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    3. Endocrinology
    4. Diabetes diagnosis and treatment

    Diabetes diagnosis and treatment

    At Mayo Clinic Healthcare in central London, our endocrinology department provides personalised assessment and treatment for type 1 and type 2 diabetes. Our approach to diabetes treatment in the UK combines specialist consultation with advanced diagnostic testing, helping us understand your health and develop a care plan tailored to your needs. 

    Diabetes affects people differently, as your treatment will reflect. Your consultant will look at your overall health, lifestyle, medicines and risk of diabetes-related complications to recommend care that is appropriate for you.

    • Diabetes is a long-term condition that causes the amount of glucose (sugar) in your blood to become too high. This happens when your body does not make enough insulin, does not make insulin at all or cannot use insulin effectively.

      Insulin is a hormone made by the pancreas. It helps glucose move from your blood into your cells, where your body uses it for energy. 

      The two main types are:

      • Type 1 diabetes, an autoimmune condition in which the immune system attacks the cells in the pancreas that make insulin. People with type 1 diabetes need insulin treatment.
      • Type 2 diabetes, which develops when the body does not respond properly to insulin or cannot make enough to keep blood glucose within a healthy range.

      Other forms include gestational diabetes, which develops during pregnancy, and less common forms caused by conditions that damage the pancreas including surgery, genetic conditions, medicines such as steroids, or other medical conditions.

    • The early signs and symptoms of diabetes can be easy to overlook, particularly with type 2 diabetes, as they may develop gradually. Some people with type 2 diabetes have no noticeable symptoms when they are diagnosed.

      Common symptoms include:

      • Feeling very thirsty
      • Passing urine more often, particularly at night
      • Feeling unusually tired
      • Losing weight without trying
      • Blurred vision
      • Cuts or wounds that take longer to heal
      • Repeated infections, including thrush

      Type 1 diabetes often causes symptoms more quickly, sometimes over days or weeks. Type 2 diabetes usually develops more gradually.

      When should you seek medical advice?

      Speak to a healthcare professional if you develop symptoms of diabetes or are concerned about your risk, even if you otherwise feel well. Blood tests can show whether your blood glucose is in the diabetes range. Depending on your symptoms and results, your clinician may repeat a test or use another test to confirm the diagnosis

      Untreated or poorly controlled diabetes can gradually affect the heart, blood vessels, kidneys, eyes and nerves. Early diagnosis can help you begin appropriate treatment and reduce your risk of complications.

      Seek urgent medical help if diabetes symptoms become rapidly worse and are accompanied by vomiting, abdominal pain, unusual drowsiness or confusion, or deep and rapid breathing. These can be signs of diabetic ketoacidosis, a serious complication that requires emergency treatment.

    • The causes differ according to the type of diabetes.

      What causes type 1 diabetes?

      Type 1 diabetes develops when the immune system mistakenly attacks the insulin-producing cells in the pancreas. The exact reason this happens is not fully understood.

      Having a close relative with type 1 diabetes or having another autoimmune condition can increase your likelihood of developing it, although many people diagnosed with type 1 diabetes have no family history.

      Type 1 diabetes is not caused by eating too much sugar or by lifestyle choices.

      What causes type 2 diabetes?

      Type 2 diabetes develops when the body becomes less responsive to insulin and, over time, may also become unable to produce enough insulin to manage blood glucose effectively.

      Factors associated with a higher risk include:

      • Having a close family member with type 2 diabetes
      • Increasing age
      • Living with overweight or obesity
      • Low levels of physical activity
      • Having high blood pressure or other cardiovascular risk factors
      • Certain ethnic backgrounds, including South Asian, Black African, African-Caribbean and Chinese backgrounds

      Your individual risk depends on a combination of factors. Not everyone with type 2 diabetes is overweight, and having one or more risk factors does not mean that you will necessarily develop diabetes.

