Diabetes treatments

Our fixed-price packages include the cost of your treatment and all appropriate follow-up appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Type 2 diabetes

Type 2 diabetes is by far the most common type of diabetes, and accounts for around 90% of cases. With type 2 diabetes, your body doesn't make enough insulin, and/or your body's cells don’t respond normally to the insulin you produce (insulin resistance). It is most common in people over 45 but is becoming more common in younger people. Type 2 diabetes is linked to lifestyle factors such as being overweight or leading a sedentary lifestyle. It often runs in families.

Type 1 diabetes

Type 1 diabetes is an autoimmune disease that occurs when your immune system mistakenly attacks and destroys the insulin-producing cells in your pancreas. It most commonly affects children and young adults but can develop at any age.

Pre-diabetes

Pre-diabetes is the stage before type 2 diabetes fully develops. Blood sugar levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. Type 2 diabetes can often be delayed or prevented with lifestyle changes during this stage.

Gestational diabetes

Gestational diabetes is diabetes that develops during pregnancy. It normally goes away once the baby is born but increases your risk of developing type 2 diabetes later in life.

Type 3c diabetes

This form of diabetes is caused by damage to your pancreas due to conditions such as pancreatitis, pancreatic cancer, cystic fibrosis, and hemochromatosis. People who have had their pancreas removed (pancreatectomy) also develop this type of diabetes.

Latent autoimmune diabetes in adults (LADA)

Like type 1 diabetes, LADA is an autoimmune disease where the pancreas stops producing insulin. It develops much more slowly than type 1 diabetes and is most common in adults over the age of 30.

Maturity-onset diabetes of the young (MODY)

MODY is a rare form of diabetes that is caused by an inherited genetic mutation that affects how your body makes and uses insulin. It runs strongly in families and affects around 1 to 2% of people with diabetes. Currently, over ten different types of MODY have been identified.

Symptoms of type 1 diabetes usually develop quickly and tend to be more severe than symptoms of type 2. Untreated type 1 diabetes can lead to a life-threatening condition called diabetic ketoacidosis.

Symptoms of type 2 diabetes usually develop gradually and may be overlooked or picked up during a routine health check.

Women with gestational diabetes don’t usually have any symptoms and the condition is normally picked up on a routine test between 24 and 28 weeks of pregnancy.

Symptoms of diabetes may include:

• Increased thirst and a dry mouth
• Peeing more than usual, especially at night
• Fatigue
• Weakness
• Blurred vision
• Unexplained weight loss
• Numbness or tingling in your hands or feet
• Slow wound healing
• Frequent infections such as skin infections and vaginal yeast infections (thrush)

Your consultant will ask you about your symptoms and medical history. If diabetes is suspected, they will order a blood test to confirm or rule out this diagnosis.

How is a diagnosis made?

Diabetes and pre-diabetes are diagnosed with a blood test to check the levels of glucose in your blood.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where your consultant will ask you about your symptoms, order any necessary tests, provide a diagnosis, and explain your options for treatment.

Your first consultation is also where we get to know you and encourage you to ask any questions you may have. It is important to us that you are well-informed about your diagnosis and treatment, so please feel free to discuss any questions or concerns with your consultant during your appointment.

At the end of your appointment, your consultant will decide on the best treatment for you and devise a treatment plan tailored to your needs.

How diabetes is treated depends on the type of diabetes you have. Type 1 diabetes is always treated with insulin injections. Type 2 diabetes may be treated with lifestyle changes, oral medication (tablets), or in some cases, insulin.

Your consultant will also advise you about a suitable diet and show you how to monitor your blood sugar levels at home.

Insulin

Insulin is used to treat all type 1 diabetics and some people with type 2 diabetes. It replaces the insulin not produced by the pancreas to control blood sugar levels. Insulin can be given by injection several times a day, or via an insulin pump that is attached to the body. There are several different types of synthetic insulin, some work very quickly and last a short amount of time and others are released slowly over longer periods. Most people use a combination of fast-acting and slow-acting insulin.

Medication

There are several types of medication for type 2 diabetes. The most common treatment for type 2 diabetes is metformin. Metformin works by improving the way your body uses insulin. It is usually prescribed when lifestyle changes such as diet and exercise haven't been enough to improve your blood sugar levels.

If metformin isn't suitable for you or doesn't work well enough, you may be offered a different medication either instead of, or in combination with metformin. These may be in the form of tablets or injections.

Tablets used to treat type 2 diabetes include:

• Sulphonylureas - work by stimulating your pancreas to make more insulin. They also help your body use insulin more effectively.
• Prandial glucose regulators - are similar to sulphonylureas but work more quickly and last for a shorter time
• Thiazolidinediones (glitazones) - help your body use the insulin it produces more effectively and protects the insulin-producing cells in the pancreas, allowing them to keep producing insulin for longer.
• Alpha-glucosidase inhibitor (acarbose) - slows the absorption of starchy foods in the gut which in turn slows the rise in blood sugar after eating
• DPP-4 inhibitors (gliptins) - stimulate your pancreas to produce more insulin as well as reduce the amount of glucose being produced by your liver
• SGLT2 inhibitors - work by reducing the amount of glucose absorbed by your kidneys and your blood

Injections used to treat type 2 diabetes may include:

• Insulin - if oral medications are not effective in managing your blood sugar levels, your consultant may prescribe insulin injections
• GPL-1 analogues (incretin mimetics) - work by increasing the levels of hormones called incretins. Incretins help the body produce more insulin when needed and reduce the amount of glucose produced by your liver. They also slow down your digestion making you feel fuller for longer which can help you lose weight and make it easier to manage your diabetes.

