to utilize glucose relies on insulin, a hormone produced by the pancreas. Insulin helps transport glucose into cells for energy, signals the liver to store excess glucose as glycogen for short-term energy, and promotes fat storage for long-term energy reserves.
After eating, blood glucose levels naturally rise, triggering insulin release to bring them back down. The amount of insulin produced depends on the meal’s size and composition. When blood sugar drops—such as between meals or after intense exercise—the pancreas releases glucagon, another hormone that prompts the liver to release stored glucose, stabilizing blood sugar levels.
A well-functioning glucose-insulin system keeps blood sugar within a healthy range. However, imbalances can lead to hyperglycaemia (high blood sugar) or hypoglycaemia (low blood sugar), both of which can strain the body. Sudden, severe fluctuations may result in organ failure, brain damage, coma, or, in extreme cases, death.
Prolonged high blood sugar can damage vital organs, including the kidneys, eyes, blood vessels, heart, and nerves. In pregnancy, gestational diabetes can lead to complications, such as larger-than-average babies who may experience low blood sugar at birth.
Treatment for Gestational Diabetes Mellitus?
If you have gestational diabetes, managing your blood sugar levels can help lower the risk of complications during pregnancy.
You will receive a blood sugar testing kit to track how well the treatment is working.
Making changes to your diet and increasing physical activity, if possible, can help lower blood sugar levels. Activities like walking, swimming, and prenatal yoga are beneficial, but be sure to consult your doctor or midwife before starting any new exercise routine.
If these lifestyle adjustments don’t sufficiently control your blood sugar, medication will be necessary. This could include either tablets or insulin injections.
You will also be closely monitored throughout your pregnancy and labour to check for any potential issues.
If you have gestational diabetes, it’s generally recommended to deliver before reaching 41 weeks. If labour hasn’t started naturally by then, an induced labour or a caesarean section may be suggested.
Earlier delivery may also be recommended if there are concerns about your or your baby’s health, or if your blood sugar levels have been difficult to manage.
* Please visit NHS link to learn more about treatments of Gestational diabetes – Treatment – NHS
What are the long term effects of gestational diabetes?
Gestational diabetes typically disappears after childbirth. However, women who experience it are at a higher risk of developing:
Gestational diabetes again in future pregnancies
Type 2 diabetes, which is a lifelong condition
It’s important to have a blood test 6 to 13 weeks after delivery to check for diabetes, and annually thereafter if the results are normal. Please contact your GP Surgery if you do not get invitation once per year.
If you notice symptoms of high blood sugar, such as increased thirst, frequent urination, or a dry mouth, see your GP right away—don’t wait for your next test.
Even if you feel fine, it’s essential to get tested since many people with diabetes don’t experience noticeable symptoms.
Your healthcare provider will also offer guidance on how to reduce the risk of developing diabetes, such as maintaining a healthy weight, eating a balanced diet, and staying active.
Some studies suggest that children born to mothers with gestational diabetes may be at higher risk for developing diabetes or obesity later in life.
What if you had Gestational Diabetes In previous pregnancy and now planning new pregnancy?
If you’ve had gestational diabetes in the past and are planning to become pregnant, it’s important to get tested for diabetes. Your GP can help arrange this.
If you are diagnosed with diabetes, your GP will advise you and possibly refer you to a specialist (pre-conception diabetes clinic) for guidance and support to ensure your condition is well managed before pregnancy.
If you have an unplanned pregnancy, it’s important to inform your GP that you had gestational diabetes in a previous pregnancy.
If tests show that you don’t have diabetes, you will be offered early screening during pregnancy, shortly after your first midwife appointment, and another test between 24 and 28 weeks if the first test is normal.
Alternatively, your midwife or doctor may recommend that you monitor your blood sugar levels at home using a finger-pricking device, just as you did during your previous gestational diabetes.
