Diabetes in NZ: Symptoms, causes, treatment, and tips on insurance

What is diabetes?

Diabetes is a long-term condition that affects how your body handles blood sugar.

Your body turns much of the food you eat into glucose. This glucose travels through your bloodstream to give your cells energy. Without it, your body and brain would not function properly.

To keep blood sugar at healthy levels, your body uses a hormone called insulin, which helps move glucose from your blood into your cells.

What happens in diabetes?

If you have diabetes:

• Your body may not make enough insulin
• Your body may not use insulin properly
• Or it may stop producing insulin altogether.

As a result, your bloodstream retains too much sugar, potentially causing kidney, cardiovascular, nerve, and eye issues.

Types of diabetes

Diabetes is not just one condition - there are types 1 and 2, plus variations.

Type 1 diabetes

Type 1 is an autoimmune condition. This means your immune system mistakenly attacks the cells in your pancreas that make insulin, so your body produces little or none.

This type often starts in childhood or the teenage years, but can develop at any age. Symptoms may appear quickly and become severe within weeks. Type 1 diabetes cannot be prevented, and people with it need insulin every day to survive.

Type 2 diabetes

Type 2 is the most common type of diabetes. Your body either does not use insulin properly (called insulin resistance) or cannot make enough of it over time.

It is more common in adults over 40, but increasingly seen in younger people and children. Family history, excess weight, and low physical activity can heighten your risk. Type 2 diabetes often develops slowly, and some people have no obvious symptoms at first.

Gestational diabetes

Gestational diabetes develops during pregnancy in women who did not previously have diabetes. It usually appears after 24 weeks and is often picked up during routine screening.

This is different from pre-existing diabetes, which means you already had type 1 or type 2 diabetes before becoming pregnant. Gestational diabetes often goes away after birth, but increases your risk of developing type 2 diabetes later in life.

Prediabetes

Prediabetes is a warning stage. Your blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes.

Many people have no symptoms. Without lifestyle changes, prediabetes can progress to type 2 diabetes. Healthy eating, regular activity, and weight management can reduce this risk.

Diabetes in New Zealand

How common is it?

Diabetes is a growing health issue in Aotearoa. In 2024, an estimated 300,000+ New Zealanders were living with diabetes.

Rates have increased steadily over the past decade, with type 2 diabetes making up the vast majority of cases. It is a major health issue for Māori, highlighting the need for earlier support, better access to care, and culturally appropriate health services.

Who is most affected?

Diabetes does not affect all communities equally.

• Pacific peoples have the highest rates
• Followed by Indian and Māori communities
• Rates are lowest among European and other ethnic groups.

In some regions, such as Counties Manukau, rates are significantly higher than in other parts of the country. Socioeconomic disadvantage is also linked to higher risk.

What about age?

Your risk increases as you get older. The highest number of diabetes cases are in those aged 56 to 70 years.

However, diabetes is not just an older person’s condition:

• In 2024, 3,659 people under 19 years old were living with diabetes
• Youth-onset type 2 diabetes is becoming more common
• Rates are rising in children and young adults.

Early-onset diabetes is particularly concerning because it can lead to complications at a younger age.

Estimated number of people with diabetes, by ethnic group and age group, 2024

Source: Health NZ

What causes diabetes?

Type 1 diabetes

Type 1 diabetes occurs when the immune system attacks the pancreas. This damages the cells that produce insulin.

The exact reason is still unclear. It often begins in childhood, but it can happen at any age, and is not linked to lifestyle choices.

Type 2 diabetes

Type 2 diabetes is usually linked to insulin resistance. Your body still makes insulin, but your cells do not respond properly.

Risk is higher if you:

• are overweight
• have a close relative with diabetes
• are over 35
• are not physically active.

Some medicines and hormonal conditions can also contribute.

Gestational diabetes

In pregnancy, your body needs more insulin than usual. If your pancreas cannot meet this demand, gestational diabetes can occur, usually improving after your baby is born.

