About diabetes

Diabetes is a long-term condition where your body cannot keep your blood sugar (glucose) in a healthy range. Over time, high blood sugar can damage your eyes, nerves, kidneys, heart and feet. The good news is that diabetes can be managed, and a lot of the day-to-day work happens at home, not in a clinic.

There are three main kinds of diabetes. They have different causes, but the goal of treatment is the same: keep your blood sugar in a healthy range, most of the time.

Type 1 diabetes

Type 1 happens when the body’s immune system attacks the cells in the pancreas that make insulin. Without insulin, glucose stays in the blood instead of being used for energy. Type 1 is usually diagnosed in childhood or young adulthood and is not caused by lifestyle. Everyone with Type 1 needs insulin every day, either by injection or insulin pump.

• Around 5–10% of people with diabetes in NZ have Type 1.
• Symptoms can develop over a few weeks: thirst, weight loss, frequent urination, tiredness.
• Treatment is insulin, blood-sugar monitoring, and a steady carbohydrate-aware eating pattern.

Type 2 diabetes

Type 2 is the most common form. The body still makes insulin but cells become resistant to it, so glucose builds up in the blood. Risk factors include family history, age (over 40), being overweight, and ethnicity — Type 2 is more common in Māori, Pacific peoples and South Asian communities.

• Around 90% of New Zealanders with diabetes have Type 2.
• It often develops slowly, sometimes without obvious symptoms for years.
• Treatment is usually a mix of food changes, regular activity, and one or more medications.
• Some people with early Type 2 can put it into remission with sustained lifestyle changes.

Gestational diabetes

Gestational diabetes is high blood sugar that first appears during pregnancy and usually goes away after birth. It is screened for as part of routine NZ antenatal care. Women who have had gestational diabetes have a higher chance of developing Type 2 later in life, so a follow-up check at 6–12 weeks postpartum and yearly checks afterwards are recommended.

Symptoms to watch for

If you notice several of these, talk to your GP about a blood-sugar test. The test is simple and is funded for most people through their PHO.

Symptom	What it usually means
Thirsty all the time	Body trying to flush extra glucose out through urine
Going to the toilet often, especially at night	Same — fluid loss caused by high blood sugar
Unexplained weight loss	Body breaking down muscle and fat for energy
Tired most of the time	Cells unable to use glucose properly
Cuts and grazes that heal slowly	High blood sugar slows healing and immune response

How insulin works

When you eat, carbohydrates are broken down into glucose, which enters the bloodstream. The pancreas releases insulin, a hormone that acts like a key — it lets glucose move from the blood into your cells, where it is used for energy. In Type 1, the keys are missing. In Type 2, the locks (cells) stop responding to the keys properly. Either way, glucose stays in the blood instead of fuelling the body.