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TitleA practical guide to living with Type 2 diabetes
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Page 1

A practical guide to living
with Type 2 diabetes
Want to take charge of your Type 2 diabetes? Want to find motivation to live
a healthier life? You’ve come to the right place!

You can also look at which is full of information and
articles about finding ways to take control and feel good – inside and out

Date of preparation: March 2017 Job code: UK/VIP/1608/0079m(1)

If you are a healthcare professional, and you would like to order additional copies of this magazine please visit: or email: [email protected]

Get more information and ideas for living
life to the full with Type 2 diabetes at

search for ‘Better Living’
in the app store

Better Living: support and inspiration for people living with Type 2 diabetes. This magazine has been produced by Takeda UK Ltd.


website • app

A fresh approach to life with Type 2 diabetes

Download the better-living app from the app store

Page 2


Introduction 4
What is diabetes? 4
Understanding diabetes 6

Type 2 diabetes: the basics
Symptoms 7
Causes 8
Treatments 9

Living with Type 2 diabetes
Managing Type 2 diabetes 10
Support with managing Type 2 diabetes 11
Lifestyle changes 12
Diet and Type 2 diabetes 12
The principles of a healthy diet 14
Exercise and Type 2 diabetes 15
Appointments and your annual review 17

Practical notes
Preparing for appointments 18
What should you do if you’re ill? 18
What is HbA1c? 19
Diabetes and medicines 20
Common Type 2 diabetes medicines 21
Legal requirements 22

Taking care of your:
Heart 23
Feet 23
Skin 24
Nerves 25
Eyes 26
Kidneys 27
Sex life 28

Learn the lingo
Jargon buster 30
Your diabetes care team 31

Page 8

The principles of
a healthy diet
If you have been given advice from
a dietician, it’s best to follow that
advice as it has been drawn up
specifically for you. However, there
are some general guidelines for
healthy eating that will help you
work out what you can and should
integrate into your daily diet:

• Portion sizes have grown in recent
years – this is one of the ways we
put weight on without realising.
Try using smaller plates to cut
back on your portions without
making your dinner look smaller.

• No single food contains all the
essential nutrients you need in
the right proportion. That’s why
you need to consume foods from
each of the main food groups to
eat well.

• Everyone should eat at least
five portions of fruit and veg
a day. Fresh, frozen, dried and
canned fruit in juice and canned
vegetables in water all count.
Go for a rainbow of colours to
get as wide a range of vitamins
and minerals as possible.

• Better options of starchy foods
– such as wholegrain bread,
wholewheat pasta and basmati,
brown or wild rice – contain more
fibre, which helps to keep your
digestive system working well.
They are generally more slowly
absorbed (that is, they have a
lower glycaemic index, or GI),
keeping you feeling fuller
for longer.

• Meat, fish, eggs, pulses, beans
and nuts are high in protein,

which helps with building and
replacing muscles. They contain
minerals, such as iron, which
are vital for producing red blood
cells. Oily fish, such as mackerel,
salmon and sardines, also provide
omega-3, which can help protect
the heart. Beans, pulses, soya
and tofu are also good sources
of protein.

• Milk, cheese and yogurt contain
calcium and are good sources
of protein. Some dairy foods
are high in fat, particularly
saturated fat, so choose
lower-fat alternatives –
but check for added sugar.

• High fat and high sugar foods can
be an occasional treat, but have
lots of calories and won’t do your
weight loss efforts any good.

• Fat is high in calories, so try to
reduce the amount of oil or butter
you use in cooking. Remember
to use unsaturated oils, such as
sunflower, rapeseed or olive oil,
as these types are better for
your heart.

• Too much salt can make you more
at risk of high blood pressure and
stroke. Processed foods can be
very high in salt, so try cooking
more meals from scratch at
home where you can control the
amount of salt you use.

• People with Type 2 diabetes
are not recommended to eat
“diabetic” foods. They are
expensive and unnecessary
and have no benefit over
ordinary foods.

Exercise and
Type 2 diabetes
Being active is good for all of us,
but is especially important if you
have Type 2 diabetes. Looking
after yourself when you have
Type 2 diabetes means increasing
your physical activity as well as
managing your diet and taking your
medication. They are all equally
important in controlling your
blood glucose levels.

