Diabetes - What You Should Know About Diagnosis & Prevention

Every November, Diabetes Awareness Month highlights one of the UK’s fastest-growing health challenges. More than 5.8 million people in the UK are living with diabetes, and an estimated 850,000 remain undiagnosed (Diabetes UK, 2024).

Understanding the condition, recognising the signs, and knowing when to speak to your GP can make a real difference to long-term health.

What Is Diabetes?

Diabetes is a condition where blood sugar (glucose) levels become too high because the body can’t use insulin effectively or doesn’t produce enough of it.

• Type 1 diabetes is an autoimmune condition in which the pancreas stops producing insulin.
• Type 2 diabetes (T2D) develops when the body becomes resistant to insulin’s effects or gradually produces less of it.

T2D is the most common form, and its onset is often gradual. Many people live with pre-diabetes (also known as non-diabetic hyperglycaemia) for years without knowing.

Unchecked, high blood sugar can lead to complications such as heart disease, nerve damage, eye or kidney issues, which is why early detection and preventive lifestyle steps are so important.

How Your GP Tests for Diabetes

If you notice frequent thirst, increased urination, tiredness, blurred vision or slow-healing wounds, it’s worth discussing these symptoms with your GP.

Typical UK diagnostic tests include:

• HbA1c test – shows average blood sugar levels over the past three months.
  • A result of 48 mmol/mol (6.5 %) or higher indicates diabetes (NICE NG28).
• Fasting plasma glucose test – after at least eight hours without food.
  • 7.0 mmol/L or above may indicate diabetes.
• Oral Glucose Tolerance Test (OGTT) – measures blood sugar before and two hours after a sugary drink, used when results are borderline.

If results are raised but below diabetic range, you may be told you have pre-diabetes and offered monitoring or referral to the NHS Diabetes Prevention Programme (NDPP).

The UK National Screening Committee currently does not recommend universal screening for type 2 diabetes, but GPs are encouraged to test those with risk factors such as family history, high blood pressure, or overweight (UK NSC 2023).

Can Type 2 Diabetes Be Hereditary?

Yes, genetics can influence your risk, but it’s not destiny. Having a close relative (parent, brother or sister) with type 2 diabetes increases your likelihood two- to six-fold compared with someone without that history (Diabetes UK, 2023).  This happens because genes affecting insulin production and glucose metabolism can be inherited, but environment and lifestyle still play the largest role.

Regular activity, balanced eating, maintaining a healthy waist circumference, and not smoking all help offset this inherited risk.

Evidence That Prevention Works

Strong UK evidence shows that type 2 diabetes can often be delayed or even prevented:

• The NHS Diabetes Prevention Programme (NDPP) has helped thousands at high risk achieve significant reductions in HbA1c and weight, cutting progression rates.
• The DiRECT trial (University of Glasgow & Newcastle University, 2017–2023) demonstrated that structured lifestyle and weight-management support delivered through primary care led to remission in up to 46 % of participants at one year.
• Public Health England (now OHID) reports that maintaining healthy weight, diet quality, and regular physical activity are the most effective protective factors.

Lifestyle Strategies Beyond Nutrition

While food choices are key, several other areas influence blood sugar and metabolic health:

1. Movement and Exercise

Even modest daily activity improves how muscles use glucose. Both aerobic exercise (like brisk walking or cycling) and strength training enhance insulin sensitivity. 

Breaking up long periods of sitting is also beneficial. Weight training is essential to helping improve insulin sensitivity too.

2. Sleep Quality

Consistently getting less than seven hours’ sleep can impair glucose control.
Prioritise a regular bedtime, reduce evening screen time, and keep the bedroom dark and cool.

3. Stress Management

Chronic stress raises cortisol, a hormone that can elevate blood sugar.
Mindfulness, deep breathing, time in nature, or supportive conversations all help moderate stress responses.

