How to live well with diabetes

LloydsPharmacy.com/diabetes

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We’re here for you at every step

At LloydsPharmacy, we’re committed to helping with support and advice to help manage type 1 and type 2 diabetes. After all, in the UK, 4.6 million people are living with diabetes. Throughout this booklet, we’ll focus on three significant areas to help you understand more about diabetes, as well as recommend positive and practical steps you can take to manage it.

1. Diet and lifestyleWe have a wealth of advice to help you live a healthy lifestyle and manage your diabetes. From simple food swaps you can try to exercises to help you keep fit.

2. Monitoring and treatmentYou’ll also find recommendations about how best to monitor your health and maintain the right treatment.

3. Management and supportAlong with information about the support we provide, we have tips and practical suggestions about how to manage diabetes.

If you have any questions or would like further advice, visit your local LloydsPharmacy and speak to your neighbourhood pharmacist or go to LloydsPharmacy.com

*Source: Diabetes UK

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What is diabetes?Diabetes is a condition that affects how the body uses glucose, a sugar that is a source of energy. Once glucose is released from the food we eat and enters the bloodstream, your body releases a hormone called insulin. Type 1 diabetes is a condition where your body can’t produce insulin which means your blood glucose levels can become too high. Type 2 diabetes is caused when the body responds abnormally to the insulin produced, creating a resistance. This means that unused glucose can build up in your bloodstream causing high blood sugar levels.

There are two main types:

Type 1 diabetesGenerally develops in people under the age of 40. The symptoms can develop suddenly and include shaking and sweating, thirstiness and weight loss. Treatment is with insulin, as well as a healthy diet and exercise.

Type 2 diabetesUsually develops in people over 40. With less obvious symptoms it develops relatively slowly and often goes unnoticed. It can be treated successfully with a healthy balanced diet and physical activity, and sometimes the addition of oral medication or insulin injections may be necessary

For more information on the other types of diabetes visit: diabetes.co.uk/diabetes-types.html

It is estimated that there are currently 3.7 million people diagnosed with diabetes in the UK, type 2 diabetes

accounts for 90% of these casesSource: Diabetes UK

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A healthy lifestyle can

make a differenceMaking simple lifestyle changes can make a big difference when living

with diabetes. That includes reviewing your diet, losing weight if you need to, and increasing your exercise levels. It doesn’t mean giving up all your favourite foods and is more a matter of adjusting how much you eat and limiting the foods that affect your blood glucose levels.

Improving your dietWhether you are living with diabetes or not, eating well is important. The NHS suggests these simple swaps to help make your daily meals, drinks and snacks more healthy.

BreakfastWhen you’re living with diabetes, breakfast is a particularly important meal. Research shows that those who eat breakfast find it easier to maintain their weight as they tend to eat less during the day.• Choose semi-skimmed, skimmed or 1% fat milk instead of whole milk.• Eat a wholegrain breakfast cereal such as porridge or shredded wholegrain wheat

cereal with no added sugar instead of a sugary breakfast.• Top your cereal with fresh or dried fruit that counts towards one of your 5-a-day

instead of sprinkling with sugar.• Choose lower-fat or fat-free Greek yoghurt or natural low-fat yoghurt instead of a

full-fat yoghurt.

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Lunch • Swap white breads, bagels and muffins for wholegrain alternatives.• Fill your baked potato with reduced-fat spread and reduced salt and sugar

baked beans instead of butter and cheese.• Choose a tuna salad sandwich on wholemeal bread with no mayo instead of

a tuna melt panini.• Replace a Cheddar sandwich filling with a reduced-fat hard cheese in your sandwich.• Ensure you include salad leaves or steamed vegetables where you can to get

your 5-a-day.

Dinner• Swap creamy or cheesy sauces for tomato- or vegetable-based sauces.• Mash your potato with low-fat spread and semi-skimmed, skimmed or 1% fat milk

instead of butter and whole milk.• Grill your meat instead of frying it and choose leaner cuts of meat such as back

bacon instead of streaky.

• Porridge with mashed banana and dried blueberries

• Muesli, fresh fruit and low-fat yoghurt• Reduced sugar and salt baked beans on

wholemeal toast• Scrambled eggs or 1-minute omelette

with optional wholemeal toast• Low-fat Greek yoghurt topped by fruit

and nuts• Smoked salmon and low-fat cream

cheese wholemeal bagel

Or if you are short of time:• Smoothies• Grab-and-go breakfast bars

Try these energy-boosting and protein-packed healthy breakfasts

• Cheese and tomato toastie.• 3-fruit salad.• Cheese and pickle canapés.• Smoked salmon and cream

cheese parcels.• Apple and peanut butter.• Baked beans on toast.• Homemade popcorn.

