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Frequently asked questions on diabetes

Publish date: 28/04/2014

How can people with diabetes manage the emotional side of living with the condition? Is there specialised help available?

There are diabetes support networks and patient groups which might be available locally and some people find these helpful. Diabetes UK may also be able to help. There are increasing community psychological services available for people with diabetes in some areas. Check with your GP, Practice Nurse or your diabetes specialist team.

I love to exercise but I'm worried it can cause my blood glucose levels to drop hours later. Is that possible?

Hypoglycaemia (low blood sugar) is a risk for those on insulin or certain type of tablets. Sometimes you’ll have to adjust your treatment or have snacks to reduce this risk. Blood glucose monitoring is also important to give you confidence that your sugars are not falling too low even hours after exercise.

When I get sick, I have the hardest time controlling my blood glucose. Why?

When we’re unwell we produce stress hormones that work against insulin and make us more insulin resistant. Increased blood glucose monitoring, maintaining your carbohydrate and fluid intake, careful adjustment of medication and early medical support are important. Avoid the temptation to stop medication without medical advice. Testing for ketones in the urine or blood in type 1 diabetes is also crucial.

My 21 year old sister has just been diagnosed with type 2 diabetes. I want to be supportive. How can I help?

Newly diagnosed patients with type 2 diabetes should be offered an education programme called DESMOND or equivalent. Why not go along or be there for her at doctor or nurse appointments? Diabetes UK has a good informative website for patients and their relatives. Understanding the importance of what she’s being told will also be helpful.

Can I continue driving? Do I have to notify the DVLA now that I’ve been diagnosed with diabetes?

If you’ve been diagnosed with diabetes but you’re controlling your condition with a change in your diet and you’re not on any medication to control your blood sugars and have no complications arising from your diabetes then you don’t need to inform the Driving and Vehicle Licensing Agency, DVLA.

If you’re taking certain medications, have complications arising from your diabetes or you’re driving certain categories of vehicle, you may need to inform them. Find out more for about the most up to date guidance from the DVLA.

You may also find some useful information on Diabetes UK.


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Diabetes and insulin devices FAQs

I’m worried about going on insulin. Is there any advice you can give me? I remember my aunt having to use big needles and vials.

Insulin syringes and vials are less common these days as there are pen devices available that are safer and easier to use. They tend to use very small disposable needles. The exact type will depend on your insulin regimen. In type 1 diabetes, insulin will be used from the moment someone is diagnosed. In type 2 diabetes, insulin is often used when satisfactory control is not obtained through diet, lifestyle modification and tablets.

Once someone starts treatment with insulin, it will involve closer monitoring of blood glucose levels. Using insulin and the monitoring required usually becomes part of a routine very quickly. It’s important to emphasise that insulin is an excellent treatment option for many to gain better control of their diabetes.

What are insulin passports?

Insulin passports are cards similar to a credit card with details of the exact insulin and insulin device you’re using. They’ll be issued to you by your doctor or your diabetes nurse specialist. They’ve only recently become available and aim to minimise any medication errors. It’s a good idea to carry the card with you at all times.

Why do I need to change my needle with each injection? Surely this is a waste.

There are several reasons why the needle should be changed with each injection.

Repeated use of the same needle will make it more prone to bending and breaking. It also increases the risk of becoming blunt. Injecting with a blunt needle increases the chances of painful injections and bruising. It increases the risk of infection because the needle won’t be sterile when used. Remember when you use a fresh needle it’s sealed and sterile and remains so up to the expiry date.

Leaving the needle on means those small amounts of insulin can flow out when you’re not using the pen. This insulin may crystalise and block the needle bore, leading to altered insulin flow. This in turn can change the concentration of the insulin due to evaporation.

It's therefore important to change the needle with each injection and dispose of them properly in a sharps bin.

I often have a bruise at my injection site. Why is this?

This can happen when your needle hits a blood vessel. It’s normal to have this from time to time and is best to avoid this area for further injections until the bruise has cleared.

If you draw a small amount of blood or clear liquid then there’s no need to worry, you simply need to apply firm pressure for a few seconds. But, if you have excessive bleeding then you need to seek advice from your diabetes specialist.

If you have frequent bleeding and bruising then the size of your needle may need to be changed and your injection technique may need to be reviewed. If you inject accidently into a muscle then you may also experience some bleeding and bruising.

How can I stop my injection from being so painful?

Nowadays the pen needles are very short and have a fine bore so pain on injection is minimised.
Make sure that:

  • You’re using a new needle, attached just before each dose
  • The insulin hasn’t just come out of the fridge but has been stored at room temperature
  • The air bubbles have been removed from the cartridge or the disposable pen before each injection
  • You’re not injecting into the muscle
  • The length of the needle is appropriate
  • You’re relaxed when injecting the dose
  • You’re not changing the direction of the needle when injecting and then withdrawing the needle.

Insulin often leaks out when I inject my dose. Is this normal?

If this happens make sure that the needles are compatible with the pen. If there’s a great deal of leakage then perform more frequent blood glucose tests so that any ‘hypers’ can be dealt with.

My nurse told me to change the site each time I inject - is this really necessary?

It’s important to rotate the injection site because repeatedly injecting in the same place can lead to increased fat deposition known as lipohypertrophy. This can be unsightly but, more importantly, affects the way that the insulin injected at this site is taken up by the body making the blood glucose harder to control.

Where do I get the sharps bin?

Your doctor will give you a prescription for a sharps bin. This can be dispensed in the usual way in a pharmacy. Not all pharmacies keep them in stock but they can order it in for you via their usual wholesalers. Your Diabetes Nurse specialist or your GP surgery may be able to provide one until you can get it on your prescription.

How do I dispose of a sharps bin?

Local authority organisations have arrangements with designated companies who are licensed to provide this type of waste disposal service.

Often GP surgeries have a contract with specialist hazardous waste companies whose dedicated team collect and dispose of sharps bins on a weekly, monthly or by appointment basis.

The collection and disposal of a sharps bin is free at the point of use for the patient providing they have been referred by their GP. It can take up to 48 hours approximately for the collection service to be set up. The GP surgery will pay the company for this service.

If your GP surgery is unable to provide this service details of companies licensed to provide this type of service can be found on the Environment Agency in England and Wales website environmentagency.gov.uk/subjects/waste/ and the Scottish Environment Protection Agency in Scotland website sepa.org.uk

I am traveling abroad next month are there any special precautions I need to take with my insulin?

If you’re travelling abroad it’s a good idea to take your insulin supplies with you in your hand luggage in a suitable insulated bag or an open necked vacuum flask.

Never put it in the hold because insulin can freeze and make it ineffective.

Your particular insulin’s manufacturer will be able to guide you on this and let you know of overseas availability. It’s worth noting that the same insulin available abroad may be under a different name and strength such as 40units/ml or 500units/ml as oppose to the standard 100units/ml available in the UK. This may mean you’ll need to change the amount you inject to receive the same dose. Always check the strength of the insulin.

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