4. Weight and Body Composition

Even a 5–10 % reduction in body weight can significantly improve blood sugar control. Focus on building muscle through gentle resistance exercise and balanced protein intake.

5. Regular Check-ups

For those living with diabetes, the annual review offered by the NHS includes checks for HbA1c, blood pressure, cholesterol, kidney and foot health, all vital for preventing complications (NHS Diabetes Care Processes, 2024).

For everyone else, periodic health checks for blood pressure, waist circumference, and glucose levels can help spot early warning signs.

Taking Action This Diabetes Awareness Month

Diabetes prevention isn’t about perfection - it’s about awareness and steady change.  This November, consider booking a routine health check, reviewing your lifestyle habits, and learning more about how small steps protect long-term health.

Explore related topics in:

• Insulin Resistance and Midlife Weight Gain
• Ultra-Processed Foods: The Hidden Driver of Weight Gain and Low Energy
• or browse the Recipe Section for balanced, real-food meal ideas.

If you’d like personalised support to improve your energy and metabolic health, book a Blood Sugar Balance Consultation.

Disclaimer: This blog is for general educational purposes only and should not replace medical advice. Always consult your GP or healthcare provider before making changes to your diet, medication or lifestyle.

Insulin Resistance and Midlife Weight Gain: Why Blood Sugar Balance Matters

If you feel like you’re doing everything right, but your energy still dips mid-afternoon or the scales won’t budge, insulin resistance could be playing a role. It’s one of the most overlooked factors in midlife weight gain and fatigue, but it’s also one that can respond really well to nutrition and lifestyle changes.

What Is Insulin Resistance?

Insulin is a hormone made by the pancreas that helps move glucose (sugar) from your bloodstream into your cells, where it’s used for energy. Over time, especially when the diet is high in refined or ultra-processed foods, your cells can become less responsive or deaf to insulin’s signal. The pancreas compensates by producing more insulin, but chronically high insulin can encourage fat storage, particularly around the middle, and lead to erratic energy and cravings.

Insulin resistance is increasingly common in our 40s and 50s. It isn’t a disease, but a sign that the body’s metabolism needs support. The earlier it’s addressed, the easier it is to rebalance.

Signs and Symptoms to Watch For

Insulin resistance often develops gradually and can go unnoticed for years. Common indicators include:

• Feeling tired or hungry soon after eating
• Energy crashes or brain fog mid-afternoon
• Sugar or carbohydrate cravings
• Difficulty losing weight despite a balanced diet
• Increased waist circumference or stubborn belly fat
• Feeling shaky or irritable if meals are delayed
• Blood tests showing higher fasting glucose or triglycerides

These symptoms don’t diagnose insulin resistance but can indicate that your blood sugar regulation needs support. Discuss any concerns with your GP and request appropriate testing if needed.

How Nutrition Can Support Insulin Sensitivity

Nutrition plays a central role in how our cells respond to insulin. Meals that combine protein, fibre and healthy fats slow the release of glucose into the bloodstream, helping to keep energy levels steady and reduce cravings.

For most people, this isn’t about cutting out all carbohydrates, it’s about choosing the right ones. Whole, minimally processed foods with natural fibre and texture support both blood sugar balance and gut health.

Lifestyle factors matter too. Regular movement, particularly strength or resistance training, encourages muscles to absorb glucose more efficiently. Prioritising sleep and managing stress can also prevent the cortisol spikes that make blood sugar harder to control.

If you’d like to explore how these principles apply to midlife, read my related post on Balancing Blood Sugar in Midlife.

Foods That Improve Insulin Response

A few small dietary shifts can have a big impact on insulin sensitivity and overall metabolic health:

• Protein with every meal: fish, chicken, eggs, tofu, beans or Greek yoghurt help regulate appetite and maintain muscle mass.
• High-fibre carbohydrates: quinoa, legumes, and a wide variety of vegetables slow glucose absorption and support gut microbes.
• Healthy fats: olive oil, avocado, nuts and seeds promote satiety and hormone balance.
• Colourful plants: berries, leafy greens, peppers and cruciferous vegetables provide antioxidants that support cell function.
• Reduce ultra-processed foods: packaged snacks, sugary cereals and convenience meals often combine refined carbohydrates with low-quality fats, disrupting blood sugar control.

