Debunking Diabetes

I have been living with diabetes for four years now.

My diagnosis was confirmed while I was an inpatient at a mental health hospital.

At the time, I was struggling to understand whether my symptoms were linked to my mental or physical health.

With support from the local diabetes education group, I learned how to manage my condition through diet and lifestyle changes.

I decided to focus on improving my diet following advice from diabetes educators and wellbeing professionals.

I now eat two main meals a day, breakfast and supper and focus on a high-protein diet that includes foods like chicken, lentils, spinach, soups, fish, eggs, beans, nuts, seeds, vegetables and fruit.

Exercise has also played a big part in my journey.

I started swimming regularly, doing ten laps each session and I also began using an app which tracks progress in three key areas:

• Weight loss
• Muscle gain or loss
• Fat loss 

By entering my details into the app, I can see a full breakdown of my body composition. Many people worry when their weight doesn’t change much but the app results showed me that I was gaining muscle while losing fat which was still a positive sign of progress.

When I was first diagnosed, my HbA1c level was 72 which confirmed diabetes.

Over time, it gradually dropped to 54, then 44 and now 41 which is just above the prediabetes range.

My goal is to reach below 42 and if this continues, my doctor may even reduce my medication.

At the start, I was taking three different types of medication to manage my diabetes.

I now only take two 500mg Metformin tablets daily.

This journey has shown me the power of knowledge, routine and small, consistent changes.

Using the app every month helps me stay accountable and motivated.

It gives me a clearer picture of how far I’ve come and reminds me that managing diabetes is possible with the right support, education and self-belief.

By Oluwademilade Idris, Foundation Trainee Pharmacist

Many people taking antipsychotics need regular physical health checks, due to possible side effects medicines can have on on a person's health, which can feel worrying. But antipsychotics do not directly cause diabetes. Some medication can increase the risk, but this risk is manageable, varies between drugs, and can be greatly reduced with the right support.

Antipsychotics don't cause diabetes, but some can increase the risk

Antipsychotics can affect the body in different ways, including:

• Promoting wieght gain
• Altering metabolism
• Affecting insulin sensitivity 

These changes can, over time, raise the risk of Type 2 diabetes, but this varies widely between medications. 

Some antipshychotics have a higher metabolic impact

Higher risk medications: 

Medicines like Clozapine and Olanapine are very effective for certain mental health conditions, but they are associated with weight gain and metabolic changes that can lead to insulin resistance. 

Lower risk medications:

Other medications in the same class, like Aripiprazole, has less impact on weight and glucose control and are often considered when metabolic risk is a concern. 

They key message is: higher risk does not mean it causes diabetes. These risks can be magaged. 

Your healthcare team actively manages this risk

Healthcare teams closely monitor physical health to spot changes early and put support in place quickly. 

Before starting medication, clinicians usually check:

• Wight and BMI
• HbA1c (blood glucose levels)
• Lipid profile (cholesterol and fats)

These are then monitored regulary (every 3-6 months) 

You won't be left to manage this risk alone

Your prescriber will consider the balance between:

• The mental health benefits of the medication
• The potential metabolic side effects
• Your physical health results over time
• You personal preferences and experiences

If concerns arise, your team can: 

• Adjust the doses
• Explore alternative medications
• Offer lifestyle support
• Refer to specialist physical health services 

Lifestyle support makes a real difference

Even if medication slightly increases diabetes risk, simple lifestyle changes can be powerful tools to keep your health on track: 

• Eating balanced, regular meals
• Keeping active in ways that feel manageable
• Getting support with emotional eating or motivation
• Attending routine physical health checks
• Asking for help early if you notice appetite or weight changes 

Combined with regular monitoring, these steps significantly reduce the chances of developing diabetes.

The key takeaway

Antipsychotics do not automatically cause diabetes. Some medicationd can increase risk, but this risk is manageable, monitored and highly individual.

With the right medication choice, regular checks, and lifestyle support, people taking antipsychotics can protect their long-term physical health while also getting the mental health support and treatment they need.

By Hafsah Ali, Foundation Trainee Pharmacist

Living with diabetes can be challenging. Living with a mental health condition can be challenging. Managing both at the same time often requires extra suppot, understanding, and a more integrated style of care. 