Cardiovascular Risk Score (QRISK3)
Cardiovascular Risk Score (QRISK3) Patient Information
What is QRISK3 score?
The QRISK3 is a medical tool that is designed to calculate the likelihood of you having a stroke or heart attack in the next 10 years. The higher the score, the greater the risk. Also, the more risk factors you have, the greater your risk.
Why is a cardiovascular risk assessment important?
Cardiovascular disease (CVD) accounts for almost a quarter of all deaths in the UK. By having a cardiovascular risk assessment, you can get an accurate estimate of your risk of developing CVD over the following 10 years and ways that you can reduce this risk.
Who should have a CVD health risk assessment?
All adults aged 40 or more should have a CVD risk assessment every five years apart from those who people who are already known to be at high risk of CVD (aged 85 y and over, people who have familial disorders of lipid metabolism, people with Diabetes mellitus or with Chronic kidney disease.
What are the risk factors that are included in QRISK3 score calculation?
Risk factors for Developing Cardiovascular Disease (CVD) are: age, gender, ethnicity, cholesterol level, high blood pressure, body mass index (height and weight), smoking, alcohol intake, medical conditions (comorbidities) such as diabetes, rheumatoid arthritis, chronic kidney disease, periodontitis (gum disease) strong family history of heart diseases (in relatives under 60 y o)
What does “the risk” means?
The risk of developing CVD is never zero and regardless of other risk factors, your risk naturally increases the older you get.
Low risk – QRISK3 score of less than 10% : This means that you have less than a one in ten chance of having a stroke or heart attack in the next 10 years.
Moderate risk – QRISK3 of 10-20% : This means that you have between a one to two in ten chance of having a stroke or heart attack in the next 10 years.
High risk – QRISK3 score of more than 20% This means that you have at least a two in ten chance of having a stroke of heart attack in the next 10 years
What lifestyle changes can I make?
List of risk factors includes things we can change : stop smoking, eat healthy and balanced diet (low fat / sugar / salt), eat 5 fruit or vegetables per day, reduce alcohol intake (recommended intake is less than 14 units per week) , keep an eye on your weight and aim for BMI between 20 – 25, try to exercise regularly (even a walk can help) , discuss with your GP if you need medications for reducing high blood pressure (antihypertensives) or for reducing lipid levels (statins)
For more information, please visit links:
British Heart Foundation
Risk factors for heart and circulatory diseases | BHF – BHF
Good / Bad Cholesterol, Statins and You
https://www.youtube.com/watch?v=-f58HVKAItI
Treating High Cholesterol with Statins & Side Effects by Dr Nigel Capps
Treating High Cholesterol with Statins & Side Effects by Dr Nigel Capps | HEARTUK Conf
Statins – NHS
Understanding Familial Hypercholesterolemia (FH for short)
https://www.youtube.com/watch?v=OonoQuH8fvw
What is QRISK3 score?
The QRISK3 is a medical tool that is designed to calculate the likelihood of you having a stroke or heart attack in the next 10 years. The higher the score, the greater the risk. Also, the more risk factors you have, the greater your risk.
Why is a cardiovascular risk assessment important?
Cardiovascular disease (CVD) accounts for almost a quarter of all deaths in the UK. By having a cardiovascular risk assessment, you can get an accurate estimate of your risk of developing CVD over the following 10 years and ways that you can reduce this risk.
Who should have a CVD health risk assessment?
All adults aged 40 or more should have a CVD risk assessment every five years apart from those who people who are already known to be at high risk of CVD (aged 85 y and over, people who have familial disorders of lipid metabolism, people with Diabetes mellitus or with Chronic kidney disease.
What are the risk factors that are included in QRISK3 score calculation?
Risk factors for Developing Cardiovascular Disease (CVD) are: age, gender, ethnicity, cholesterol level, high blood pressure, body mass index (height and weight), smoking, alcohol intake, medical conditions (comorbidities) such as diabetes, rheumatoid arthritis, chronic kidney disease, periodontitis (gum disease) strong family history of heart diseases (in relatives under 60 y o)
What does “the risk” means?