Risk factors

Anyone can develop diabetes. But some people are at higher risk, especially for type 2 diabetes.

Risk factors for type 2 diabetes

You are more likely to develop type 2 diabetes if you:

• have diabetes in your whānau
• are over 45 (risk increases further over 55)
• are overweight
• have high blood pressure
• have prediabetes
• had gestational diabetes during pregnancy
• have polycystic ovary syndrome (PCOS).

Your ethnicity also plays a role. Risk is higher if you are:

• Māori
• Pacific
• South Asian (including Indian)
• from some Asian or Middle Eastern backgrounds.

Risk factors for type 1 diabetes

Type 1 diabetes is an autoimmune condition and cannot currently be prevented.

Known risk factors include:

• Having a parent or sibling with type 1 diabetes
• Being a child, teenager, or young adult (though it can happen at any age).

Risk factors for gestational diabetes

You may be at higher risk during pregnancy if you:

• are over 25
• are overweight
• have a family history of type 2 diabetes
• have had gestational diabetes before
• have PCOS.

While you cannot change some risk factors, understanding them can help you take early action and seek testing if needed.

Diabetes symptoms

The signs of diabetes are not always obvious. Some people feel unwell quickly. Others feel completely fine for months or even years.

Your symptoms often depend on how high your blood sugar is and how suddenly it rises.

Early warning signs

Common signs of diabetes include:

• Being unusually thirsty
• Passing urine more often, especially overnight
• Feeling very tired
• Unplanned weight loss
• Increased hunger
• Blurred eyesight
• Dry or itchy skin
• Cuts and sores that heal slowly
• Frequent infections, such as urinary, skin, or yeast infections
• Tingling or numbness in your hands or feet.

These symptoms happen because excess sugar in your blood affects how your body uses energy and fluids.

Fast-onset symptoms

In some cases, especially with type 1 diabetes, symptoms can appear quickly and feel intense.

You might notice:

• Stomach pain
• Nausea or vomiting
• Rapid or deep breathing
• Breath that smells sweet or fruity.

These symptoms can signal a dangerous build-up of acids in the blood, needing urgent medical attention.

Mild or hidden symptoms

Type 2 diabetes often develops slowly. You may not notice anything unusual at first. Some people only discover they have diabetes after a routine blood test.

Other signs can include:

• Darkened skin around the neck, armpits, or groin
• Repeated infections
• Ongoing fatigue that doesn’t improve with rest.

Gestational diabetes during pregnancy usually has no clear symptoms. This is why routine screening is so important.

When to see a doctor

Book an appointment if you notice any possible signs of diabetes. The sooner it is diagnosed, the sooner you can protect your health.

Seek urgent help if you feel very unwell, have severe stomach pain, are breathing quickly, or notice a fruity smell on your breath.

Even if you feel well, regular testing is important if you have risk factors. Early action can prevent serious complications later on.

​Complications

Complications usually happen after years of high blood sugar. They are also more likely if your blood pressure is often high or if you smoke.

Good blood sugar control lowers your risk and regular check-ups catch problems early, when treatment works best.

Eye problems

Diabetes can damage the blood vessels in your eyes, which is why regular diabetes eye checks are important, even if your vision feels fine.

Possible issues include:

• Diabetic retinopathy, which can lead to vision loss
• Cataracts, where the lens becomes cloudy
• Glaucoma, which increases pressure inside the eye.

Some eye damage has no early symptoms, so screening is key.

Nerve and foot problems

High blood sugar can injure nerves. This is called neuropathy, causing:

• tingling, numbness, or burning pain
• reduced feeling in your feet.

If you cannot feel a blister or cut, it can worsen without you noticing. Diabetes can also reduce blood flow to your feet, making infections harder to heal. In severe cases, this can lead to ulcers or amputation.

Kidney disease

Diabetes can damage the tiny filters in your kidneys over time. This is called diabetic nephropathy.

