Published on 15 December 2016

Healthcare professionals have reminded people with diabetes to be more aware of the importance of keeping good mealtime control of their blood sugar levels.

The call follows the results of a new survey that highlighted more than two thirds of people with diabetes did not discuss the symptoms of high blood glucose levels (hyperglycaemia) with their nurse or doctor.

The recently published survey, carried out by Novo Nordisk, found that just one in three out of 200 people living with type 1 or type 2 diabetes, who need mealtime insulin to control their blood glucose levels, discussed symptoms of high blood glucose levels (hyperglycaemia) with their nurse or doctor.

This was despite the negative impact hyperglycaemia has on their day-to-day physical and mental wellbeing. 

Improved insulin control around meal times could help reduce the effects of hyperglycaemia

Among the symptoms of hyperglycaemia include tiredness, thirst and needing to urinate frequently, in addition to difficulty concentrating, reduced productivity and irritability.

When asked why they chose not to discuss these symptoms with their healthcare professional, the reasons given included fear of being criticised for not taking their insulin properly and belief that they should be experienced enough to handle the chronic condition themselves.

Dr Lalantha Leelarathna, Consultant Diabetologist and Honorary Senior Lecturer at Manchester Diabetes Centre, Manchester Royal Infirmary, said: “The fact that many people with diabetes choose not to discuss their symptoms with their healthcare team suggests that we, as clinicians, need to be more proactive in asking about hyperglycaemia and better educate our patients on the importance of good mealtime control.”

Of those surveyed, a third of people said they took their insulin during or after a meal. However, NICE guidance says that mealtime insulins should be taken before meals to control a ‘spike’ in post-prandial glucose (or PPG – after meal blood sugar readings).

Another finding from the study was that 57% of people were unfamiliar or did not fully understand the concept of “post-prandial glucose” levels.

As well as causing unpleasant short-term symptoms, regular hyperglycaemia after meals can increase the risk of serious long-term complications, such as amputation and blindness.

Dr Leelarathna added: “Achieving good post-meal glucose control is challenging for many people with diabetes, even when they follow current advice. As healthcare professionals, we need to better educate our patients and provide treatment strategies and solutions to minimise post meal glucose excursions.

“Greater awareness is our best defence against diabetes-related complications and I welcome these latest survey results as an opportunity to highlight these important issues.”

Dr Ponnusamy Saravanan, Associate Clinical Professor and Honorary Consultant Physician, Warwick Medical School, University of Warwick and George Eliot Hospital, said: “We need to get people thinking seriously about the impact of high blood glucose after meals. In addition to immediate and sometimes dangerous symptoms such as blurred vision and extreme tiredness, regular high blood glucose levels could lead to serious long-term complications, including heart disease, blindness, nerve damage and amputation.

“The survey results show a lack of education and awareness of the consequences of poorly controlled blood glucose levels around mealtimes, leaving people at real risk of developing irreversible complications. If we don’t get this message out to our patients and peers now then we will continue to spend billions each year on treating these complications on the NHS, in addition to significant social costs to the individuals affected and their families.”

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