A good starting point is to aim to
take part in a moderate activity
such as 30 minutes brisk walking
5 times a week. This might be
something you could achieve now
or you may be able to build up to it
over a period of time.

If you haven’t exercised for a while,
it is very important that you ask for
advice from your doctor or nurse
before starting.

Why should you exercise?

• Keeps the brain active
• Keeps the joints mobile
• Strengthens the heart
• Regulates blood glucose levels
• Improves insulin

• Improves circulation
• Lowers blood pressure
• Releases endorphins (happy

hormones) – making you
feel good

• Reduces stress – relaxation
• Increases lung capacity
• Strengthens the muscles and

• Tones the stomach
• Strengthens the back
• Reduces fat around organs
• Helps you lose weight
• Reduces the risk of heart disease
• Lowers blood sugar

Being active is great
for your physical
well-being, but on
top of that are also
the benefits it can
have for your mind,
reducing stress.

Adopting active habits
• Choose the stairs

– walk up escalators
• Walk or cycle for short journeys
• Turn off the TV and get out

and about
• Do housework to music:

it’s fun and chores seem easier
• Find someone to exercise with –

it could even be your dog (if you
don’t have one there are plenty
of dog rescue centres in need of
volunteer dog walkers)

• Park further away from work,
walking just that bit further
each day

Living with Type 2 diabetes

14 15 For more information visit our website Download the better-living app from the app store

Page 9

and your annual
Regular reviews play an important
part in ensuring that you lead a
normal and healthy life, managing
your Type 2 diabetes as effectively
as possible. The following aspects of
your life will be examined
and tested:

• Your general wellbeing; how you

are coping with your diabetes
• How your family and/or your

friends have adjusted to your
lifestyle changes

• Your current treatments
• Your Type 2 diabetes control –

including home monitoring results
• Any problems or concerns you

may have
• Discussions about smoking habits,

alcohol consumption, stress, sexual
problems, exercise and healthy
eating issues. You should have
the opportunity to discuss these
topics with your team as well as
receive additional support such as
advice on smoking cessation and
emotional/psychological support

Physical examinations
• Weight calculated as Body Mass

Index (BMI). This informs your
doctor about your weight in
relation to your height. From this
you may be advised to lose weight,

if needed, which will aim to further
improve the control of your Type 2
diabetes. Waist circumference
and/or waist-to-hip ratio
measurements may also be taken

• The skin on your legs and feet
should be examined to check
circulation and nerve supply

• Blood pressure should be
measured. A blood pressure of
130/80 mmHg or less is ideal

• Eyes should be photographed
annually so any early changes to
the eyes can be detected. This
examination is free of charge and is
carried out either at your optician’s,
local hospital, or at a mobile
screening unit

Lab tests and investigations
• Blood glucose control: an HbA1c

blood test will examine your
long-term blood glucose control.
Generally, you should aim for an
HbA1c around 6.5% (48 mmol/mol).
However, your doctor or nurse will
confirm your specific target with

• Kidney function: urine and blood
tests will show whether your
kidneys are healthy and
working properly

• Blood fats and cholesterol: a blood
test should be performed

• These tests may not be carried
out every time you see a member
of your diabetes care team. Your
doctor or nurse will know which
tests/investigations are needed

Exercise ideas
If you are less mobile, you can
increase your activity with armchair
exercise, gentle walking and
stretching programmes.

Incorporate three components of
fitness in your activities: strength,
stamina, and flexibility.

The talk test: how to know how
hard you’re working

While you are doing your activity
you can easily find out if you are
gaining fitness:

• If you can sing during exercise –
you could perhaps work harder

• I f you can talk during exercise –
that is about right

• If you are gasping during exercise
– slow down and get your breath

Activity ideas
At leisure centres
and health clubs:
Aqua aerobics
Spin classes
Circuit training

At home:

Tidying/sorting clutter
Stair climbing
Exercise biking
Exercise DVD



In groups:

Ten pin bowling
Join an exercise class
Martial arts
Mountain biking

Living with Type 2 diabetes

16 17 For more information visit our website Download the better-living app from the app store

Page 15


…sex life
For women
Poorly controlled diabetes can
damage the blood vessels and
nervous system, which can reduce
blood flow and sensation in the
sexual organs. This can contribute
to vaginal dryness. In addition,

high blood glucose levels is linked
to infections such as thrush, which
can also make sex uncomfortable.
An unhealthy lifestyle (e.g.
smoking, being stressed, drinking
a lot of alcohol etc), can also
contribute to sexual problems.