A balanced plate might look like grilled salmon with quinoa and broccoli - a simple, nutrient-dense combination that supports steady energy and hormone balance - see image above.

Taking the Next Step

If sugar cravings, fatigue or weight gain feel familiar, it may be time to look beyond willpower and consider what’s might be happening with your blood sugar balance.
Addressing insulin resistance early can transform energy levels, appetite regulation and long-term metabolic health.

You can learn more about building Metabolic Resilience in my post here or book a Blood Sugar Balance Consultation to explore personalised nutrition and lifestyle strategies that work for you.

Disclaimer: This blog is for general educational purposes only and is not a substitute for medical advice. Please consult your GP or healthcare provider before making changes to your diet, supplements or medication.

Do you have symptoms such as always feeling tired, constant pangs of hunger, inability to lose weight, sugar cravings all the time, fatigue after meals, central weight gain, and generally just feeling rubbish?

Well, you just might be suffering with insulin resistance – this is one of the main symptoms I see in perimenopausal and menopausal women (hello menobelly!), but it is also one of the main drivers of PCOS.

If you think you might be suffering with insulin resistance, here are my top tips to help you get back to feeling well again:

1. Cut down on refined carbohydrates

These foods are the main trigger for insulin production, as your body needs the hormone insulin to move the glucose from these foods out of your bloodstream. 

Reducing your intake of these kinds of foods can improve your insulin sensitivity as you won’t need to produce as much insulin. 

Firstly, ditch all those sugary snacks entirely – you really don’t need them. I’m talking cakes, biscuits, ice cream, sugary drinks, desserts. And then think about the quality and the quantity of complex carbohydrates that you’re having. 

Maybe replace your big bowls of spaghetti with some courgetti or think about eating steamed new potatoes instead of jacket potatoes.

2. Reduce stress

Stress is a major contributing factor to your blood sugar balance. When we are stressed, our body switches into ‘fight or flight’ mode so that we can battle or evade danger. 

One of the things that happens is the stress hormones we produce encourage our body to break down its energy stores into glucose, so that it will enter our bloodstream and be ready for fuel for our muscles. 

However, if this stress is constant rather than acute (I’m thinking work or family stress as opposed to facing a tiger), then we can end up with persistently high blood sugar levels ergo high insulin and, bam, possible insulin resistance. 

Whilst we can’t always change or remove the stressors in our lives, we can learn to build resilience to those stressors. Yoga, tai chi and meditation have been shown in research to help build stress resilience. Something to think about adding to our daily routines.

3. Get better sleep

We all know that sleep is great for our health! But studies have linked poor sleep to reduced insulin sensitivity. 

Our body does a lot of repair and resetting work while we sleep, so if we are not having enough sleep, this work won’t be getting done. 

Research shows that how much a person sleeps impacts both their insulin and their cortisol (stress hormone) levels, thereby affecting their insulin sensitivity. Aim for 7-9 hours per night, but with a regular sleep and wake-up time.

4. Get more exercise

Regular exercise is an excellent way to improve our insulin sensitivity. It helps us move sugar into the muscles for storage and it immediately improves our insulin sensitivity for up to 48 hours dependent on the type and duration of exercise undertaken.  

While both weight training and aerobic exercise have been seen to be beneficial, research shows that it’s a combination of both that is most effective in increasing insulin sensitivity.

5. Eat more veggies

Replacing refined carbohydrates with more veggies makes sense when we want to be healthy, doesn’t it? 

But eating more veg can make us more insulin sensitive too. Firstly, many vegetables are excellent sources of fibre, particularly soluble fibre. 