Try these snacks – only 100 kcal each

For advice on eating out, visit diabetes.org.uk and search for

“eating out”

Source: nhs.uk

Drinks• Switch to a ‘skinny’ coffee made

with semi-skimmed or skimmed milk instead of whole milk.

• Swap hot chocolate made with whole milk and whipped cream for hot chocolate made with skimmed milk and avoid the cream.

• Choose a cordial or squash with no added sugar.

• Try 100% fruit juice (with no added sugar) mixed with sparkling water instead of a cola or fizzy drink.

Snacks• Swap a blueberry muffin for a

currant bun on its own or with reduced-fat spread.

• Try rices cakes with lower-fat cream cheese instead of cheese straws.

• Choose unsalted nuts over salted ones.

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Want to learn more? NHS Choices have a useful Eatwell Guide that can help you ensure you’re getting

all the right portions for a healthy diet. Simply search online for ‘NHS The Eat Well Guide’ and click on the interactive link

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Staying in control of your portion sizesWhen managing your diet, it’s just as important to manage the amount, and the type of food you eat. When it comes to a balanced diet, it’s best to eat everything in moderation.

Food watch outs Keep fresh fruit on the menuYou might think you can’t eat fruit if you have diabetes because of its sugar content. But the sugar in fruit is natural and is different to the added sugar in drinks, chocolate, cakes, biscuits, fruit juices and honey.

A portion of fresh fruit contains natural sugars as well as vitamins, minerals, fibre and 15-20g of carbohydrates. Try to snack on fruit rather than foods loaded with sugar like a chocolate muffin or a small bar of chocolate.

Also consider the difference between fresh and dried fruit: a serving of dried fruit has a much higher carbs and sugars content than an apple that also takes longer to eat. Fruit juices with no added sugar can still add to your intake of carbs and sugars. It’s best to try drinks with zero sugar or stick to 1 small glass a day (150ml) and make your drink go further by diluting it with water.

For more information visit diabetes.org.uk and search for fruit juice.

For advice on vegetarians or vegans search diabetes.org.uk

Cut down on saltThe recommended daily intake of salt for adults is just a heaped teaspoon (about 6g). Although salt doesn’t affect your glucose levels, eating too much salt can raise your blood pressure which increases the chance of stroke, as well as heart and kidney problems.

Try to avoid or cut down on these foods because of their high salt content:• Processed foods such as ready meals

and takeaways• Hams, bacon and sausages• Snacks such as crisps, salted nuts

and biscuits• Stock cubes, gravy powder and soy sauce• Cheese• Prawns, smoked fish and tinned anchovies• Some bread and breakfast cereals• Canned, packet and instant soups

Alternatives to saltCutting down on salt doesn’t mean eating tasteless dishes. Here are some great flavouring ideas:

• Sprinkle your potatoes with paprika, ground white or black pepper, chives or mild chilli powder.

• Try oily fish such as salmon with ginger, dill and spring onions.

• Chop coriander into your curries.• Add garlic or basil to liven your pasta dishes.• Thyme and sage works well on chicken

and turkey.

Visit Diabetes UK for more advice on salt intake at diabetes.org.uk

Low carb vegetables

(at least half your plate)

Bean, seeds, nuts and fruit

Proteins, including dairy

and soya

Whole grains and starchy vegetables

Source: Diabetes UK

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9Source: diabetes.org.uk/Guide-to-diabetes/Enjoy-food/Eating-with-diabetes/Food-groups/Salt-and-diabetes

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You can still drink alcohol but…Having diabetes doesn’t mean you can’t enjoy a few drinks at home or when you’re out, but you need to know how it can affect your body and how to manage it.

Alcohol makes your blood sugars drop, which increases the chances of a hypo (see page 20 for more information on hypos). And although it’s not a risk in itself to diabetes, alcohol can be full of calories that can make you put on weight. Some drinks like beers, ales and ciders have carbohydrates that can increase your blood sugar levels. Try, spirits, dry wines or Prosecco instead.

Follow UK Government guidelines It’s recommended that adults don’t drink more than 14 units a week, but what does that actually mean?

Drink lots of waterDrink a pint of water before you go to bed to keep hydrated.