Getting control of your diabetes
and improving your lifestyle are
part of addressing the problem.
You can also talk to your doctor
or diabetes nurse to see if there
are any therapies that can help.

For men
A common sexual problem (for
men with or without diabetes) is
erectile dysfunction, or impotence.

This may be caused by physical
factors of diabetes or the
medication you are taking,

or both. Emotional and lifestyle
factors can also contribute
to sexual dysfunction. Poorly
controlled diabetes can damage
the blood vessels and nervous
system, which can reduce
blood flow and sensation in
the sexual organs.

Getting control of your diabetes
and improving your lifestyle are
part of addressing the problem.
You can also talk to your doctor
or diabetes nurse about the range
of medical products available,
to see which might be suitable
for you.

Get more information and ideas for living
life to the full with Type 2 diabetes at

28 29 For more information visit our website Download the better-living app from the app store

Page 16

Learn the lingo

Jargon buster
A lot of technical and medical
terms are used in the management
of diabetes, either by healthcare
professionals who have forgotten
that the rest of us don’t have
medical degrees, or when there just
isn’t any other word to describe
something. Here’s our handy guide
to some of the commonly used
terms you may encounter – you can
always ask your diabetes care team
to explain something further.

The simple name for the HbA1c test.
This used to measured as a % but is
now mmol/mol.

A blood protein that can leak into the
urine. If it’s there, it can be a sign of
kidney problems.

A condition caused by problems with
the arteries carrying blood to the heart;
the person has short periods of chest
pain and a feeling of constriction or

Basal insulin
The background insulin needed to
control the normal levels of glucose in
the blood between meals and at night.

Beta blockers
A class of drugs which reduce high
blood pressure.

Blood glucose levels
The amount or concentration of glucose
(sugar) in the blood. UK measurement
is millimoles per litre (mmol/l). US
measurement is milligrams per decilitre
(mg/dl). 1 mmol/l=18 mg/dl.

Blood glucose meters
Electronic devices which can measure
your blood glucose levels.

Body Mass Index (BMI)
A measure of a person’s weight in
relation to their height, showing if
they are overweight or underweight.

Brittle diabetes
Diabetes which is very unstable with
swings in blood glucose levels from
very high to low.

Carbohydrate foods
A class of food which comprises
starches and sugars and is made readily
available by the body for energy. Found
mainly in plant foods for example rice,
bread, potatoes, pasta, dried beans.

A podiatrist: a health professional that
looks after people’s feet.

A fat-like material found in all animal
tissue. Diets rich in fat may increase
the amount of cholesterol in the blood.
Cholesterol is known to speed up the
blocking of the arteries in the heart.

A reduction in bowel movements.
Symptoms include having less than 3
bowel movements a week, straining and
pain when you have a bowel movement,
and hard lumpy stools.

Diabetes mellitus
A chronic condition where blood
glucose levels are higher than normal.

Diabetes (gestational)
Diabetes occurring in pregnancy. Blood
glucose levels usually return to normal
after birth.

Diabetes Specialist Nurse (DSN)
A nurse who works exclusively with
people living with diabetes.

A doctor who has specialist knowledge
about diabetes and its management.

A health professional that has specialist
knowledge about nutrition and the
effects of different foods and drinks on
the body.

Dilated eyes
Eyes which have had special drops put
in them to make the pupil bigger so
that the eyes can be examined.

Erectile dysfunction (impotence)
Where a man cannot have sex because
he cannot get or keep a full erection.

Fibre is the indigestible part of food.
Fibre absorbs a lot of water and
ensures faeces are soft and easy to
pass out of the body. Good sources
of fibre are wholegrain cereals, e.g.
wheat, rice, oats, wholemeal bread and
breakfast cereals. There is also some
fibre in fruit and vegetables, especially
in the skin.

A sugar occurring naturally in fruit and
honey. It does not require insulin for
its metabolism, so is often used as a
sweetener in diabetic foods.

An examination of the back of the
eyes (retina).

Where the stomach doesn’t empty
properly into the intestine.

A form of sugar made by the digestion
of carbohydrates. It is absorbed into
the blood stream, where it circulates
and is used for energy.