Soluble fibre feeds the friendly bacteria in our guts and having a balance microbiome has been linked to increased insulin sensitivity. Brussel sprouts, avocados, broccoli, black beans and sweet potatoes are all good sources.

So, these are my tips to getting you back on track! Try them out and see if they can help relieve your symptoms, particularly if you are suffering with PCOS, perimenopause symptoms, or you just can’t move the weight around your midriff. Or why don’t you book in a free 30-minute health review with me – just click here.

Feel More Energised

There’s a lot to like about getting older. You’ve made most of the silly mistakes you’re going to (and survived), you’ve likely got more time on your hands since your children have flown the nest (or are at least at a more self-sufficient stage), you now have the confidence to care much less about what other people think of you and no longer suffer fools, you may find that you have more money in the bank to do with as you wish, and since the desire for more and better has diminished, you’re calmer and more content.

But do you find yourself wishing ‘if only…’ in relation to your health and wellness?

You may wonder where your energy and vitality has gone, your skin has probably lost its dewy glow and freshness, your digestion is more troublesome than it’s been in years, and you want to ensure you’re taking care of your long-term health, so there are no nasty surprises lurking round the corner.

I want to let you know that the food you eat matters more than you think. What and how you eat influences every area of your health and eating the right diet for YOU coupled with some positive lifestyle changes, like getting the sleep you need and managing stress, will help you feel like a new person.

There’s no reason that you cannot feel fabulous at any age, if you take the right actions, and it’s my job as a nutrition coach to motivate and support my clients to do just that. Of course, working one-to-one means I can create a nutrition and lifestyle strategy built around your exact needs. But here is my number 1 tip – get your blood sugar balanced.

There are so many reasons that you might be feeling more sluggish than you’d like, and pinpointing what’s behind your lack of energy is something we’d need to discuss in person. But what I’m going to share with you is a simple strategy that can make a big difference.

Balancing blood sugar levels is one of the key things I help my clients with. Eating in a way that provides a constant supply of energy through the day will help you avoid dips in blood sugar than can leave you feeling tired, grumpy and craving the ‘wrong’ kinds of foods.

Very simply, you’d want to have a little protein at every meal and snack. This includes meat, fish, eggs, and vegetarian protein sources like tofu, lentils, beans, chickpeas and quinoa. You also need plenty of non-starchy veg (starchy veg include potatoes,parsnips, sweet potatoes, corn) and smaller portions than you may be used to of starchy carbs like potatoes, rice, bread and pasta.

Unfortunately, the staple diet for many people involves cereal, sandwiches and pasta – often several servings in the same day – and this can contribute to blood sugar highs and subsequent crashes.

See if you can move to three meals a day, with no snacks. Eat enough at each meal to sustain you – including protein and healthy fats will help with this. And be mindful of the quality and quantity of carbohydrates you are including.

Watch out for your caffeine and alcohol intake too, as these drinks can seriously mess with your blood sugar balance. 

If you’d like further tips on getting the balance right, why not book in a call with me here?

Six Steps to Blood Sugar Balance

Blood sugar balance is something I work on with *every* client. It is the key to feeling more energised, avoiding that mid-afternoon slump and losing weight. You only feel better with it!

Following these main tips are first steps:

• • 3 meals a day, no snacks
  • Protein with every meal (and snack if you have one)
  • Watching the quality and quantity of your carbohydrates
  • Watching caffeine and alcohol
  • Meal timings - trying to eat your meals within a 10-hour window

However, there are some simple hacks that can help you feel more balanced and can keep you on your health path:

• EAT VEGGIES TO START WITH
  • This means that you are lining your gut with gorgeous fibre and stopping the glucose from being absorbed too rapidly.
  • Think: asparagus, kale, courgette, peppers, broccoli, lettuce, tomatoes, as well as pulses and beans, and even, at a pinch, coleslaw. 
  • You can even do as the French do and have a light green salad before your meals. 
• START WITH THE APPLE CIDER VINEGAR: 
  • Research shows that vinegar before meals may help people on a weight-loss diet. 
  • Just drink a tablespoon of vinegar in a large glass of water just a few minutes before eating.  I’d start with just a teaspoon to begin with and build up.
  • But if you’re really not keen, why not add a vinaigrette dressing to your salad starter.
• DITCH THE SWEET – BREAKFAST SAVOURY: 
  • Have you ever noticed that when you eat sugary breakfast cereal, you’re nearly always hungry again within the next couple of hours? 
  • What you eat first thing massively affects your blood sugar levels for the rest of the day.
  • So starting with a savoury option can be really helpful. Think: eggs, full fat Greek yoghurt, nut butter, nuts& seeds, protein powder, tofu, meat, and fish.
• TAKE A WALK AFTER EATING:
  • That post-Sunday-roast walk is a brilliant idea. 
  • 10 to 20 minutes is enough to reduce blood sugar spikes.
• EAT FOOD IN THE PROPER ORDER:
  • Rather than going for your faves, the ‘proper order’ is: fibre, protein, fat, then carbs and sugars.
  • If we eat veggies first at meals, the fibre in the vegetables helps to slow down the rapid absorption of sugars into our bloodstream.
• ALWAYS DRESS YOUR CARBS:
  • If you pair carbs with protein and/or fat it can be an effective tool for helping us to feel satiated and balance blood sugar levels, especially if we are insulin resistant.
  • This is because when it is combined with protein and/or fat, the glucose from a carb food is absorbed more slowly and evenly into the bloodstream. 
  • Protein and fat also help to delay digestion, which means you’re fuller for longer. 

If you’d like to know more about blood sugar balance and how it can help your health, why not get in touch? You can book a free 30-minute call with me here.

Blood Sugar Monitoring: What is it and how does it work?

You’ve probably seen folk online talking about continuous glucose monitors (CGMs). Perhaps you’ve seen the adverts for the Zoe programme. Or else you might well have spotted people wearing a little white disk on their upper arm and wondered, what’s that all about?  Then there are those devices you can blow into to measure your metabolic health, and let’s not forget the time-honoured finger-prick blood tests to check out your blood glucose or ketone levels. Want to know how all of this relates to you and, of course, whether you should invest in one? Read on. 

What do these devices do?

Whether you’re talking CGM, Lumen or a blood glucose monitor, the reason people are using these devices is that they want to know what their blood sugar levels are. For some, this is a medical necessity. They have been told they have diabetes, for example, and want to get back in control of their glucose levels or, for type 1 diabetes, they need real-time information to work out how much insulin they need to dose. Since very high sugars are dangerous to the body and very low sugar levels (hypos) can be life-threatening, these monitors can mean the difference between life and death. 

Over the last couple of years, more and more people who are simply interested in their health are investing in them. These might be people who have been told they have prediabetes and who want to reduce the risk of developing type 2 diabetes, or those who are looking for answers to why their energy is lacking, or they’re struggling to lose weight, or maybe even those people who love getting data on what their body is doing. 

Blood glucose monitors

These pocket devices have been around for years, and you can buy them from pretty much every pharmacy and online. They usually come in a kit with a lancing device that spikes your finger, releasing a little drop of blood and a pack of testing strips. You insert a glucose testing strip into the machine and drop the blood onto it and, within seconds, you have your reading. 

Diabetic patients would test their glucose levels at different points in the day, perhaps first thing in the morning (this a good general indicator of blood sugar management), right before a meal and then 2 hours after a meal (when levels should fall back to the baseline level). If you don’t have diabetes, but you have prediabetes or you just want to know what your body is telling you, it’s most likely you’ll measure first thing in the morning, just after you’ve got out of bed and before having a morning cuppa or anything to eat. This is your fasting glucose reading. 