Always have breakfastEven if you don’t feel like eating it’s important to try to have breakfast as it helps you manage your blood sugar.

Check your sugar levelsIf you use a blood sugar meter, check your levels at regular intervals the next day. It’s important to understand if you could be having a hypo attack as the symptoms are similar to a hangover.

If you take insulin, you may need to adjust your dose according to these blood sugar readings. Ask your pharmacy team or diabetic nurse to advise you if you’re in any doubt. Source: Diabetes UK

218ml218ml

Standard13% wine

76ml 25ml 250ml

Standard40% whisky

Standard4% beer

What 1 unit of alcohol looks like

Diets to tryThe DASH DietThe DASH diet can help you lose weight in both the short and long term while keeping your blood sugar on an even keel. It also cuts your risk of conditions such as heart conditions, strokes and can help reduce your blood pressure and cholesterol.

It’s a delicious high-fibre diet that can easily fit in with most lifestyles. It’s rich in vegetables, fruit and wholegrains, with fat-free or low-fat dairy, fish, poultry, beans, nuts and vegetable oils. You can still enjoy a very small amount of foods high in saturated fat such as fatty meat, full-fat dairy product, and tropical oils such as coconut, palm kernel and palm oils. But it also limits how many sugar-sweetened drinks you have as well as sweets in general.

Explore recipes you can try at home at dashdiet.org

The Mediterranean DietThis diet follows traditional healthy living from countries bordering the Mediterranean Sea and has been scientifically proven to help you stay healthy. It’s high in vegetables, fruits, beans, nuts, cereals, grains, fish and unsaturated fats such as olive oil.

To try this out, eat: • Plenty of fruit and vegetables• Less meat • Fish• Plenty of starchy foods such as bread

and pasta • More products made from vegetables

and plant oils such as olive oils Source: Leicester Diabetes Centre

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Sticking to a dietPeople usually feel the most motivated during the first few weeks of a lifestyle change. However, as the weeks pass, it’s normal to start to lose momentum, especially if you can’t see instant visible results. Don’t worry though, there are plenty of ways to keep yourself on track.

How to stay motivated and positive1. Treat yourself to non-food rewards e.g. cinema, haircut, new clothes, bubble bath.

2. Surround yourself with positive encouragement from your friends and family.

3. Break down your ultimate goal and tick off when you’ve achieved steps along the way.

4. Picture your goal – remember why you wanted to make this change and the benefits it will bring.

5. Find a buddy – having someone on the same mission can be really supportive for you both.

Many of us reach for our favourite treats when we’re feeling sad, want to celebrate, or are just a bit bored. There’s nothing wrong with this sometimes, but it could be more beneficial to identify and manage your emotions, rather than using food to cover them up.

If you’d like help to manage comfort eating, Diabetes UK has a helpful guide on emotional eating and feasting. Visit diabetes.org.uk to find out more.

Comfort eating

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Best for those who want to know how their DNA can help manage their weight. myDNA Weight Management £59 The answer’s in your DNA. All you need to do is take a swab of the inside of your cheek, register online and send it in the post. Your report will be available to access online whenever you need it. myDNA provides advice to help you make more informed health and lifestyle choices for the long term, as the test results show you how your body responds to certain diets.

Best for those eating a lower calorie and fat diet who want a weight loss boost. Alli Capsules 84 pack £35*For every two pounds you lose, Alli helps you lose a further pound. You must be 18 or over with a BMI (body mass index) of 28 or above.

Best for those who need help reducing their calorie intake. XLS Medical Max Strength 40 tablets £34.99*It’s clinically proven, and contains ClavitanolTM , a patented natural substance that reduces the breakdown and absorption of carbohydrates, sugar and fat into calories.

Best for weight lossWhen looking to lose weight, make sure to talk to your GP or diabetic nurse first. Our health care experts can also give you advice on how to lose weight safely and offer ongoing support. The best way to lose weight is through changes to your diet and exercising. But, there are also products that can help if you need them. Come in and discuss with your Pharmacist which one might work for you.

Can total meal replacement plans really help with type 2?If you replace your meals with a nutritionally-complete liquid formula for 12 weeks, you’ll be cutting your calorie intake to just 800-1200 kcals per day. Tests have shown this is effective for weight loss in those with type 2 diabetes leading to an average weight loss of 15kg (33lbs) with food re-introduced after the 12 weeks. What’s more, nearly half of patients went into remission from their symptoms as a result*.*46% of participants

Source: Leicester Diabetes Centre reference Primary care-led weight management for remission of type 2 diabetes (DiRECT) Lean ME, Leslie WS, Barnes AC et al

*Discuss with your GP or diabetic nurse before starting treatment

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Fitness apps you could try Couch to 5kCouch to 5K is a running plan for absolute beginners. It was developed by a new runner, Josh Clark, who wanted to help his fifty-something mum get off the couch and start running too.