Lifestyle changes

It's important to live a healthy lifestyle if you have diabetes. Your consultant will talk to you about some lifestyle changes that will improve your overall health and make managing your condition easier. Some lifestyle changes for people with diabetes include:

• Following a healthy diet. Your consultant may refer you to a dietician to learn about healthy food choices when you have diabetes.
• Take regular exercise
• Stop smoking
• Reduce stress
• Limit alcohol intake

Surgery

Surgery isn't normally an option in the treatment of diabetes, but in some cases, it may be recommended to prevent life-threatening low blood sugar, when there is severe kidney damage, or to aid weight loss in very overweight patients.

Surgical procedures to treat diabetes may include:

Islet cell transplantation

Islet cell transplantation involves extracting insulin-producing (islet) cells from the pancreas of a deceased donor and implanting them into the liver of someone with type 1 diabetes. In the UK, islet cell transplants may be offered on the NHS for type 1 diabetics who have severe low blood sugar (hypoglycaemia) without any warning signs.

Pancreas transplant

A pancreas transplant is when a donor pancreas, and in some cases a kidney, are transplanted from a deceased donor into someone with type 1 diabetes. Pancreas transplants are rare and are only performed as a last resort in someone with type 1 diabetes who has debilitating episodes of low blood sugar, or severe kidney disease.

Bariatric surgery

Bariatric surgery, also known as weight loss surgery, may be recommended for people with type 2 diabetes who are very overweight (have a BMI between 35 and 40) and have tried other weight loss methods without success. There are several different types of bariatric surgery available. The procedure involves bypassing or reducing the size of your stomach so that you feel fuller faster, eat fewer calories, and lose weight.

Monitoring your blood sugar levels

Monitoring your blood sugar is very important when you have diabetes. You can either use a machine that measures your blood sugar using a drop of blood from your finger, or via a sensor called a continuous glucose monitor (CGM). A CGM is a small circular sensor that is attached to your upper arm. A sensor just below the skin monitors your blood sugar continuously and transmits readings to your mobile phone or other device.

Regular health checks

If you have diabetes you will be offered regular health checks. Diabetes can cause serious long-term complications, so it's important to attend all your check-ups.

Check-ups are normally yearly, but your consultant will create a plan of care tailored to your individual needs.

Regular check-ups for people with diabetes include:

• HbA1c - a blood test that measures your average blood sugar levels over the past three months
• Blood pressure
• Weight and BMI
• Full blood count - to check your general health including your cholesterol, thyroid, and kidney function
• Urine test - to check the health of your kidneys
• Eye screening - to check for signs of diabetic retinopathy
• Foot check to check the nerves and circulation in your feet

Like all medication, diabetes medication carries a small risk of side effects, however, the risk of poorly managed diabetes far outweighs any potential risks of treatment.

It can sometimes take a while to find the right treatment or combination of treatments for diabetes. Your consultant will work with you to find the treatment regimen that is best for you.

Potential side effects of insulin include:

• Low blood sugar (hypoglycaemia) - this can be severe and life-threatening. It's important that you learn to recognise the early signs of low blood sugar and know what to do when it happens. Symptoms of low blood sugar may include:
  • Pale skin
  • Shaking
  • Sweating
  • Hunger
  • Headache
  • Nausea
  • Rapid heartbeat
  • Weakness or fatigue
  • Irritability or anxiety
  • Difficulty concentrating
  • Dizziness
  • Tingling or numbness of the lips, tongue, or cheek
• Weight gain - when you first start taking insulin, you may put on weight. Insulin is a type of growth hormone and can make you feel hungrier than normal. Talk to your consultant if you are worried that you are gaining weight because of your insulin. Never skip or reduce your insulin dose without speaking to your consultant.
• Lipohypertrophy - a build-up of fatty lumps under the skin from repeated insulin injections in the same place
• Allergic reaction - an allergy to insulin or its ingredients is rare but can occur. It can range from a localised reaction (such as swelling, itching, and redness) around the injection site to a life-threatening allergic reaction (anaphylaxis).

Potential side effects of oral diabetes medications include:

• Low blood sugar (hypoglycaemia)
• Bloating
• Diarrhoea
• Constipation
• Weight changes
• Nausea

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about diabetes treatment, book your appointment online today or call a member of our team directly on 0808 189 5499

Diabetes Treatments Diabetes UK

Diabetes Treatments Endocrine Society

Understanding medicine. Type 2 diabetes  NHS

Insulin, Medicine & Other Diabetes Treatments National Institute of Diabetes and Digestive and Kidney Diseases