Lifestyle changes to help with type 2 diabetes
If you have type 2 diabetes or have been told that you may get it in the future (prediabetes), lifestyle changes can help lower your blood glucose (sugar) levels. This can help to manage diabetes and possibly avoid having to take medicine.
Lifestyle changes can sometimes lower your blood glucose to a normal level and stop diabetes (remission).
What you can do to make lifestyle changes:
Do
try to
including fruit, vegetables, wholegrain foods such as wholemeal bread and oats, and pulses such as chickpeas and lentils
improve your diet slowly if you're finding it difficult – a small change every week can make it easier
talk to a GP or diabetes nurse if you're finding it hard to change your diet as they may be able to find support in your local area
try to spend at least 2.5 hours (across the whole week) either walking or doing another activity that leaves you out of breath
if you've been told you're overweight
– having diabetes increases the harmful effects of smoking
try to limit how much alcohol you drink
have regular dental check-ups to help prevent gum disease
Don’t
do not eat too much processed foods with lots of salt and sugar – this may include things like bacon, chips, cheese, sweets and biscuits
do not change to a very strict, low-calorie diet without talking to a health professional first – this type of diet may not be suitable if you're taking insulin or other diabetes medicine
Children with type 2 diabetes will be under specialist care.
Diabetes courses
Diabetes courses are recommended for everyone with type 2 diabetes. They’re designed to give you the confidence and skills you need to manage diabetes.
You should be offered a free course within 1 year of being diagnosed. There are also online courses that you can do at your own pace.
For example:
NHS services to help change your lifestyle
If you have type 2 diabetes or have prediabetes and are at risk of developing type 2 diabetes, you may be eligible for an NHS programme that can help you.
Speak to your doctor or nurse about the NHS:
Diabetes Prevention Programme (NHS DPP)
Digital Weight Management Programme
Medicine for type 2 diabetes
If you need medicine to treat your type 2 diabetes, and you do not have any other serious health conditions you'll usually be offered a combination of 2 medicines:
– lowers your blood sugar levels by improving the way your body handles insulin
a type of medicine called an SGLT2 inhibitor – these help lower your blood sugar levels by allowing extra sugar to pass out of your body in your pee
If you have side effects from taking metformin, you may be recommended to only take an SGLT2 inhibitor.
If you have a history of heart disease, you may also be offered a type of medicine called a GLP1-agonist. This is given by injection, usually once a week.
If you're also living with obesity, you may also be offered a GLP1-agonist, if other treatments cannot lower your blood sugar levels.
If metformin, or any other diabetes medicines do not help, you may need to take
. It's usually used to treat type 1 diabetes, but it can be used to treat type 2 diabetes, as well.
You may need to take insulin a few times a day, either by injection or through a pump. This will help keep your blood glucose levels within a normal range.
You'll be told how much to take and when to take it. Taking too much insulin can cause your blood glucose levels to go too low. This is known as
or having a "hypo".
If you feel ill, such as vomiting, diarrhoea or a very high temperature, while you're taking diabetes medicine, speak to a doctor or a member of your healthcare team. They may tell you to stop taking your medicine temporarily, until you feel better. Do not stop taking your medicine unless your healthcare professional or doctor tells you to.
Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:
you're taking diabetes medicine and have vomiting, diarrhoea or a very high temperature
You can call 111 or
.
Appointments and tests
If you have type 2 diabetes, you'll need check-ups to make sure your treatment is working, and your condition is being managed.
These include:
checking your average blood glucose levels (an HbA1c test) every 3 to 6 months
a foot check-up once every 2 years if your last check was OK, or once a year if you need it
checking your weight, body mass index (BMI), cholesterol, blood pressure and kidneys at least once a year
You or your child (aged 12 years and over) will also be offered
when you're diagnosed, and reviewed every 1 or 2 years as part of the NHS diabetic retinopathy screening programme.
Other changes you may need to make
Managing type 2 diabetes may also involve making other changes, such as:
wearing a medical ID wristband, in case of emergency
remembering to pack medicines in your hand luggage when you go on holiday so you have it with you
getting a letter from your GP to take with you when you go on holiday
If you have health problems caused by type 2 diabetes or you get hypos (a drop in blood glucose levels that can cause dizziness), you may need to contact the Driving and Vehicle Licensing Agency (DVLA).
Contraception, pregnancy and type 2 diabetes
If you're thinking of having a baby, and have type 2 diabetes, it's important to plan your pregnancy as soon as possible. This usually means:
asking to be referred to a pre-conception clinic (if there's one available), or to a diabetes care team
changing your medicines to ones that are safe to take in pregnancy
If you have type 2 diabetes, talk to a doctor about the best contraception to use and how to take or use it. These may include the combined pill, progestogen-only pill or contraception inserted into the womb (uterus).