The plan involves 3 runs a week, with a day of rest in between, and a different schedule for each of the 9 weeks.

Look at your app store to download the app and keep a track of your progress.

Active 10A brisk 10 minute walk every day can make a difference to your health. Each 10 minute burst of exercise is known as an “Active 10”.

Brisk walking is simply walking faster than usual, at a pace that gets your heart pumping. Start with a 10 minute brisk walk a day and then see if you can gradually build up to more.

It’s the easy way to improve your health and wellbeing. No gym memberships, no Lycra. Just 10 minutes and you.

Find out more at nhs.uk/oneyou/active10/

Fitness trackersFitness trackers can come in all shapes and sizes. From ones that simply track your steps, to those that can record your heart rate. Some can even go under water.. Whichever you choose, look for one that helps keep you motivated.

Not sure which tracker is right for you? Take a look

at our guide to fitness trackers on our blog at

Blog.LloydsPharmacy.com

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Adults with type 2 diabetes should ideally

do both aerobic and resistance exercise for

the best resultsSource: Leicester Diabetes Centre

Your guide to staying fit and well Exercise is extremely beneficial to general health. It can lower blood pressure, heart rates and cholesterol, and improve circulation. Those who exercise have higher rates of metabolism and consequently better weight control, they sleep better and have more energy.

Why is exercise so important for people with diabetes?Exercising regularly improves sensitivity to the body’s own insulin and the body becomes better at transporting glucose. This happens because exercise stimulates the body’s muscles.

It reduces the level of fat in the body and can improve blood glucose control and because the blood flows better, some of the blood vessel complications associated with diabetes may be avoided.

Easy exercises to tryTry to find something you enjoy as you’re more likely to stick with it. You could start with a short daily walk and gradually increase the distance or jog some of the way. Or maybe get off the bus a couple of stops earlier and walk the rest of the way at a brisk pace. Consider joining a gym, seek out your local swimming pool, or check out local sports teams. Exercising with friends old or new make it sociable and more fun, while you can also support and motivate each other. It’s important to check that your condition allows you to exercise, so see your GP beforehand.

Alternatives to aerobic exerciseHIIT – low-volume high intensity interval training, involves short bursts of intense activity interspersed with longer periods of recovery at low to moderate intensity, For HIIT it’s best to be clinically stable, and have been participating in regular moderate-intensity exercise.

For older adults, why not try flexibility and balance training like yoga and tai chi 2-3 times per week. This can increase flexibility, muscular strength, and balance.

Whatever you decide to do, it’s important to increase your total daily physical activity which can include housework, walking the dog, and gardening. This kind of unstructured activity reduces total daily sitting time and helps you exercise, if you are unable to take part in more structured exercise.

For more information go to diabetes.org.uk and search “exercise”.

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Cycling is great exercise and if you live close

enough to work, why not make your commute

your exercise?

Try outdoor exercise equipment. Many parks and public

spaces are now adding gym equipment that can be used for free.

Most of us haven’t skipped since we were a child, but this is a great workout and you could even borrow your kids’

skipping ropes!Playing football at the park is not only a good

exercise, but it’s also a fun activity to keep everyone entertained

There are a whole host of workout videos available online with exercise routines you can do in the comfort

of your own home

Many charities host park runs that bring people

together as well as encourage donations and awareness to great causes Even if you don’t

have a dog of your own, you could

take a neighbour’s canine companion

for a walk

Don’t underestimate the energy and

calories you could burn just by tending

to your garden

Lots of the best exercises, such as

triceps dips, can be done at home by

simply using a sofa or chair. Line yourself up with an appropriate

piece of furniture and lower your body

weight using only your arms for an effective

and free workout.

Simply going up and down your

stairs is a form of exercise that helps

burning calories during your day

Just like walking groups, there are also a variety of running

clubs that you can join to connect with people who have

similar goals to you

Exercise doesn’t have to be expensive. Consider some of these ideas that will help you keep active, without breaking the bank.

FREEexercises

Why not join a walking group and meet like-minded

people who can help you stay motivated to

get out and about?