For many people - including those living with schizophrenia, bipolar disorder, severe depresion, or anxiety disorders - diabetes management isn't just about blood glucose numbers. It's about motivation, routines, cognitive capacity, emotions, environment, medication effects and day to day stability. 

A holistic, compassionate approach can make a significant difference.

Why diabetes and mental health need to be managed together 

People with mental health conditions may face unique challenges that make diabetes harder to manage, such as:

Emotional and motivational symptoms

• Symptoms like low motivation, reduced energy, and flat mood (common in schizophrenia and depression) can impact regular eating, exercise, or mediaction routines. 

Cognitive and social barriers

• Difficulties with concentration, memory, social interaction, or decision making may make it harder to follow complex treatment plans or remember appointments. 

Overstimulating and unpredictable healthcare environments 

• Sleep patterns, meal timing, and daily structure may vary, impacting blood sugar stability. 

Physical effects of high or low blood sugar

• Hyperglycaemia (high blood sugar) can worsen confusion, irritability, or concentration, potentially exacerbating mental health symptoms.
• Hypoglycaemia (low blood sugar) can trigger anxiety, agitation, or disorientation, which may mimic or intensify paranoia or hallucinations or disorganised thinking 

Medication interaction

• Some antipsychotic medications can raise blood glucose.
• Fluctuating glucose levels can worsen mental health symptoms.

This two-way relationship makes joined-up care essential. 

Impact on engagement

Together, these factors may lead to:

• Missed reviews
• Irregular medication adherence
• Poorer diabetes management
• Faster progression of diabetes-related complications

This isn’t an individual problem, it reflects that diabetes and mental health conditions are deeply interconnected. 

How we can help: holistic, person-centred care

Supporting people well means looking at the whole picture, not just blood sugar readings or mental health symptoms. 

Simplify and support medication routines

• Keep medication regimens as simple as possible.
• Provide clear, structured, step-by-step instructions.
• Use pill organisers, reminders, or written plans if helpful.

Collaborate across services

Integrated care works best when:

• Psychiatry
• Primary care
• Diabetes specialists
• Dietitians
• Community mental health teams

…share information and coordinate plans. 

Tailor lifestyle advice to each person

Lifestyle guidance should be:

• Realistic
• Achievable goals
• Matched to someone’s cognitive and motivational capacity 

Create calm, accessible appointment spaces

• Use quieter rooms where possible
• Minimise interruptions
• Offer more time if someone is anxious or struggles with processing information
• Provide written summaries or reminders 

Repeat key messages gently and consistently

• Cognitive symptoms may affect memory, repetition helps build understanding and confidence. 

Use clear, friendly language

• Avoid jargon.
• Check understanding.
• Never assume a person knows the names or doses of their medications, many don’t. 

 Celebrate small successes

• Consistent glucose monitoring, attending a review, remembering medication, or making a small lifestyle tweak are all meaningful steps. Positive reinforcement builds confidence and motivation. 

The key takeaway

For people living with both diabetes and mental health conditions, the best outcomes come from coordinated, compassionate, whole-person care. This holistic approach empowers people, boosts engagement, improves health outcomes, and helps them feel truly seen and supported.

By Oluwademilade Idris, Foundation Trainee Pharmacist  

This is one of the most common misunderstandings about diabetes, and it can be deeply misleading. It creates stigma, makes people blame themselves unnecessarily, and can delay people seeking help. 

The truth is that people of any body size can develop diabetes. Weight may play a role, but it’s not the cause.

Type 1 diabetes has nothing to do with weight

Type 1 diabetes is an autoimmune condition. The body’s immune system mistakenly attacks the insulin-producing cells in the pancreas.  

Type 1 diabetes can affect:

• children
• teenagers
• adults

This type of diabetes is unrelated to weight and can occur in people of all shapes and sizes.  

Type 2 diabetes has many causes, weight is just one risk factor

Higher body weight can increase risk, but it is not the cause of Type 2 diabetes, and it does not determine who will or will not develop it. Many people with a higher weight never develop diabetes and many people with a “healthy” weight do.

