With 1.5 million sufferers in the UK - half of these women - more and more have to get through their day coping with diabetes

Life as a diabetic is a balancing act. If your blood sugar gets too high or too low, your body can't use it properly. Coping with dizziness, tiredness, the shakes and blurred vision, as well as the inconvenience of taking medication, insulin injections or drugs and regular blood testing will inevitably impact the way you live.

Diabetes day-to-day
Living with diabetes means taking part in certain daily rituals to keep symptoms at bay, regardless of whether you may have had a pressured day in the office or lead a hectic family life. Professor Barnett, who heads the biggest diabetes unit in the UK for the NHS in Birmingham, outlines the impact, 'Diet needs to be adjusted and more exercise needs to be taken. Diabetes sufferers may need to take tablets daily or have insulin injections. Also as blood pressure increases in up to 80 per cent of sufferers, so treatment may need to be taken to prevent heart attacks and strokes,' he says.

As well as the medication, there is also the monitoring, which a diabetic has to fit into their everyday lives. 'A diabetes sufferer will need to monitor lifestyle carefully - testing blood or urine, depending on their treatment. In addition more care in diet and increased physical activity are required, which should make people feel a lot better,' adds Professor Barnett.

As well as the short-term care, there are longer-term implications for type 2 sufferers. With this strand of diabetes, the body doesn't make enough insulin, or the insulin produced does not work properly. 'As there is a dramatic increase in heart attacks, diabetes sufferers will commonly need to take blood pressure and cholesterol tablets. Half of all type 2 diabetics will need to go on to insulin to maintain control,' explains Professor Barnett.

Rachel Underhill, 29, has type 1 diabetes which appears at a younger age where the body is unable to produce insulin. She has a busy career and is the single parent of young twins. When her sugar levels plummet, she feels faint and shaky; if they are too high, she feels sick, sweaty and confused. Like many diabetics she takes insulin in tablet form every day and tests her own blood first thing in the morning.

Dealing with diagnosis
Rachel, like many others, has learned to get by with her condition, but the initial 'finding out' can be a distressing and difficult time. Over 50 per cent of those with type 1 are diagnosed under 20 years of age and type 2 can appear as late as the late 40s or 50s.

It wasn't easy for Rachel, even though she knew she was at risk, 'My gynaecologist told me that there was a chance that I would develop diabetes in my 40s as my grandparents were diabetic. But at the beginning of last year the symptoms started. I felt very sick, tired and hot and I thought it was the polycystic ovarian disease that I suffer from, so I went to my gynaecologist. Three weeks later I received a letter telling me I had diabetes. I was terrified. I didn't know what to do because I felt so unwell.'

Professor Barnett says Rachel's reaction was normal, 'Because it is a chronic disease, people often feel unwell for some time before more serious complications set in. There is shock and anxiety, which requires extreme sensitivity and careful handling. A significant number of sufferers will not be surprised as diabetes may be in the family.'

Attitudes to diabetes
Four out of five people in a recent survey by Roche Diagnostics think there is not enough awareness about their actual symptoms. 'People think it is just because you eat the wrong things. People don't see diabetes as a serious illness. I think people underrate it,' agrees Rachel Underhill.

'Diabetes is still often downplayed by many health professionals. You still hear of doctors saying 'mild form of diabetes', which is totally wrong,' says Professor Barnett.

But it is hard to come to terms with when those close to you don't understand what you have to go through. According to the Roche survey, one in five feel diabetes affects their more intimate relationships. The same lack of understanding destroyed Rachel's marriage, 'I split with my husband six months after my diagnosis. He wasn't supportive and he didn't recognise it as a major illness. So I decided to sort my life out and we broke up,' she explains.

Affects on sex drive are also common putting pressure on relationships, 'sexual relationships in women diabetes sufferers are affected because of the quality of life and depression rather than diabetes. Men may suffer erectile dysfunction because of diabetes,' explains Professor Barnett.

And it's inevitable, as with any chronic illness that you may feel low - half of sufferers in the UK in the survey by Roche said they felt depressed because of their condition. Professor Barnett says, 'chronic disease is often associated with depression and a reduction in quality of life and those factors alone will affect life. Diabetes is the most common cause of blindness and kidney failure.' Despite this, Rachel soldiers on, 'I do get really low days but I am independent and positive and battle on with it.'

Diabetic and a mum
Being a mother of five-year-old twins requires constant energy that Rachel has to deliver despite her condition. Rachel has found that getting her children to understand that she is unwell helps. 'It affects my twin girls. They know what to do when I get an attack. I tell them 'Mummy's feeling poorly' and they sit and play quietly.'

Diabetes at work and play
One in three sufferers experience difficulties at work because of diabetes, says the Roche survey. Although Rachel's colleagues are now understanding, it was tough at first, 'I work with five men and they were all a bit shocked when I was diagnosed and I used to check my blood six times a day at first. Some were squeamish,' she says.

Something as simple as a trip to a restaurant can cause embarrassment. 'I have got a new boyfriend and quite often we want to eat out, and it makes me realise how little there is for diabetic people on menus. People eating with you feel they can't eat non-diabetic meals when you are around because they feel guilty,' she explains.

To get around this problem, Rachel and her new boyfriend often dine early and then take a trip out to the cinema instead of focusing on food, 'I have to make sure that I eat at regular times. I need to have dinner at 6pm to stop myself getting into a situation where my blood sugar gets too low'.

Restaurants are becoming more understanding and many cater for the variety of dietary needs people have - for example, a low cholesterol diet or food intolerances. A diabetic should be able to order the healthy options that are available, like salads, fish and baked food from the menu. There are also a growing number of organic restaurants, providing options for diabetes sufferers.

Diabetes UK recommend planning before going out for dinner, for example, if you are going to a dinner party try to establish what time the food is being served so you can plan your insulin intake around it, then you can relax and enjoy the evening.