Downloading fitness apps guide you through a number

of different exercise plans and help you track your progress. Why not try My Fitness Pal,

One You Couch to 5k or Nike Training Club?

Use weights from around the home such as soup

tins or bags of flour work to pump your muscles

You could even start a sports group

by gathering a group of friends

to play any sport you enjoy, such as netball

or football.

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Regular monitoring is key

There are a few things that can help manage your diabetes day-to-day. If you’re on sulphonylureas, meglitinides and insulin, regular monitoring of your blood glucose levels is as important as keeping your levels under control. This is because it can indicate to

your healthcare team if your treatment needs to be altered and can decrease the risk of any complications in the future.

Managing your blood glucoseTesting your blood glucose levelsAlways follow the advice of your GP or diabetic nurse about self-testing, but generally the recommended frequency of testing is:

Type 1 diabetes: Depending on the treatment you’re on you should be testing four times a day or up to 10 if you’re using an insulin pump.

Type 2 diabetes: Not everyone with type 2 diabetes will need to monitor their levels. Discuss with your healthcare team what’s right for you.

It’s important to balance what you eat and how active you are with any medication or insulin injections. If any of these are out of balance, your blood glucose levels can become too high (hyperglycaemia), or too low (hypoglycaemia).

4mmol/l or below is too low and there’s a possibility of a hypoglycaemic attack. Follow our advice on how to treat a hypo, find out more on page 27.

4-7mmol/l is the ideal range for your blood glucose levels. Keeping this level of control also reduces your chances of developing future complications.

10.1 mmol/l or above could mean your blood glucose level is too high. Over sustained periods this could increase your chances of developing complications. If you have type 2 diabetes and this happens occasionally, there is no need to worry. If you’re using insulin you can use your glucose readings to see if you need to take more. If you have type 1 diabetes and stay at these levels, check your blood for ketones with a ketone testing kit which may indicate a lack of carbohydrate. It’s also advisable to ask your GP for more information as you may need to increase your insulin or take an extra dose.

Managing your insulin:Carbohydrate counting can be an effective way to manage type 1 diabetes. It is a way of matching your insulin requirements with the amount of carbohydrates you eat and drink.

For more information about the best way to match your carb counting to your insulin visit diabetes.org.uk

What do your readings mean?Everyone’s target range is different depending on what treatment you’re on, but your levels before you eat should be:

> 10.1 mmol/l Risk of hyper

7.1 – 10 mmol/l Result slightly

raised

4 – 7 mmol/l Target range

< 4 mmol/l Risk of hypo

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It’s important to rebalance your blood glucose

following a hypo. Try to eat a piece of fruit, a glass of milk

or two biscuits.

What to do if you’re having a hypoWe recommend taking 15-20g of oral glucose by choosing one of these:• 150ml can of non-diet fizzy drink• 200ml carton of smooth orange juice • 4-5 glucose tablets• 4 large jelly babies• 2 teaspoons sugar or 3 sugar lumps

(10g glucose)Then wait 10-15 minutes and test your blood glucose again.If you don’t feel better or your blood glucose is still less than 4 mmol/l, repeat one of the recommendations in the list. Repeat this cycle three times. If you still feel hypoglycaemic, seek urgent medical advice by contacting your GP, or calling 999.

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What’s a hypo?A hypoglycaemic attack or a ‘hypo’ as it’s commonly known, is when your blood glucose is too low (less than 4mmol/l). Several things make a hypo more likely if you’re on insulin, sulphonylureas or meglitinides: • Injecting too much insulin.• Drinking alcohol without food.• Not having a meal at your regular time.• Not eating enough carbohydrates.A hypo can also be triggered if you suddenly exercise more without adjusting your medication.If you think you’re experiencing hypos, let your pharmacist and GP know about them as you may need to have your medication changed or adjusted.

Who’s at risk of a hypo?People who are at particular risk of having an attack include those: • With strict glycaemic control. • Taking a mix of different medicines.• With other long-term medical

conditions. • Who are breast-feeding mothers.• Who have kidney problems.

It refers to glycated haemoglobin (A1c), which identifies average plasma glucose concentration. An HbA1c test will usually be taken at intervals of three, six or 12 months and gives an overall picture of your average blood sugar levels over a period of weeks or months.

What’s HbA1c?

diabetes.co.uk

References: TREND-UK, NICE at https://bnf.nice.org/treament-summary/hypoglycaemia.htmlSource: LDC

Being able to look out for the signs of a hypo can help you treat it. These are some of things you could experience during an attack.