The risk of developing CVD is never zero and regardless of other risk factors, your risk naturally increases the older you get.
Low risk – QRISK3 score of less than 10% : This means that you have less than a one in ten chance of having a stroke or heart attack in the next 10 years.
Moderate risk – QRISK3 of 10-20% : This means that you have between a one to two in ten chance of having a stroke or heart attack in the next 10 years.
High risk – QRISK3 score of more than 20% This means that you have at least a two in ten chance of having a stroke of heart attack in the next 10 years
What lifestyle changes can I make?
List of risk factors includes things we can change : stop smoking, eat healthy and balanced diet (low fat / sugar / salt), eat 5 fruit or vegetables per day, reduce alcohol intake (recommended intake is less than 14 units per week) , keep an eye on your weight and aim for BMI between 20 – 25, try to exercise regularly (even a walk can help) , discuss with your GP if you need medications for reducing high blood pressure (antihypertensives) or for reducing lipid levels (statins)
For more information, please visit links:
British Heart Foundation
Risk factors for heart and circulatory diseases | BHF – BHF
Good / Bad Cholesterol, Statins and You
https://www.youtube.com/watch?v=-f58HVKAItI
Treating High Cholesterol with Statins & Side Effects by Dr Nigel Capps
Treating High Cholesterol with Statins & Side Effects by Dr Nigel Capps | HEARTUK Conf
Statins – NHS
Understanding Familial Hypercholesterolemia (FH for short)
https://www.youtube.com/watch?v=OonoQuH8fvw
Blood Glucose Monitoring
BLOOD GLUCOSE MONITORING AND KETONE MONITORING
Blood glucose levels indicate the amount of glucose (sugar) present in a person’s blood, and they are sometimes referred to as blood sugar or blood glucose monitoring readings.
These levels are measured in mmol/l, which stands for millimoles per liter. A mole is a scientific unit commonly used to measure chemicals.
Maintaining proper glucose control is crucial in preventing serious complications of diabetes, which can affect the eyes, kidneys, brain, heart, and nerves.
High blood glucose levels are known as hyperglycaemia, while low levels are called hypoglycaemia.
What is the difference between Continuous Glucose Monitoring (CGM) and Flash Monitoring?
Both CGM and Flash monitoring systems consist of:
A sensor, a small device attached to the arm or abdomen that measures glucose levels in the fluid beneath the skin, known as interstitial fluid.
A reader or receiver, which displays the results. These results can also be accessed on your smartphone.
CGM – The sensor continuously sends glucose data to your phone’s receiver every few minutes. Some models can transmit the data to an insulin pump, allowing you to view glucose levels directly on the pump.
Flash – To check the results, you need to scan the sensor using either the reader or your smartphone.
Even if you use these monitoring systems, your nurse will still measure and document your blood glucose levels.
How to do finger prick testing ?
Please read useful information on link Checking your blood sugar levels | Diabetes testing | Diabetes UK
You can also watch video with all instructions.
Who needs to monitor blood glucose?
Blood glucose monitoring is commonly performed for patients with diabetes, with the frequency depending on the type of diabetes and individual circumstances:
For those on insulin, blood glucose levels may be checked up to four times daily. In a hospital setting, readings are typically taken before insulin administration and, in some cases, afterward.
For individuals taking oral diabetes medications, blood glucose checks may be necessary if the medication increases the risk of hypoglycaemia or if there is a history of hypoglycaemic episodes.
For diet-controlled diabetics, routine monitoring is generally not required unless there is a history of hypoglycaemia or if the individual becomes unwell.
There are specific situations where increased monitoring may be needed, such as during pregnancy, when taking steroids, experiencing acute illness (physical or mental health-related), or undergoing significant dietary changes.
