- I've been told I have prediabetes. What is this and what should I do?
- I've started getting pain in my joints/muscles. Could this be related to diabetes?
- I am unwell and can't face eating anything, what should I do?
- I can't get/maintain an erection any more. I'm too embarrassed to talk to the doctor/nurse about this. What should I do?
- Now that I've been diagnosed with diabetes, will I go blind/lose my leg?
- I need to lose weight but I am not sure how.
Prediabetes is NOT a medical condition.
What doctors usually mean by this is that someone has Impaired Glucose Tolerance (IGT) or Impaired Fasting Glycaemia (IFG) or Impaired glucose regulation (IGR) or Non-diabetic hyperglycaemia (NDH).
Musculoskeletal conditions (conditions affecting the muscles or skeleton) can affect anyone, but people with diabetes can be at an increased risk of developing them. The reasons for this are not fully understood but it is thought that raised blood glucose levels may, over time, cause changes to the naturally occurring protein collagen. Collagen is the main constituent of connective tissue and is present in the skin, cartilage, tendons and ligaments. Glucose can bind to strands of collagen in a process known as glycosylation, and lead to the formation of cross-links with adjacent collagen strands. As a result the whole structure of the skin, or a tendon or ligament, can become thicker and less flexible, and this may lead to, or aggravate, a range of musculoskeletal conditions.
Good blood glucose control can help reduce the risk of developing this type of disorder.
If musculoskeletal conditions do develop then treatment options include resting the affected joint, physiotherapy, anti-inflammatory painkillers, steroid injections (to help reduce any inflammation) and, in extreme cases, surgery. Ultrasound may also sometimes be beneficial – the reasons for this are not fully understood, but it is thought to help reduce inflammation.
In addition, statins – a group of drugs prescribed to reduce cholesterol levels – can also cause pain in the joints and muscles. If you started getting the pain around the same time as you started taking statins, this may be worth investigating further. Talk to your doctor or pharmacist.
Keep taking your insulin or tablets even if you are not eating. Remember, your blood glucose level naturally goes up during illness and you need to keep it under control.
You may need to increase your dose of insulin or tablets. Your tests will show you if this is needed.
Contact your GP or a member of your diabetes care team if you are in any way unsure what to do about your insulin or tablet dose.
Test your blood or urine four or more times a day and write the results down. If you are not well enough to do this, ask someone to do it for you. Your test results are your guide as to how you are getting on and if you contact your GP or a member of your diabetes care team, they will want to know the results so they can advise you on your tablet or insulin dose.
If you have Type 1 diabetes and you blood glucose level is 15mmol/l or more or you have two per cent glucose in your urine, you will also need to test your urine or blood for ketones. Ketones are a sign that your diabetes is seriously out of control. Ketones are especially likely when you are vomiting and can very quickly make you feel even worse. If a ketone test is positive, contact your GP or diabetes care team immediately.
It is important to drink plenty of sugar-free drinks and keep drinking as much as your can. Aim to drink at least three litres (five pints) a day. Try to keep to your normal meal pattern. but if you are off your food or cannot eat properly, you can replace your meals with carbohydrate containing drinks such as soup, milk or fruit juice. Have sugar-free drinks in between. If you are being sick and cannot keep anything down, take regular sips of sugary drinks such as fruit juice, ordinary cola, or lemonade. In this situation, these can help to regulate the blood glucose levels.
Q: I can't get/maintain an erection any more. I'm too embarrassed to talk to the doctor/nurse about this. What should I do?
Erectile dysfunction or impotence are medical terms for the inability to get or sustain an erection for sexual intercourse. It can be caused by tiredness, stress, too much alcohol, certain medications and diabetes. All men experience difficulties in achieving an erection at some time in their lives, but about one man in every ten has continuing erection problems and over half of all men with diabetes are affected.
Sex is an important part of a relationship for people and an unfulfilling sex life can cause problems within a relationship, with feelings of frustration, hurt and rejection. Many couples maintain a conspiracy of silence about the issue. They are reluctant to talk about it for fear of causing each other more stress. Open communication is important as discussion can lead to greater understanding of each other's perception of the problem and a greater understanding of each other's sexual and emotional needs.
There are many treatments available for erectile dysfunction and you may want to try out alternatives before you decide on the one which best suits you and your partner. To access these treatments, the best person to speak to is your doctor but in the first instance, you may wish to talk through the options with a Careline Counsellor. The Careline staff are trained counsellors who have the time to provide you with information and support. The service is confidential and you can choose to remain anonymous. You can also contact the Sexual Dysfunction Association:
Sexual Advice Association
Windmill Place Business Centre
2-4 Windmill Lane
Helpline: 020 7486 7262
It's very common for people to worry about the possible complications of having diabetes, especially if they know of someone who has experienced one or more of these. However, losing your sight completely or losing a limb is the worst case scenario and with regular checks, treatment can be provided to help ensure that neither of these things happen. This is why your annual health check is so important.
If you would like to talk through your worries and concerns, please do call our Helpline. The line is staffed by trained counsellors who also have knowledge of diabetes. You will be given as much time as you need and although the service is confidential, you can choose to remain anonymous if you prefer. You can also send us an email or write to us.
Maintaining a healthy weight is an important part of managing your diabetes, of whatever type.
Find out more about managing your weight.