    • At Mayo Clinic Healthcare, your assessment starts with a consultation. Your specialist will discuss your symptoms, medical and family history, lifestyle, current medicines and any previous test results before recommending investigations.

      Tests may include:

      • Blood tests, including HbA1c (which measures your average blood glucose level over the past two to three months) and blood glucose testing (which measures the amount of glucose in your blood at a particular time)
      • Urine or blood ketone testing when type 1 diabetes or diabetic ketoacidosis is suspected
      • Kidney function and cholesterol tests, which can help assess your wider health and risk of diabetes-related complications
      • Diabetes autoantibody tests, which may help confirm type 1 diabetes in adults
      • C-peptide testing in selected cases when it remains unclear which type of diabetes you have
      • Imaging of the pancreas to exclude a structural cause

      Your consultant may also check your blood pressure, weight and other cardiovascular risk factors. Not everyone needs every test. Your specialist will select investigations according to your symptoms and clinical history and will explain what your results mean.

    • Your diabetes treatment is dependent on the type of diabetes you have, your blood glucose levels, your general health and your individual treatment goals.

      Your endocrinology specialists will work with you to develop a plan that aims to manage your blood glucose while also protecting your long-term cardiovascular, kidney and overall health.

      Treatment for type 1 diabetes

      People with type 1 diabetes need insulin because their body can no longer produce enough of its own.

      Treatment and ongoing management may include:

      • Insulin injections or an insulin pump
      • Regular blood glucose monitoring
      • Continuous glucose monitoring where appropriate
      • Advice on adjusting insulin around meals and physical activity
      • Support with recognising and treating low blood glucose, known as hypoglycaemia
      • Nutrition and lifestyle guidance
      • Regular HbA1c and health reviews

      Diabetes technology continues to develop. Your specialist can discuss which monitoring and insulin-delivery options may be suitable for your circumstances.

      Treatment for type 2 diabetes

      Treatment for type 2 diabetes depends on your blood glucose levels, overall health and individual needs. Your consultant may recommend:

      • Changes to diet and physical activity
      • Weight management where appropriate
      • Medicines to help manage blood glucose
      • Treatment for high blood pressure or raised cholesterol
      • Initially tablets or newer GLP-1 agonist therapies, and insulin when clinically appropriate

      Your consultant will recommend medicines based on factors such as your heart and kidney health, other medical conditions and treatment goals.

      For some people, significant and sustained weight loss can bring type 2 diabetes into remission. This means blood glucose remains below the diabetes range without glucose-lowering medicines, although ongoing monitoring is still important.

      Ongoing diabetes care

      Diabetes care continues beyond your initial diagnosis. Regular reviews help your consultant understand how well your treatment is working and identify changes that could affect your long-term health.

      Depending on your circumstances, ongoing care may include assessment of:

      • HbA1c
      • Blood pressure
      • Cholesterol
      • Kidney function
      • Cardiovascular health
      • Eye health
      • Foot and nerve health
      • Weight and nutrition

      Your treatment goals may change over time. Regular specialist review allows your care plan to change with them.

    • At Mayo Clinic Healthcare, your diabetes care is led by an experienced endocrinology consultant who considers your symptoms, test results, medical history and wider health. Where diabetes affects other aspects of your health, your care can involve specialists from relevant disciplines.

      Our London team can also draw on expertise from colleagues across Mayo Clinic in the United States when this may add value to your care.

    Private health insurance

    Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. Self-pay arrangements are also available.

    We recommend checking the details of your individual policy and obtaining any required authorisation before your appointment.

    Book a private assessment

    If you have symptoms of diabetes, have recently received a diagnosis or would like a specialist review of your current treatment, our endocrinology team can help.

    Request an appointment today or call +44 (0) 207 871 2575 to book your private diabetes assessment at Mayo Clinic Healthcare in London.

     

    Medically Reviewed by

    Dr Vanderpump, Consultant Endocrinologist

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