If you have diabetes and feel unwell, it is always recommended to check your blood glucose levels.
Additionally, blood glucose readings may be taken even without a diabetes diagnosis in cases where:
You become unwell
You experience a reduced appetite
Healthcare staff have concerns about your physical health
What is considered “healthy target”?
Blood glucose levels can fluctuate, but as a general guideline, a reading between 4-7 mmol/L is considered normal upon waking and before meals.
While some individuals may have a naturally higher ‘normal’ range, any reading below 4 mmol/L is always classified as low.
For those whose usual readings are higher than the general guideline, a level below 5-6 mmol/L may be considered too low for them.
What are the signs of Hypoglycaemia and Hyperglycaemia?
Hyperglycaemia
Tiredness and lethargy
Thrush or other recurring bladder and skin infections
Headaches
Blurred vision
Weight loss
Feeling sick
Hypoglycaemia
Passing more urine than normal, especially at night
Being very thirsty
Lips feeling tingly
Feeling tearful
Lack of concentration
Night sweats
Blurred vision
Headaches
Feeling sick
Going pale
Feeling shaky
Being hungry
Tiredness
Feeling disorientated
Sweating
Being anxious or irritable
Palpitations and a fast pulse
If your blood glucose reading is high, your nurse will inform a doctor or physical healthcare practitioner. The level of urgency will depend on how elevated the reading is, taking into account what is normal for you. It would be advisable to check ketone levels too.
What is ketone reading, why and when it is needed?
Ketone readings may be requested if there are concerns about your physical health, particularly if you have persistently high blood glucose levels.
Normally, the body uses insulin to transport glucose into cells for energy. However, if there is insufficient insulin, glucose remains in the bloodstream, leading to hyperglycaemia.
In response, the body starts breaking down fat for energy, causing the liver to produce ketones. When ketones accumulate in the blood, they become acidic, which can result in diabetic ketoacidosis (DKA)—a serious medical emergency that can be life-threatening.
Ketones should be checked as soon as requested by a doctor or physical healthcare practitioner. A ketone test is typically ordered in the following situations:
Persistently high blood glucose levels, usually 15 mmol/L or above
As part of an assessment if an individual appears unwell
Ketones can be measured using either a urine dipstick or a blood test. While a dipstick can indicate the presence of ketones, it does not provide an exact measurement. A blood test using a ketone meter offers a more precise reading.
What to do if your readings are positive to ketones?
If you monitor your own ketone levels, you should inform your nurse immediately of the results, especially if they are high. The nurse will then relay this information to a doctor or physical healthcare practitioner.
Saxonbrook HCA’s and Nurses conduct a ketone test using the Trust-approved blood glucose and ketone meter. Based on the results, the doctor or healthcare practitioner will provide appropriate guidance and treatment.
If you are worried or your test results are abnormal please book an appointment at the Surgery
Blood glucose levels indicate the amount of glucose (sugar) present in a person’s blood, and they are sometimes referred to as blood sugar or blood glucose monitoring readings.
These levels are measured in mmol/l, which stands for millimoles per liter. A mole is a scientific unit commonly used to measure chemicals.
Maintaining proper glucose control is crucial in preventing serious complications of diabetes, which can affect the eyes, kidneys, brain, heart, and nerves.
High blood glucose levels are known as hyperglycaemia, while low levels are called hypoglycaemia.
What is the difference between Continuous Glucose Monitoring (CGM) and Flash Monitoring?
Both CGM and Flash monitoring systems consist of:
A sensor, a small device attached to the arm or abdomen that measures glucose levels in the fluid beneath the skin, known as interstitial fluid.
A reader or receiver, which displays the results. These results can also be accessed on your smartphone.
CGM – The sensor continuously sends glucose data to your phone’s receiver every few minutes. Some models can transmit the data to an insulin pump, allowing you to view glucose levels directly on the pump.
Flash – To check the results, you need to scan the sensor using either the reader or your smartphone.
