Diabetes Mellitus

Type 1 Diabetes: The body makes too little insulin because the immune system destroys the cells that produce it.

Type 2 Diabetes: The body makes normal or high insulin, but it doesn’t work effectively.

If you're unsure which type of diabetes you have or want to review your current management, book an assessment.

Type 2 diabetes is primarily managed by improving the way the body handles insulin and glucose.

The first and most effective strategy is to increase glucose disposal. Skeletal muscle is the largest site for glucose uptake, and exercise dramatically enhances its ability to extract glucose from the bloodstream.

The second strategy is to reduce the supply of glucose to the system. This is achieved by reducing dietary carbohydrates, which are the main source of glucose. Carbohydrates include both sugars and starches—hence why food labels list sugar under “carbohydrates.” Modern diets are dominated by carbohydrate-rich foods such as bread, rice, pasta, and pizza.

When lifestyle measures are no longer sufficient, we introduce medications in a stepwise manner:

1. Oral medications to:

• improve the body’s sensitivity to insulin,
• modulate the liver’s release of glucose, and
• enhance alternative pathways of glucose handling.

2. Injectable insulin is used only when other options fail. Insulin works by overwhelming the body’s resistance, saturating the system to force glucose into cells. This is generally the least desirable approach because it does not address the root problem of impaired glucose disposal.

Notably, persons with diabetes on insulin therapy who increase their capacity to extract glucose - primarily through consistent exercise - often require less injected insulin. This reflects an optimisation of their natural glucose-handling mechanisms rather than heavy reliance on pharmacologic intervention.

Want to optimise your Type 2 diabetes management and reduce your medication needs? Schedule a consultation.

Type 1 diabetes is managed very differently from Type 2 diabetes.

In Type 1 diabetes, the body makes very little insulin because the insulin-producing cells are destroyed over time. The only way to manage this is to give the body insulin from outside.

Without enough insulin, the body starts breaking down fat for energy, which produces ketones. If ketones build up too much, they can make the blood acidic - a dangerous condition called diabetic ketoacidosis (DKA). DKA can develop quickly, sometimes in just a few hours, and can be life-threatening.

People with Type 1 diabetes need insulin to survive. Missing doses can cause serious problems quickly. People with Type 2 diabetes can also face serious health risks, but these usually develop more slowly, over years, through complications like heart attacks or strokes.

If you live with Type 1 diabetes, ensure you have an emergency plan and regular follow-ups - book your review here.

Diabetes often feels invisible - you may not feel unwell, and medications might not seem to change how you feel.

But better control lowers your risk of:

• Vision loss
• Heart attacks and strokes
• Kidney failure requiring dialysis
• Serious foot problems and amputations

Learn how to protect your long-term health in our full diabetes care guide.

At present, there is no cure for either Type 1 or Type 2 diabetes. Research is ongoing, and a future cure for Type 1 diabetes is possible, though it may involve trade-offs like immune system suppression.

A permanent cure for Type 2 diabetes is less certain. However, maintaining good physical fitness and a metabolically healthy diet can greatly support overall health and reduce the impact of diabetes - habits that are beneficial for everyone.

Start your personalised health plan today — book a healthspan assessment.

Yes, diabetes can run in families - but the details matter.

Most people with Type 2 diabetes inherit a mix of genes that increase their risk. This is called polygenic inheritance. It doesn’t mean one single gene causes it, but rather a combination. Type 1 diabetes also has some genetic risk, especially related to the immune system.

There are also rare forms of diabetes, like MODY (Maturity Onset Diabetes of the Young), which are caused by a single gene change. These can sometimes be mistaken for Type 1 or Type 2 diabetes.

If you or your family members developed diabetes at a young age, or if the diagnosis doesn’t quite fit the typical Type 1 or Type 2 picture, it might be worth exploring whether a rare genetic form could be involved.

Read more about rare diabetes types and whether you should discuss genetic testing with your doctor in our blog post.

Diabetes management is highly individual. The right strategy can protect your health for decades.

Book a consultation today to create a personalised diabetes management plan.