It may be picked up through blood and urine tests before you feel any symptoms. In advanced cases, kidney failure can occur, and treatment may include dialysis.

Heart disease and stroke

Diabetes increases your risk of cardiovascular disease, including heart attack and stroke. In type 2 diabetes, cardiovascular disease is the leading cause of death.

Heart risk checks, managing cholesterol and blood pressure, and staying active can make a real difference.

Emergency complications

Some complications happen quickly and need urgent treatment.

These include:

• Diabetic ketoacidosis (DKA) is more common in type 1 diabetes
• Severe low blood sugar, especially if you use insulin, also known as severe hypoglycemia.

If you feel very unwell, confused, or have vomiting and fast breathing, seek medical help immediately.

How is diabetes diagnosed?

Getting tested for diabetes can feel stressful, but a diagnosis is also a turning point, and gives you clarity.

In New Zealand, diabetes is usually diagnosed with simple blood tests. Most tests are done at a laboratory, and results are generally very reliable.

Who should get tested?

Talk to your GP, nurse, or healthcare provider about testing if you:

• have signs of diabetes (such as thirst, frequent urination, tiredness, weight loss, or frequent infections)
• have risk factors, such as diabetes in your whānau, being overweight, high blood pressure, or previous gestational diabetes
• are Māori, Pacific, or Indo-Asian, as screening often starts earlier
• have already been told you have prediabetes.

You may also be offered screening as part of a cardiovascular risk assessment (heart and stroke risk checks), especially as you get older.

Why early diagnosis matters

Diabetes can cause damage quietly, even before you feel unwell. Early diagnosis and treatment can reduce the risk of complications, such as heart disease, eye damage, kidney disease, and nerve problems.

It also gives you the best chance to prevent or delay type 2 diabetes if you are still in the prediabetes stage.

Tests used in New Zealand

Your healthcare provider may use one or more of these:

1. HbA1c blood test (the most common test): This shows your average blood sugar level over the last 2–3 months. It is used to diagnose prediabetes and type 2 diabetes, and can also help confirm diabetes if you have symptoms.
2. Fasting blood glucose test: This checks your blood sugar after fasting for at least 8 hours.
3. Random blood glucose test: This can be done at any time. It is often used when you have symptoms and need a quick answer.
4. Oral glucose tolerance test (OGTT): You drink a sugary liquid and have blood tests over the next few hours. This is often used:

• if HbA1c results may not be reliable for you
• to diagnose gestational diabetes in pregnancy.

Tests for type 1 diabetes (when needed)

If type 1 diabetes is suspected, your doctor may also check for:

• ketones (a sign your body is struggling to use sugar for energy)
• autoantibodies, which can indicate an autoimmune cause.

If you are worried about diabetes, the best next step is simple: book a check-up and ask about the right test for you.

Treating and managing diabetes

Hearing that you have diabetes can feel overwhelming. You might worry about treatment methods, food rules, or what it means for your future. The good news is that diabetes can be managed with the right support, allowing a full, active life.

Your treatment plan will depend on the type of diabetes, your blood sugar levels, and overall health. Your GP, nurse, or diabetes specialist will work with you to create a plan that suits your lifestyle.

Treatment options

Type 1 diabetes

If you have type 1 diabetes, your body no longer makes insulin. This means you will need insulin every day to stay well.

Insulin can be given through:

• injections using a pen or syringe
• an insulin pump, which delivers insulin throughout the day.

In New Zealand, insulin pumps and their supplies may be publicly funded for people who meet certain criteria. For some people, pumps can improve blood sugar control and reduce severe low blood sugar episodes.

Type 2 diabetes

Type 2 diabetes often develops gradually. Treatment usually starts with lifestyle changes, but many people also need medication.

Common medicines include:

• Metformin, which helps your body use insulin more effectively
• Other tablets or injectable medicines that lower blood sugar
• Insulin, if tablets alone are not enough.

