What diabetes is
Diabetes is a common, lifelong condition where the amount of sugar (glucose) in the blood gets too high. Normally the body uses a hormone called insulin to move sugar out of the blood and into the cells, where it's used for energy. In diabetes, that system doesn't work properly — so sugar builds up in the blood instead.
There are two main types, and the difference matters for the people you support.
Type 1 diabetes is where the body makes little or no insulin at all. People with type 1 need to take insulin every day, for life, and to check their blood sugar regularly. It isn't caused by lifestyle, and it can't be prevented.
Type 2 diabetes is far more common. Here the body still makes insulin, but not enough, or it doesn't work well. The NHS says type 2 is usually managed with healthy eating, being active, and often medicines such as metformin — and some people also need insulin over time.
You don't need to be an expert in the difference. What helps is knowing that the person's care plan and their diabetes team set out exactly how their diabetes is managed — and your job is to support that, not to change it.
The signs to be aware of
Diabetes that isn't well controlled can make someone unwell, so it helps to notice the general signs. The NHS lists common symptoms of higher blood sugar as feeling very thirsty, needing to pass urine more often (especially at night), feeling very tired, losing weight without trying, and blurred vision. If you notice these in someone who hasn't been diagnosed, that's worth gently raising so they can see their GP.
For someone who already has diabetes, the things to watch are the two swings in blood sugar — too low, and too high.
"Hypos" — when blood sugar goes too low
A "hypo" (short for hypoglycaemia) is when blood sugar drops too low — Diabetes UK uses the simple reminder "4 is the floor", meaning below 4mmol/L. Hypos happen mainly in people who take insulin or certain diabetes tablets. They can come on quickly and need treating fast.
Signs of a hypo can include:
- shaking or trembling
- sweating
- looking pale
- feeling hungry, dizzy, or weak
- a fast or pounding heartbeat
- becoming confused, irritable, or "not themselves"
- tiredness or difficulty concentrating
This is one to take seriously, because a hypo can get worse quickly. If the person is awake and able to swallow safely, the usual first response — set out in their care plan — is a sugary drink or fast-acting glucose, followed by a longer-lasting snack like a sandwich once they pick up. Their care plan will say exactly what they have and how you help.
The important boundary: you follow the plan and support the person — you don't take over their medical treatment. NICE and Diabetes UK guidance is clear that some treatments, like a glucagon injection, are only given by someone trained to do it. If a person having a hypo becomes very drowsy, can't stay awake, or passes out, do not put food or drink in their mouth (they could choke) — treat it as an emergency, call 999, and follow your training and their care plan.
"Hypers" — when blood sugar goes too high
A "hyper" (hyperglycaemia) is when blood sugar runs too high. It usually comes on more slowly than a hypo — over hours or days — and can make someone feel thirsty, tired, and need the toilet often. On its own, the occasional high reading isn't an emergency, but blood sugar that stays high needs attention, and you should report it so the right people can act.
Sometimes very high blood sugar, especially in type 1 diabetes, can lead to a serious condition called diabetic ketoacidosis (DKA). Signs can include feeling very unwell, being sick, tummy pain, breathing fast, or breath that smells fruity. This is a medical emergency — get urgent help and call 999.
How you help, safely
Most of what makes a real difference is everyday and within your role:
- Support the routine. Help the person eat regular, balanced meals and stay active in the way their care plan describes. Missed meals can trigger hypos.
- Keep hypo treatment to hand. Make sure their fast-acting sugar and snacks are where they should be, so they're ready if a hypo starts.
- Notice and report. You see the person regularly, so you're well placed to spot when they seem off — more tired, more confused, more thirsty than usual — and to pass it on.
- Help them get to their checks. People with diabetes have regular reviews and eye and foot checks; supporting them to attend protects their health.
- Look after feet. Diabetes can affect the feet, so report any cuts, sores, or changes you notice — but never treat a wound yourself.
And, just as importantly, the things that aren't your role: you don't decide on or change someone's insulin or diabetes medicines, you don't give injections unless you've been specifically trained and it's in the care plan, and you don't make medical judgements. Those belong to the person, their family, and their diabetes team. When you're unsure, the safe answer is always to ask.
The takeaway
Diabetes is common and very manageable, and good day-to-day support makes a genuine difference to how well someone lives with it. Your part is to understand the basics, support the person's routine and care plan, spot the signs of a hypo or hyper, and know when something needs reporting or is an emergency. Do that, and you're helping keep someone safe and well — which is exactly what good care looks like.
Where this comes from
- NHS — Diabetes; Type 2 diabetes symptoms (nhs.uk)
- NICE — low blood glucose (hypoglycaemia) guidance (nice.org.uk)
- Diabetes UK — hypos and hypers, and support for families and carers (diabetes.org.uk)
This article is general information to build awareness. It is not medical advice and not a substitute for a person's care plan or their diabetes team. Always follow the care plan and current professional guidance, and seek medical help when needed.