Type 2 diabetes is influenced by a combination of modifiable and non-modifiable risk factors, including: 

Non-modifiable:

• Genetics and family history
• Ethnicity (higher risk at lower BMI for South Asian, Afro-Caribbean, Black African, and Hispanic communities)
• Age (risk increases as we get older) 

Modifiable:

• Fat distribution - carrying weight around the abdomen (visceral fat) is more strongly linked to diabetes than overall weight
• Sleep, stress, and mental health
• Medication effects (including some antipsychotics)
• Lifestyle and environment 

Health is more than the number on a scale

Focusing only on weight can make people miss what really matters: metabolic health.

A person in a larger body who:

• eats a varied, balanced diet
• is physically active
• sleeps well
• looks after their mental wellbeing

…can be metabolically healthier than someone who is thin but inactive, stressed, or living on highly processed foods.

In fact, around 10% of people with Type 2 diabetes are not overweight at all. 

Why this myth is harmful

This misconception can:

• Make people feel guilty or ashamed
• Create stigma for people taking diabetes medication
• Stop people seeking support early
• Lead to missed diagnoses in people who look “healthy”

Changing the conversation helps everyone, especially in mental health settings where stigma around weight and diabetes can add to emotional distress. 

The key takeaway

Diabetes is not a disease of size. It is a complex condition influenced by genetics, biology, environment, mental health, and lifestyle.

Instead of focusing on weight, the most helpful approach is to support:

• Nourishing eating habits
• Regular, enjoyable movement
• Better sleep
• Managing stress
• Routine health checks
• Compassionate, stigma-free conversations 

By Hafsah Ali, Foundation Trainee Pharmacist & Oluwademilade Idris, Foundation Trainee Pharmacist 

Type 2 diabetes is very common in many South Asian families, which can understandably lead to the belief that developing it is almost inevitable. But while the risk is higher, this doesn’t mean type 2 diabetes is unavoidable or that people have no control over their health. This myth can leave individuals feeling discouraged, when in reality small, manageable changes can make a meaningful difference. 

Genetics has an influence, but it does not determine your future

Research shows that South Asian communities have:

• A tendency to store more visceral fat (fat around the organs), even when someone looks slim.
• A smaller body-frame size, meaning BMI can underestimate risk.
• A genetic predisposition to reduced insulin secretion and faster beta-cell decline.

These factors increase vulnerability, but they don’t remove the impact of lifestyle. In fact, it means that simple lifestyle changes often have an even greater positive effect for South Asian people. 

Lifestyle and environment make a big difference

Like many communities, modern lifestyles and everyday pressures contribute as well:

• More time sitting down
• Fewer opportunities for physical activity
• Greater availability of ultra-processed foods
• Higher stress levels (which can affect appetite, energy, and sleep) 

Lifestyle changes do help, even for those with higher genetic risk

Evidence shows that eating well, staying active, and reducing visceral fat can:

• Improve insulin sensitivity
• Stabilise blood sugar
• Delay or prevent type 2 diabetes
• Slow disease progression if diabetes has already developed
• Reduce risk of other diabetes related health complications

Even people who appear to be a “healthy weight” can benefit, because visceral fat isn’t always visible from the outside. 

You don’t need to give up traditional foods

Traditional South Asian food can absolutely be part of a healthy diet. The focus is on:

• Portion size
• Balancing meals
• Healthy cooking methods
• Adding more fibre and vegetables
• Reducing sugary drinks and highly processed snacks

Many beloved dishes can be adapted with simple swaps to reduce fat, sugar, and salt while keeping flavour and cultural identity. 

Diabetes UK Asian Food Guide

Practical tips for healthier eating

These choices support better blood glucose control and help reduce visceral fat: 

Choose healthier carbohydrates:

• Brown rice, whole oats, wholemeal options
• Lentils, chickpeas, beans
• Plenty of vegetables
• Fruit (in moderation if high-sugar varieties) 

Increase lean protein:

• Chicken, fish, eggs, pulses, unsalted nuts
• Oily fish (e.g., salmon, mackerel) for omega-3 for heart health

Cut back on:

• White rice and white flour foods (e.g. white bread)
• Sugary drinks and processed snacks or cereals
• Red and processed meat
• Salty foods (aim for <6g salt/day) 

Alcohol:

• Keep within 14 units/week
• Avoid drinking on an empty stomach, especially for those on diabetes medication (reduces risk of hypos)

And it’s not just about food: other habits that support better blood sugar control

Move more throughout the week

• Aim for around 30 minutes of moderate activity most days — walking, cycling, dancing, or home workouts all count.
• Include strength exercises 2–3 times a week (e.g., bodyweight moves, resistance bands).  