Shaky

Tired

Moody

Tearful

Hungry

Headaches

Sweating

Unable to concentrate

Vision seems blurred

Some people also turn pale

Knowing the signs

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Important guidance if you’re on diabetes medicationHypoglycaemia is the most common side effect of insulin, sulphonylureas and Repaglinide (anti-diabetic drugs) in people who’ve been taking the medication for less than two years. Source: UK hypoglycaemia study group 2007

However, if you use other medications without insulin, sulphonylureas, or Repaglinide they are unlikely to cause hypoglycaemia. These include:

• Biguinide (Metformin)• Thiazolidinedione (Pioglitazone)• DPP-4 inhibitors• GLP-1 analogues• SGLT-2 inhibitorsSource: Leicester Diabetes Centre

If you take insulin, it’s more common for you to get a hypo attack during

the night, known as nocturnal hypoglycaemia.

Find out more at LloydsPharmacy.com/

diabetes

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What’s a hyper? This is the opposite of a hypo as this is when your blood glucose becomes too high (above 7mmol/l). This can be caused by:

• Not taking your medication. • Not taking enough medication.• Eating too many carbohydrates. • Feeling stressed.• Being unwell.• Prescribed medicines which can cause

high blood sugar.Common symptoms include feeling:• Very tired.• Thirsty.• Going to the toilet more often,possibly

over night.• Generally unwell.

Treating a hyperIf your blood sugar stays high for just a short while, you probably don’t need any treatment. If it stays high (7mmol/l or higher before a meal or 8.5 mmol/l or higher two hours after a meal), drink plenty of sugar and caffeine-free fluids. If you take insulin, you may need to take more at this time.

Freestyle Libre Starter PackUnlike traditional blood glucose monitoring, using the FreeStyle Libre sensor does not involve routine finger pricks. It consists of one reader and two sensors which last up to 14 days, providing you up to one month’s use. The sensor is applied on the back of the upper arm with an applicator. Abbot Diabetes Care users found that inserting the sensor was no more painful than a typical finger prick test*. It automatically measures and stores your glucose readings day and night. It updates every minute, storing up to eight hours of readings in 15-minute intervals. You can link to a smartphone app to monitor remotely. Ask at your next appointment with your diabetes team whether it’s suitable for you and available on prescription.

*https://www.freestylelibre.co.uk/libre/products/sensors.html

iHealth AlignA small portable glucose meter that is inserted directly to your smartphone or tablet to provide fast, accurate readings wherever you are. It works exclusively with iHealth test strips and a downloadable app called Gluco-Smart. The kit includes all you need to measure and record your blood glucose readings and share these with your GP direct from your smartphone or tablet.

Accu-Chek Performa Nano Blood Glucose SystemA reliable small meter that offers style and performance with its compact design and smart simplicity. With a large, automatic backlit display, it’s easy to read in low-light conditions. It’s ready to use as there’s no initial set up or coding required.

Blood Pressure Monitor and CuffThis fully automatic blood pressure monitor is an accurate, portable monitor and provides you with the convenience of testing at home. It’s easy to use – just place the cuff on your arm, ensuring it’s level with your heart, press the start button to inflate the cuff, and relax and wait for the results.

Monitoring your blood glucoseWe have a range of products to help you manage your diabetes.

We recommend

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Who can it affect?• Those with type 1 diabetes• Those with type 2 diabetes• Pregnant women with

gestational diabetes

If you want to prevent a hyper:• Be careful of what you eat – be

particularly aware of how snacking sugary foods or carbohydrates can affect your blood sugar levels.

• Stick to your treatment plan – try to take your diabetes medication, or insulin as your diabetic nurse or GP has recommended. If you are experiencing hypers regularly, you may need to change your treatment or lifestyle. Speak to your diabetic nurse or GP for more advice.

• Be as active as possible – being active can stop your blood sugar levels rising, but check with your GP first if you’re managing your diabetes using medication.

• Take extra care when you’re ill – ask your diabetic nurse or GP for advice on what to do when you’re not feeling well, to help you manage your blood glucose levels.

• Monitor your blood glucose levels closely.

Sometimes your doses and medication regimes may need to be altered. To reduce the chance of hypos, visit your GP for essential reviews, or ask

your Pharmacist for a Medicines Check Up. (Don’t forget to take your blood glucose

readings with you).

For more information about hyperglycaemia visit nhs.uk and search for hyperglycaemia.