A hormone produced in the pancreas. It
causes a rise in blood glucose by freeing
glycogen from the liver. It is available as
injections for treating hypoglycaemia.

A carbohydrate which is stored in the
liver. It is also known as animal starch.

Glycaemic index
A measure of how quickly a food is
broken down into sugar that enters
the blood.

HbA1c test
A blood test that gives an indication
of how well your blood sugar level
has been controlled over the previous
6 weeks. It measures the amount of
glucose attached to the haemoglobin in
your blood.

Healthy digestion
When food has been eaten, it must be
broken down in the body by the process
of digestion so that it can be absorbed
into the blood stream. The whole
process takes place in the digestive
system which begins at the mouth and
ends at the anus.

Heart attack
When part of the heart is permanently
damaged because one of the heart
arteries is blocked and blood has been
unable to get through to the heart.

Hyperglycaemic (Hyper)
Abnormally high blood glucose levels,
where the body is unable to remove
and change the glucose to energy.

Also known as high blood pressure,
diagnosed when blood pressure
readings are consistently 140/90 mmHg
or higher.

Hypoglycaemic (Hypo)
Abnormally low blood glucose levels.
Patients usually experience symptoms
when blood glucose levels drop below
4 mmol/l.

Hormone produced by the pancreas
which is essential for regulating the
levels of sugar in the blood.

Insulin analogue
A synthetic form of insulin
manufactured to be similar to
human insulin, but with different
characteristics that can make it shorter
acting (for mealtime use) or longer
acting (as a background insulin).

Insulin resistance
In Type 2 diabetes the body produces
some insulin but the body’s cells are
unable to use it efficiently.

A condition where a person has raised
blood glucose levels and is dehydrated
so that metabolic acidosis develops
(where the body’s natural acid-base
balance becomes disturbed).

Ketones are the acid breakdown
products of fats in the body.

The body needs minerals to grow
and control body processes e.g.
transmission of nerve impulses.
Minerals also form an essential part
of body fluids. Some minerals are
required in relatively large amounts
e.g. calcium, iron, sulphur, phosphorus,
potassium and chlorine. Others are
required in small amounts e.g. iodine,
manganese, zinc and fluoride.

Monounsaturated oils
Fats may either be saturated or
unsaturated. Monounsaturated fatty
acids are found in most animals and
plant fats and oils, especially olive oil.

Multidisciplinary team
A team of different types of healthcare
professionals who work together to
make sure that people have the care
they need, at the time they need it; for
diabetes, these are known as diabetes
care teams.

A doctor who has specialised in
diagnosing and treating kidney

Damage to the kidneys.

Damage to the nerves.

Nicotine replacement therapies
A substitute for nicotine, an addictive
substance contained in cigarettes. They
can take the form of patches, chewing
gum, nasal sprays or inhalers.

A doctor who has specialised in
diagnosing and treating eye conditions.

A health professional that looks after
people’s feet.

A gland behind the stomach which
produces insulin and other hormones.

The light-sensitive area at the back of
the eye.

Damage to the back of the eye (retina).

Saturated fats
Saturated fats are predominantly
found in fats that are solid at room
temperature e.g. animal fats.

Smoking cessation clinics
A clinic led by a trained advisor to help
people find ways to stop smoking.

Where the blood stops getting through
to an area of the brain, which may
result in loss of function in part of the

A fungal infection. It produces creamy
white patches and extreme itching and
soreness, usually in the genital area or
the mouth. Repeated attacks may be
triggered by excessively high glucose
levels in the urine.

A component of fat in the blood. Higher
than normal levels are associated with
an increased risk of heart disease,
strokes and other circulatory diseases.

An open sore that becomes red and
painful (inflamed); in diabetes, one
of the aims is to stop ulcers from
developing on the feet.

A group of different chemical
substances. The body requires only
small amounts of each vitamin but as
it cannot make most of them itself they
must be obtained from food. Vitamins
are needed to help the body grow,
to maintain the body, and to control
metabolic reactions in cells.

Your diabetes care team:


Diabetes Nurse:





You may also phone 111 (NHS 111 Service, England; NHS 24, Scotland) for advice, but the adviser answering your call will not have
detailed knowledge about you. They will, however, be able to give you general advice or direct you to further help if necessary. If
you live in Wales; call NHS Direct Wales (0845 46 47).

30 31 For more information visit our website Download the better-living app from the app store

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