Strengthening muscles helps the body use insulin more effectively, which in turn reduces visceral fat.

Stress management matters 

Chronic stress can raise blood sugar levels. Techniques such as:

• Yoga
• Meditation
• Breathing exercises
• Mindfulness 

…can all support both mental wellbeing and blood sugar control. 

Prioritise quality sleep 

Poor sleep can affect appetite, cravings, and how the body manages blood sugar. Regular sleep routines can meaningfully improve metabolic health.

All of these small habits work alongside healthy eating to keep the body’s insulin system working well.

The key takeaway

Type 2 diabetes is largely preventable. Genetics increases vulnerability, but lifestyle still makes a powerful difference. Small, achievable changes can:

• Lower the risk
• Improve wellbeing
• Delay complications
• Support both physical and mental health 

By Hafsah Ali, Foundation Trainee Pharmacist & Oluwademilade Idris, Foundation Trainee Pharmacist

GLP-1 medications (such as Ozempic, Trulicity and Victoza) have been getting a lot of attention lately, often described online as “miracle injections” for weight loss. This has led to confusion about what they actually do and who they are meant for.

The reality is more complex. GLP-1 medicines were first developed to help manage type 2 diabetes, and while they can support weight loss, they aren’t quick fixes or replacements for healthy lifestyle changes.

What GLP-1 medications actually do

GLP-1 receptor agonists mimic a natural hormone in the body called glucagon-like peptide-1, which helps regulate blood sugar after eating. They work by:

• Increasing insulin production when blood sugar rises after eating
• Suppressing glucagon, which stops the liver from releasing extra sugar
• Slowing digestion, which helps people feel fuller for longer
• Reducing appetite, which may support weight loss

These effects help stabilise blood sugar levels, and for many people with type 2 diabetes, this is their primary benefit. 

They are not “fat-burning injections”

Healthy and sustainable weight loss is gradual, often just a few kilograms over several months. GLP-1 medications don’t “burn fat” or cause rapid weight loss, they are a supportive therapy, that simply help people feel full sooner and eat smaller portions, which may lead to weight loss.

Their benefits are strongest when combined with:

• Balanced diet
• Regular physical activity
• Behaviour change support
• Regular reviews with a healthcare professional

Without these, improvements tend to be limited and may not last. 

Access on the NHS and privately

Because supply is limited, these medications are not freely available and are not prescribed for cosmetic weight loss.

Private prescriptions:

• GLP-1 medications can be prescribed privately, but only after a consultation with a healthcare professional who will check if the medication is suitable, discuss risks and benefits, and ensure it is safe for the individual.
• They cannot legally be sold without a clinical assessment.

On the NHS – access is limited and highly selective:

• For type 2 diabetes, GLP-1s are usually considered after other medications (i.e. triple therapy) haven’t worked or aren’t suitable.
• For weight management, they may be offered to people with a BMI ≥ 35 and other health risks, criteria vary depending on the specific GLP-1 medication. 

They require ongoing monitoring

People taking a GLP-1 medication need structured follow-up, including checks at the start, 3 months, and 6 months:

• Average blood sugar levels (HbA1c)
• Weight
• Kidney function
• Treatment goals

Continuing treatment depends on whether the medication is helping. 

Side effects are common

GLP-1 medications are effective for many people, but they don’t suit everyone. Around 1 in 5 people stop treatment within a year, due to cost (for private prescriptions), adverse effects and comorbidity burden. Common side effects include:

• Nausea
• Bloating
• Diarrhoea or constipation
• Altered taste
• Mild injection-site reactions

Support from healthcare professionals is important to manage side effects and adjust treatment.

The key takeaway

GLP-1 medications are not quick fixes and not only for weight loss. They are a valuable supportive tool in type 2 diabetes and weight management, but they work best when paired with lifestyle support and regular monitoring.

They offer a dual benefit, better blood sugar control and potential weight loss, but they are not magic solutions. A supportive, holistic approach to lifestyle and wellbeing, including healthy eating, regular physical activity and healthcare professional reviews, remains essential.