Some newer funded medicines in Aotearoa New Zealand also help protect your heart and kidneys, which is important because diabetes increases the risk of these complications.

Everyday management

Medication is only one part of the picture. Daily habits play a big role in how you feel.

• Healthy eating: You do not need special diabetic foods. Instead, aim for balanced meals with vegetables, whole grains, lean protein, and healthy fats.

Try to:

• • eat regular meals
  • limit sugary drinks
  • watch portion sizes.
  • If you use insulin, learn how carbohydrates affect your blood sugar so you can adjust your dose safely.

• Physical activity: Moving your body helps lower blood sugar and improves your mood. A simple goal is 30 minutes of moderate activity on most days. Walking, swimming, gardening, or kapa haka all count.

• Monitoring your blood sugar: Checking your levels helps you understand patterns. You may use finger-prick testing or, in some cases, a continuous glucose monitor. Regular HbA1c blood tests show your average levels over the past few months.

• Managing stress and wellbeing: Living with diabetes can affect your mental health. Stress can also raise your blood sugar. Talking to someone you trust, joining a support group, or learning relaxation techniques can make a real difference.

Can diabetes be cured or reversed?

At the moment, type 1 diabetes cannot be cured, and insulin will always be needed.

With type 2 diabetes, some people can achieve remission. This means blood sugar levels return to a non-diabetes range without medication, often after sustained weight loss and lifestyle changes. However, ongoing check-ups are still important.

Gestational diabetes usually settles after birth, but it does increase your future risk of type 2 diabetes. Regular follow-up testing is essential.

While diabetes may be a lifelong condition for many, it does not have to define you. With the right plan and support, you can take control.

How to prevent diabetes

Type 1 diabetes is an autoimmune condition and not preventable. So, if you or your child develops type 1, the focus is on early diagnosis and good management.

Lowering your risk of type 2 diabetes

Type 2 diabetes is different. In many cases, it can be prevented or delayed, especially if you act early.

Here are steps that can help:

• Keep your meals balanced: You do not need a strict diet. Aim for realistic changes you can stick with.

• Be active in ways you enjoy: Regular movement helps your body use insulin better.

• Aim for a healthy weight: If you are above your ideal weight, even modest weight loss can reduce your risk. Focus on steady, long-term habits rather than quick fixes.

• Stay on top of your health checks: If you have prediabetes, have had gestational diabetes, or have a strong family history, regular blood tests are important. Early changes can stop diabetes from developing.

You cannot control your genes or your age. But everyday choices matter, and can significantly lower your risk of type 2 diabetes.

Diabetes and insurance

A diabetes diagnosis can impact your finances. Having the right insurance in place helps.

Already have insurance cover?

If you already have health, trauma, or life insurance and are later diagnosed with diabetes, talk to your insurer or broker. Some comprehensive health insurance plans cover:

• private hospital treatment related to diabetes
• specialist consultations
• certain non-Pharmac-funded medicines.

Trauma insurance may also help. Some policies provide partial or full lump sum payments for:

• severe diabetes with serious complications
• adult insulin dependent diabetes mellitus (in some plans).

A lump sum payment can help you:

• replace lost income
• cover household bills
• pay down debt
• fund rehabilitation or home adjustments.

Every policy is different. The key is to review your cover and understand your options with the right insurance broker.

Thinking about getting insurance?

If you already have diabetes, you may still be able to buy health insurance. Having diabetes does not automatically mean a decline.

Insurers usually consider:

• the type of diabetes
• how long you have had it
• your HbA1c results (a measure of control)
• any complications
• blood pressure, cholesterol, and weight.

Well-managed diabetes can improve your chances. In some cases, premiums are higher, or exclusions may apply. But over time, consistent good test results and health checks may help reduce loadings.

Policywise works with multiple insurers. We can help you understand what is realistic, compare options, and advocate on your behalf.

How Policywise can help you stay informed

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