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Managing your medicationWhether you are newly diagnosed or have lived with diabetes for years, we understand that it can be difficult to get to grips with your medicine especially if you have more than one to take. We are here to help you so come into store and ask our Pharmacist for advice.

Taking multiple medications?If you are taking a number of different medicines, taking the right tablet at the right time of day can be important. However, sometimes it can be difficult to remember what needs to be taken when, and whether it’s with food or without.Here are some useful tips to help you manage your medication:• Create a timetable that sets out

the time for each medication and whether you need to take it with or without food or any other instructions. Put this somewhere you see regularly such as on your fridge.

• Try a pillbox. These can help make sure that you take the right dose at the right time. They are also handy if you’re away from home. Check out our range at LloydsPharmacy.com

• Make taking medications part of your daily routine. For example, take them when you do something at the same time each day such as your first cup of tea, when you make breakfast, watch the evening news or when you go to bed.

• Keep your medications in a relevant place. So, if you have to take it at mealtimes, keep it near where you prepare the food. Similarly, if you take them last thing at night, keep them by your bed.

• Use technology such as smartphones to alert you at the right times.

• Ask family and friends to remind you by phoning or texting.

• If you find that you regularly forget, keep the medicine by your toothbrush and take the medication before you clean your teeth in the morning or evening.

We’re here to help youMedicines Check UpIf you need more information or advice about managing multiple medications, come in to your local LloydsPharmacy for a FREE Medicines Check Up. You can get answers to all your questions during a private consultation with our Pharmacist. You can also make sure that you’re taking your medicines properly and getting the most from them as a result.

New Medicine Service Our New Medicine Service (NMS) is a FREE NHS-funded service available at all our stores in England and the Isle of Man. It’s designed to help you get the most out of any newly-prescribed medicines, providing the support you need to understand your condition. You’ll also be shown how taking your new medicine can help you manage your symptoms.

Instore Prescription ServiceWe do everything we can to make sure that you’re getting the right care and that your medicines are in stock when you need them. What’s more, when you come in and speak to your Pharmacist, you’ll get expert medication and lifestyle advice, plus additional support like product recommendations that complement your prescription. You can even call your Pharmacist if there’s anything you’re unclear about once you get home.

Ask our healthcare team for more information on our healthcare services.

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Helping you manage diabetes

Whether you’ve been recently diagnosed, or you’ve had diabetes for years, we want you to keep healthy, so, we’re here with advice and support and a wide range of products to help

you manage your condition.

1. Blood pressure monitoring to check for any early signs of heart disease that people with diabetes are at greater risk of developing.

2. Cholesterol testing Poor cholesterol control can lead heart disease, so testing helps alert you to any required changes to your diet and lifestyle.

3. Smoking to record smoking status. Smoking heightens the chances of developing complications with diabetes. We can help you stop smoking, so ask for advice from our expert healthcare team.

4. BMI Test to check that you are a healthy weight. Your waist measurement is also a good indicator of good health. Depending on your result you may be given weight loss advice.

Make sure you have your eight annual health checks

Other considerationsThere are other things to consider when managing diabetes, besides keeping your blood glucose at the right levels. Whether you want advice on pregnancy, fasting for Ramadan or want to understand the rules for driving, find out more at LloydsPharmacy.com/diabetes

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5. Foot check to see if there are any changes to the skin, circulation and nerve supply. Not managing your diabetes can cause poor circulation, nerve damage and reduce the feeling in your feet.

6. Blood glucose levels to measure your levels of HbA1c (blood glucose) and check overall blood glucose control so that healthy targets can be set for you.

7 & 8. Urine Albumen and Serum Creatinine tests to check your kidney function. These require a blood and urine sample to test the protein levels both.

We offer a range of FREE healthcare services at your local LloydsPharmacy. Come in store and ask our healthcare team or go to LloydsPharmacy.com

to find out more.

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Good blood glucose control To keep your feet healthy, it’s important to keep control of your glucose and blood pressure levels. Ask your Pharmacist about our range of blood glucose meters, blood pressure monitors and circulation boosters.

• Check your feet daily for any changes – use a mirror to help you see the bottom of your feet.