Even if you use these monitoring systems, your nurse will still measure and document your blood glucose levels.
How to do finger prick testing ?
Please read useful information on link Checking your blood sugar levels | Diabetes testing | Diabetes UK
You can also watch video with all instructions.
Who needs to monitor blood glucose?
Blood glucose monitoring is commonly performed for patients with diabetes, with the frequency depending on the type of diabetes and individual circumstances:
For those on insulin, blood glucose levels may be checked up to four times daily. In a hospital setting, readings are typically taken before insulin administration and, in some cases, afterward.
For individuals taking oral diabetes medications, blood glucose checks may be necessary if the medication increases the risk of hypoglycaemia or if there is a history of hypoglycaemic episodes.
For diet-controlled diabetics, routine monitoring is generally not required unless there is a history of hypoglycaemia or if the individual becomes unwell.
There are specific situations where increased monitoring may be needed, such as during pregnancy, when taking steroids, experiencing acute illness (physical or mental health-related), or undergoing significant dietary changes.
If you have diabetes and feel unwell, it is always recommended to check your blood glucose levels.
Additionally, blood glucose readings may be taken even without a diabetes diagnosis in cases where:
You become unwell
You experience a reduced appetite
Healthcare staff have concerns about your physical health
What is considered “healthy target”?
Blood glucose levels can fluctuate, but as a general guideline, a reading between 4-7 mmol/L is considered normal upon waking and before meals.
While some individuals may have a naturally higher ‘normal’ range, any reading below 4 mmol/L is always classified as low.
For those whose usual readings are higher than the general guideline, a level below 5-6 mmol/L may be considered too low for them.
What are the signs of Hypoglycaemia and Hyperglycaemia?
Hyperglycaemia
Tiredness and lethargy
Thrush or other recurring bladder and skin infections
Headaches
Blurred vision
Weight loss
Feeling sick
Hypoglycaemia
Passing more urine than normal, especially at night
Being very thirsty
Lips feeling tingly
Feeling tearful
Lack of concentration
Night sweats
Blurred vision
Headaches
Feeling sick
Going pale
Feeling shaky
Being hungry
Tiredness
Feeling disorientated
Sweating
Being anxious or irritable
Palpitations and a fast pulse
If your blood glucose reading is high, your nurse will inform a doctor or physical healthcare practitioner. The level of urgency will depend on how elevated the reading is, taking into account what is normal for you. It would be advisable to check ketone levels too.
What is ketone reading, why and when it is needed?
Ketone readings may be requested if there are concerns about your physical health, particularly if you have persistently high blood glucose levels.
Normally, the body uses insulin to transport glucose into cells for energy. However, if there is insufficient insulin, glucose remains in the bloodstream, leading to hyperglycaemia.
In response, the body starts breaking down fat for energy, causing the liver to produce ketones. When ketones accumulate in the blood, they become acidic, which can result in diabetic ketoacidosis (DKA)—a serious medical emergency that can be life-threatening.
Ketones should be checked as soon as requested by a doctor or physical healthcare practitioner. A ketone test is typically ordered in the following situations:
Persistently high blood glucose levels, usually 15 mmol/L or above
As part of an assessment if an individual appears unwell
Ketones can be measured using either a urine dipstick or a blood test. While a dipstick can indicate the presence of ketones, it does not provide an exact measurement. A blood test using a ketone meter offers a more precise reading.
What to do if your readings are positive to ketones?
If you monitor your own ketone levels, you should inform your nurse immediately of the results, especially if they are high. The nurse will then relay this information to a doctor or physical healthcare practitioner.
Saxonbrook HCA’s and Nurses conduct a ketone test using the Trust-approved blood glucose and ketone meter. Based on the results, the doctor or healthcare practitioner will provide appropriate guidance and treatment.
If you are worried or your test results are abnormal please book an appointment at the Surgery
For more information on Diabetes follow the links below
