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Type 2 diabetes Q&As

Published by Bupa's health information team, July 2009.

Answers to questions about type 2 diabetes

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How will type 2 diabetes affect my work?

Although being diagnosed with type 2 diabetes can leave you feeling worried about the future, it shouldn't stop you leading an active and full career. However, you may need to plan well and make some changes to your activities.

Explanation

Type 2 diabetes can potentially have an impact on many areas of your life including work. How you manage your condition, how well controlled your diabetes is and any other medical conditions you have can all influence how well you cope with work and the choices you make.

You can't join or continue to serve in the armed forces if you have diabetes. Otherwise, there are very few jobs that you're unable to do if you have diabetes but you may need to make some adjustments. Your doctor or nurse can give you more information and advice about your individual circumstances.

Working shifts can sometimes cause difficulties because you may need to change mealtimes and adjust any tablets or insulin you take. If food isn't readily available, you will need to plan well to make sure you don't go without. If you have a physically demanding job, you may also need to make changes to your treatment or your work patterns.

Although most people with diabetes wouldn't see themselves as being disabled by their condition, they are protected at work by the Disability Discrimination Act (DDA). The DDA protects people from being discriminated against at work because they have a disability. Your employer has to make "reasonable adjustments" to enable you to access the recruitment process or to do your actual job. You don't have to tell your employer that you have diabetes, but if they know it may help them to help you, by being flexible with things such as doctor's appointments.

Further information

Sources

  • Diabetes and work. Diabetes UK. www.diabetes.org.uk, accessed 11 February 2009
  • Disability Discrimination Act 1995. Office of Public Sector Information. www.opsi.gov.uk, accessed 11 February 2009
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Can I drive if I have type 2 diabetes?

You can continue to drive a car or motorcycle if you have type 2 diabetes. However, you may need to contact the Driver and Vehicle Licensing Agency (DVLA) to inform them about your condition and also take certain considerations into account.

Explanation

In the interests of road safety you must be sure that you can safely control a car at all times. You need to be aware of how your condition might affect your ability to drive safely, for example if your blood glucose levels fall or your eyesight gets worse over time.

If your diabetes is well controlled with tablets and you don't have any complications such as poor sight, you don't need to inform the DVLA. However, if you take sulphonlyureas or insulin, alone or in combination with other medicines, you may be at risk of hypos when driving. Therefore, you should always:

  • check your blood glucose before you start a long journey
  • not drive with a blood glucose level of less than 4mmol/litre
  • not drive for more than two hours without stopping for a snack
  • keep glucose tablets where you can reach them quickly
  • keep some kind of carbohydrate, such as sweets and a sugary drink, in the car

If a hypo starts while you're driving:

  • pull over and stop somewhere safe
  • take glucose tablets or some other form of fast-acting carbohydrate immediately
  • leave the driver's seat and take the keys out of the ignition to make it clear that you're no longer in charge of the car
  • don't start driving again until all your symptoms have gone

You do need to tell the DVLA if your diabetes is managed with insulin or if you have another associated condition, such as eye problems or nerve damage to your legs or feet - even if your diabetes is treated with tablets. The DVLA may contact your doctor for information about how your condition is managed, how well controlled it is and whether you have any complications that might make you unsafe to drive.

If your diabetes is managed with insulin, you won't be able to drive a heavy goods vehicle or a passenger vehicle. Contact the DVLA for more information about your specific circumstances.

Further information

Sources

  • For medical practitioners: at a glance guide to the current medical standards of fitness to drive. Driver and Vehicle Licensing Agency. www.dvla.gov.uk, accessed 11 February 2009
  • Information: driving and diabetes. Diabetes UK. www.diabetes.org.uk, accessed 11 February 2009
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Can I go on holiday if I have type 2 diabetes?

Yes, it's fine to go abroad on holiday if you have diabetes so long as you are well prepared.

Explanation

Yes, it's fine to go abroad on holiday if you have diabetes so long as you are well prepared.

Explanation

People with diabetes travel all over the world and take the same kinds of holiday as people without the condition. However, it makes sense to plan well. Bear the following in mind when you go on holiday.

  • Consider carrying or wearing some form of diabetic identification, particularly if you're travelling alone.
  • If you're travelling across time zones, you may need to adjust your tablets and insulin. Get advice from your doctor or nurse.
  • If you become unwell while you're away, drink plenty of fluids and if you can't eat, make sure you have sugary drinks. If you can't eat or drink anything, go to hospital for treatment.
  • Security issues at airports may mean you have to make special arrangements if you need to travel with insulin. Carry diabetes identification and a letter from your doctor and check with the airline you're flying with before you go.
  • If you take insulin, you, and the people you travel with, should know how you behave if you have a hypo and should know what to do about it.
  • Declare your condition when you buy travel insurance and never travel without it.

If you have any questions or concerns about travelling, speak to your doctor or specialist nurse.

Further information

Sources

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What am I aiming for with my day-to-day treatment?

It's important to aim to lead a healthy lifestyle - to be the right weight for your height, to be active, to eat the right foods and not smoke. You have a large part to play in the control of your condition so it's important that you understand and follow your treatment plan.

