Don’t Sugar-Coat It: Let’s Talk About Diabetes

Let’s Talk About Pre-Diabetes and Diabetes: What You Need to Know

Diabetes is something we hear about a lot, but many people aren’t quite sure what it actually means—or how to spot the early signs. As a doctor, I often see people who didn’t realise they were on the path to diabetes until much later. So let’s break it down.

What is Diabetes?

Diabetes is a condition where your body struggles to manage blood sugar (glucose) levels. Glucose is the body’s main source of energy, but when it builds up in the blood instead of getting into your cells, it can cause health problems over time.

There are two main types:

• Type 1 diabetes – usually diagnosed in children or young adults, where the body stops making insulin completely.

• Type 2 diabetes – more common and often linked to lifestyle. The body either doesn’t make enough insulin or doesn’t respond properly to it.

  
  

This article will focus on Type 2 Diabetes and Pre-diabetes.

What is Pre-Diabetes?

Pre-diabetes or "borderline" means your blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes—yet. It’s a warning sign that you’re at higher risk, but the good news is, with the right steps, it’s often possible to prevent or delay diabetes altogether.

How is it Treated?

Treatment depends on the type and stage. For many with pre-diabetes or early type 2 diabetes, lifestyle changes are the first step:

• Healthy eating

• Regular physical activity

• Weight management:

  • Sometimes, medication may be needed if lifestyle changes alone aren’t enough. For type 1 diabetes, daily insulin injections are essential.

Medication remains a cornerstone in managing diabetes. With added lifestyle changes there are even cases of reversing type 2 diabetes.

There are several types of medications used to treat type 2 diabetes, each working in a slightly different way to help manage blood sugar. Metformin is usually the first choice—it helps your body respond better to insulin and reduces sugar production in the liver. Sulfonylureas (like gliclazide) help the pancreas release more insulin. DPP-4 inhibitors (like sitagliptin) help the body increase insulin and lower sugar after meals. SGLT2 inhibitors (like empagliflozin) help the kidneys remove excess sugar through urine. GLP-1 receptor agonists (injectable medications like semaglutide) help reduce appetite, slow digestion, and increase insulin in response to food.

In some cases, insulin injections may also be needed if other treatments aren’t enough.

When Should You See a Doctor?

See a doctor if you:

• Are feeling unusually tired, thirsty, or needing to pass urine often

• Have noticed unexplained weight loss

• Have a family history of diabetes

• Have high blood pressure or cholesterol

• Have been told your blood sugar is high or borderline

Catching diabetes early makes a big difference—it’s easier to manage and can help prevent long-term complications like heart disease, nerve damage, or vision problems. Regular diabetic check ups are also crucial in preventing complications.

Evidence-Based Lifestyle Tips

You don’t need to overhaul your life overnight—small changes can go a long way.

1. Get moving – but make it enjoyable:

Aim for at least 150 minutes of moderate activity per week. That could be:

• Brisk walking

• Swimming

• Cycling

• Dancing, even housework or gardening counts if it gets your heart rate up.

  
  

2. Eat smarter, not less

Focus on:

• Whole grains (like oats, brown rice, wholemeal bread)

• Vegetables (especially leafy greens, broccoli, carrots)

• Lean proteins (chicken, fish, lentils, eggs)

• Healthy fats (nuts, seeds, olive oil)

Foods to cut down on:

• Sugary drinks (including juices and fizzy drinks)

• White bread, pastries, and highly processed carbs

• Fried foods

• Large portions of red and processed meats

• “Low-fat” foods that are high in sugar

  
  

3. Keep an eye on portions and timing

Try not to skip meals, and avoid large, heavy dinners late in the evening. Eating regularly and mindfully helps your body manage sugar better.

4. Sleep and stress matter too

Poor sleep and chronic stress can affect blood sugar and appetite. Aim for 7–9 hours of sleep a night and make time to unwind.

5. Do not forget to attend regular diabetic follow ups with your doctor:

Well controlled diabetics should see their doctor at least once or twice a year. Poorly controlled diabetics will need more input. This is to make sure that complications are closely monitored and dealt with as this has shown to make a major difference in the progression of this disease