• Every six to eight weeks, cut your toe nails straight across following the shape of the toe to avoid ingrowing toe nails

• Wash your feet daily and dry them carefully especially between the toes

• Exfoliate, and use a pumice to remove any hard skin

• Avoid garters, and stockings or socks with elastic tops that may restrict circulation

• Moisturise daily using a cream that’s suitable for the whole foot

• Always wear well-fitting shoes and check before putting them on for sharp edges and stones

• Test your toes regularly by lightly touching them for loss of sensation, record the results and inform your GP of any changes

• Maintain good glucose control to help keep your nerves and blood vessels in your feet healthy

• Make sure that you attend your annual full foot examination with your GP, diabetes nurse or our Pharmacist

Easy steps towards healthy feet

Diabetic peripheralMany people with diabetes will experience nerve pain in their feet, which is sometimes referred to as diabetic peripheral neuropathic pain. Look out for a tingling sensation, pins and needles, sweating less, feet that are red and hot to touch, changes to the shape of your feet, hard skin, and loss of feeling in your feet or legs.Other symptoms that can indicate damage to your blood supply include cramp in your calves (at rest or when walking), shiny smooth skin, loss of hair on your legs and feet, cold, pale feet, changes in the skin colour of your feet, wounds or sores that do not heal and pain or swelling in your feet.

Diabetic socksDiabetic socks have been designed specifically for people with diabetes to help avoid the chance of developing complications with your feet.

The socks are ridgeless with flat seems minimising the risk of rubbing and sores. Made from cotton, they keep in the warmth through colder months and allow feet to breath when it’s warm.

Shop our range of diabetic socks at

LloydsPharmacy.com

When managing type 1 or type 2 diabetes, it’s important to take particular care of your feet. In fact, a daily routine caring for your feet is as important as managing your blood glucose levels and diet. This is because there’s a chance raised sugar levels can cause damage to your circulation and sensation.

Looking after your feet

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Help and supportWhere can you get support?If you’ve been newly diagnosed with diabetes you may be feeling overwhelmed. There’s a lot of information to take in and you may not be sure where to start. Even if you’ve been living with diabetes for a while you might still be unsure of the best ways to manage your diabetes.

Diabetes UKhas active support groups working locally all over the country. Groups typically meet once a month, but they often also take part in many other activities such as fundraising, campaigning and raising awareness. Visit diabetes.org.uk or call 0345 123 2399. To find out what’s going on in your area visit diabetes.org.uk/in_your_area

Diabetes Research & Wellness Foundation aims to raise awareness of diabetes and provides support to people living with the condition. It is a good source of information for parents and carers of those living with diabetes. Visit drwf.org.uk or call 023 92 637808.

InDependent Diabetes Trust (IDDT) is run by patients living with diabetes and offers support to entire families, it also raises awareness of the condition and helps others understand it. Visit iddt.org or call 01604 622837.

Diabetes.co.uk offers helpful advice and information for those diagnosed with type 1 and type 2 diabetes. There’s everything you need from recipes and diet advice to the best ways to keep active and information on how to manage your diabetes. There is also a forum where you can talk to others with diabetes to find support, ask questions and share your experiences. Find out more at diabetes.co.uk/forum/

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4Did you know if you have diabetes, you are entitled

to a FREE NHS flu jab? Visit LloydsPharmacy.com/flu

for more information.

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Other ways we can help you stay wellBlood Pressure TestingOur FREE service is quick and confidential. High blood pressure rarely has noticeable symptoms, so the only way to know yours is to get tested. We can offer any advice and support you need to manage your blood pressure.

Cholesterol and Heart Check*A 15 minute check at your local store can help you discover your risk of developing heart disease in the next ten years. We’ll give you your results immediately along with a personalised plan to advise of simple lifestyle improvements that you can make.

Stop Smoking Service*You’re four times more likely to stop smoking with help¹. Our healthcare team can give expert advice to help you quit with ongoing support. We can also advise you on which Nicotine Replacement Therapy (NRT) products are right for you to help manage your cravings.

Medicines Check UpOur FREE Medicines Check Up can give you more information about what your medicines do, and help you understand why you take them. Our Pharmacists can also advise on the best way to take them to get maximum benefit for your health.

Type 2 Diabetes Screening*During our FREE Type 2 Diabetes screening you will be asked a series of questions to assess your risk of developing the condition. If you are at risk our healthcare team will give you advice on steps you could take. They may also measure your blood pressure and take a small finger prick sample of blood to measure your blood glucose levels. Depending on your result we may ask you to come back for further assessment or refer your to a doctor.

Deep LloydsPharmacy * Find the nearest pharmacy to you offering

these services at lloydspharmacy.com

¹ NHS Smoke Free: Local Stop Smoking Services, January 2017

Lloyds Pharmacy Limited, Coventry, CV2 2TX.

Order by 3pm for next day deliveryLloydsPharmacy.com