Your doctor may routinely have taken a fasted reading like this if you’ve ever had blood taken. It’s considered a reasonably poor measure of your blood sugar levels but the essential thing to note is that it is just one moment in time – literally the time you pricked your finger – and it might have been different yesterday and it might be different tomorrow. This is why having your own kit can be helpful, and it is also why doctors who are genuinely interested in what your blood sugar levels have been doing over time would test your HbA1c. 

HbA1c stands for haemoglobin A1c, which is a blood test used to measure the average blood sugar levels over the past three months. Haemoglobin is a protein found in red blood cells that carries oxygen to different parts of the body, and glucose can attach to it, forming a "glycated" haemoglobin molecule.

The HbA1c test measures the percentage of glycated haemoglobin in the blood, reflecting the average blood sugar levels over few months. This is why it’s more interesting for medical professionals to know what this number looks like for their patients rather than a single measurement taken on the one day they were in the blood test centre. You can get your HbA1c done privately and relatively inexpensively. It’s a test I often recommend to my clients. 

You can also buy similar monitors to measure your ketone levels if you’re a fan of the ketogenic diet. Some machines can measure both and you would need different strips to measure ketones to the ones you use for glucose. Otherwise, the machine works in the same way. The drop of blood, in this case, indicates whether you are in ketosis or not. 

BLOOD GLUCOSE READINGS: 

Morning fasting glucose levels should be between 4mmnol/L and 5.4mmol/L (72 to 99 mg/dL) for non-diabetics. 5.5 to 6.9 mmol/l (100 to 125 mg/dl) may be indicative of prediabetes. 7.0 mmol/l or more (126 mg/dl or more) may suggest diabetes. I

f you are measuring your fasted sugar levels and get a reading you don’t like, don’t jump to conclusions. If you have a few consecutive readings, make an appointment to see your doctor. There are a few things outside of food and drinks that have an impact on blood glucose readings, not least stress.

BLOOD KETONE READINGS:

Nutritional ketosis begins at 1.0 and an optimal therapeutic zone is between 3.0 and 5.0. 

Continuous glucose monitors (wearable blood glucose monitors)

When you see someone wearing a little disc attached to their upper arm, chances are, it’s a continuous glucose monitor (CGM) or, more specifically, a related device called a flash glucose monitor (FGM). The two terms are used interchangeably although there are some very subtle differences in the way they fetch their readings.

Both devices are designed to monitor blood glucose levels. A CGM continuously tracks glucose levels in real-time and provides continuous updates to the user throughout the day and night. It can also talk to insulin pumps. 

In contrast, a flash glucose monitor (like those used with the Zoe programme or the popular brand FreeStyle Libre), takes some automatic readings but it also requires the user to scan a small sensor worn on the skin with a reader or a smartphone app to get the glucose readings. The readings are stored on the sensor and can be reviewed later to get a general idea of glucose trends over time. It can only store eight hours of data, so users typically have to ensure they scan before bed and shortly after they get up just to make sure readings have been taken and there are no gaps in data. 

If you are diabetic, you might be entitled to a device on prescription. If you are simply interested in your metabolic health, you will not. You can take part in the Zoe programme, which also includes a stool test, but there is often a wait of a few months before you can participate and you pay for the programme upfront, making it quite pricey. You can also buy the FreeStyle Libre device from selected pharmacies and also directly from the manufacturer Abbott. Monitors last 14 days and cost between £55-75 each. 

Or alternatively, you can come and work with me. I often use CGMs with clients with blood sugar imbalance or insulin resistance, for example, women in menopause or with PCOS, or for those who are looking to lose weight. I’ve found the information that a CGM can provide about an individual’s reaction to certain foods can really help to personalise their programme. Plus, we can also see the effect that exercise, stress, sleep and relaxation might be having on their blood sugar levels, and subsequently their metabolic health. 

If you’d like to know more about blood sugar balance and the tech you can use to help with it, why not get in touch? You can book a free 30 minute call with me here.