Explanation

In the long term, uncontrolled high blood glucose (hyperglycaemia) can be very damaging to your health and can increase your risk of heart disease, stroke, kidney failure, nerve damage and blindness.

It's important to aim for your blood glucose levels, blood pressure readings and cholesterol (lipid) levels to be as near to normal as possible. The better your control of these factors, the less likely you're to have short-term and long-term health problems associated with diabetes.

If you manage your condition well, it can also help you to feel better and have a better quality of life. The main targets that you're aiming for with your treatment are described here.

  • A negative urine test for glucose. Your GP may ask to test your urine for glucose, instead of a blood test. This is more likely if you're elderly or have difficulties testing your blood.
  • Blood pressure levels of 130/80mmHg or below. Many people with type 2 diabetes develop high blood pressure. Having high blood pressure as well as diabetes puts you at even greater risk of developing heart problems or stroke. This is why it's very important to keep your blood pressure well controlled. You can do this with lifestyle changes and medicines.
  • Aim for an HbA1c level of less than 7 percent with few or no hypos. HbA1c is a blood test that you have at least twice a year. It shows what your average blood glucose levels were like over the previous six to eight weeks and is a good guide to how well controlled your blood glucose levels have been.
  • Blood glucose levels before meals of 4 to 7mmol/l. This is the level you're aiming for when you test your blood glucose at home. Your GP will advise you on whether home monitoring of your blood glucose levels is suitable for you.
  • Total blood cholesterol levels of less than 4mmol/l. Like high blood pressure, raised blood cholesterol can also increase your risk of heart problems and stroke. Your doctor will ask you to eat foods that are low in saturated fats and to be active. He or she may also ask you to take medicines to lower your cholesterol levels. These are likely to be statins, but you may be prescribed other medicines called fibrates as well or instead of statins if these aren't suitable for you.

Type 2 diabetes is a progressive condition, which means that it will gradually worsen as time goes on. This means that in future you will probably need to increase the amount of medication you take, or move on to insulin, in order to keep your condition well controlled.

Further information

Sources

  • Diabetes. World Health Organization. www.who.int, accessed 11 February 2009
  • National Collaborating Centre for Chronic Conditions. Type 2 diabetes: national clinical guideline for management in primary and secondary care (update). Royal College of Physicians, 2008. www.rcplondon.ac.uk
  • Cardiovascular disease. Diabetes UK. www.diabetes.org.uk, accessed 11 February 2009
  • CG66 Diabetes - type 2 (update). National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk, December 2008
  • Blood fats (cholesterol). Diabetes UK. www.diabetes.org.uk, accessed 13 February 2009
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Can I look after my diabetes myself?

Yes you can, and you will be encouraged to do so. Care for people with diabetes is planned around you and helping you to take control of your condition. Your GP and nurses can help you to manage your diabetes but ultimately you live with it day to day and have to be able to manage your condition at home by yourself. You will be responsible for leading a healthy lifestyle, taking any medicines and learning how to spot health problems. The better you do this, the less chance there is of you developing serious health problems in later life.

Explanation

When some people are diagnosed with type 2 diabetes they find it quite overwhelming. The fact that type 2 diabetes is a lifelong illness means that your treatment must also be lifelong and this can be a difficult thing to come to terms with. Making changes to your life to fit in around your diabetes can be hard work and you won't always get it right, particularly when it's all very new.

You will be managing your diabetes as part of a team that includes your GP, practice nurse, and possibly a specialist doctor. Some people visit their local hospital for check-ups and others go to their GP surgery. You will have at least one full review of your condition and health every year. This will include testing to see whether your kidneys are working properly and looking at your feet and eyes to check that they are healthy. Outside of these visits to your doctor or nurse, you're very likely to be looking after your condition yourself.

Your GP or nurse will discuss your choices with you and help you to find the information and support you need to feel confident at home. When you're first diagnosed with type 2 diabetes, your GP or nurse may give you the option of monitoring your own blood glucose levels at home. Depending on how your diabetes is treated, you may be asked to test your urine or blood regularly.

You might be invited to take part in a more structured diabetes education programme. There are lots of different courses available, depending on where you live. These courses are usually held in small groups. They aim to help you to manage and change your lifestyle, to learn how to look after your condition and how to monitor it.

One programme that you might see is called DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed). DESMOND is a six-hour educational programme on type 2 diabetes. It's run for one day or over two half days. It has been shown to reduce your risk of serious health problems in the future and to help you give up smoking, lose weight and become more active. It may help you to feel more in control of your condition.

Further information

Sources

  • CG66 Diabetes - type 2 (update). National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk, December 2008
  • What care to expect. Diabetes UK. www.diabetes.org.uk, accessed 13 February 2009 www.diabetes.org.uk, accessed 13 February 2009
  • Five years on: delivering the diabetes national service framework. Department of Health, 2008. www.dh.gov.uk www.dh.gov.uk
  • Davies M, Heller S, Skinner T, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ 2008; 336:491-5
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2009

Type 2 diabetes factsheet

 

 

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