Private Diabetes Specialist UK

Practice information from Dr Syed Kashif Hussain Kazmi, Consultant Endocrinologist. View professional profile on Top Doctors.

Quick answer

Diabetes is a long term condition in which blood glucose is higher than normal. A diabetes specialist (endocrinologist) can clarify the type of diabetes, review medicines and technology, and plan care alongside your GP. Dr Kazmi offers virtual consultations across the UK and in person care in Cambridge.

What is diabetes?

Diabetes is a long term condition in which the level of glucose in the blood is higher than normal because the body does not make enough insulin, or cannot use it effectively. Type 1 diabetes is an autoimmune condition that usually needs insulin from diagnosis. Type 2 diabetes is much more common and is linked to age, family history, weight and other factors. Less common forms include diabetes caused by pancreatic disease, certain medicines such as steroids, or a single-gene (monogenic) change.

Metabolic health is a wider term. It describes how the body handles glucose, fats and blood pressure, and it matters because these factors together shape long term risk to the heart, kidneys, eyes, nerves and liver.

What are the symptoms of diabetes?

Symptoms vary, and many people with type 2 diabetes have none when it is first found. When present they can include:

Feeling more thirsty than usual and passing urine more often, including at night
Tiredness that is out of proportion to your day
Unintentional weight loss
Blurred vision
Recurrent thrush or other skin and urinary infections
Cuts and sores that heal slowly

When should you see a diabetes specialist?

Most people with diabetes are looked after well by their GP and NHS diabetes team. A private specialist assessment may be helpful when:

The type of diabetes is uncertain, for example diagnosis at a young age, a slim build with type 2 diabetes, or a strong family history
Blood glucose levels remain difficult to control despite treatment
You have frequent or severe low blood glucose (hypoglycaemia) or very variable readings
You would like to understand your options for newer medicines or glucose-monitoring technology
You have diabetes and are planning a pregnancy, or you are moving from children’s to adult diabetes services
Complications such as kidney, nerve or eye problems are developing
You want a second opinion or a single, joined-up review of diabetes alongside cholesterol, blood pressure and liver health

How is diabetes investigated?

Assessment starts with a detailed history and review of your medicines, home glucose or sensor readings and previous results. Tests are chosen to fit your situation and may include:

HbA1c and fasting or random glucose
Kidney function and urine albumin-to-creatinine ratio
Cholesterol and other blood fats, liver function tests
Diabetes autoantibodies and C-peptide when the type of diabetes is unclear
Screening and review of eyes, feet and nerve health, usually coordinated with the NHS screening services you already use

How is diabetes treated?

Treatment is individual and follows national guidance such as NICE. Broad approaches include:

Food, activity and weight

Practical, realistic advice on eating patterns, physical activity and, where relevant, weight management.

Glucose-lowering medicines

Choosing among tablets and injectable medicines according to your heart and kidney health, weight, risk of hypoglycaemia, preferences and cost considerations.

Insulin and technology

Insulin regimens, glucose-monitoring results and the potential role of diabetes technology can be discussed during assessment. Suitability depends on individual clinical needs.

Diabetes and pregnancy

If you are planning a pregnancy or are pregnant, diabetes care should be coordinated with your maternity and diabetes teams. Discuss the appropriate specialist service before booking.

Protecting the heart and kidneys

Addressing blood pressure, cholesterol and kidney health alongside glucose, as these often matter as much as the HbA1c itself.

Working with your GP

With your agreement, findings and recommendations can be shared with your GP so care stays joined up.

HbA1c explained: what the number means and what can skew it

HbA1c reflects your average blood glucose over roughly the last two to three months. In the UK, below 42 mmol/mol is in the normal range, 42 to 47 is prediabetes, and 48 or above is in the diabetes range. Anaemia and some inherited blood variations can make the result unreliable.

What does an HbA1c test measure?

Glucose in the blood sticks to haemoglobin, the protein in red blood cells. HbA1c is the share of haemoglobin carrying glucose. Red cells live for about three months, so the result reflects your average glucose over that period rather than a single moment, which is why you do not need to fast for it.

What are the UK HbA1c ranges?

A diagnosis is usually confirmed with a repeat test unless you have clear symptoms or very high glucose. Your clinician reads the result alongside your symptoms and other tests.

NHS guidance uses these ranges for adults:

Below 42 mmol/mol (6.0%): normal range
42 to 47 mmol/mol (6.0 to 6.4%): prediabetes, meaning a higher risk of developing type 2 diabetes
48 mmol/mol (6.5%) or above: in the diabetes range

When can an HbA1c result be misleading?

In these situations other tests, such as fasting glucose or sensor data, may be more reliable. Tell your clinician if any of these apply.

HbA1c depends on red blood cells, so anything that changes them can skew it:

Anaemia, including iron or vitamin B12 deficiency
Recent blood loss or a blood transfusion
Inherited haemoglobin variations, such as sickle cell trait or thalassaemia trait
Some kidney and liver conditions
Pregnancy

What HbA1c target is right for you?

If you already have diabetes, the target is individual. It depends on the type of diabetes, your medicines, the risk of low blood sugars, your age and other health conditions, and it is agreed with your diabetes team rather than taken from a table.

When is a specialist opinion useful?

A specialist review can help when HbA1c does not match your meter or sensor readings, when it stays high despite treatment, when the type of diabetes is unclear, or when low blood sugars are a problem.

When to seek urgent help

If you have diabetes and develop vomiting, abdominal pain, fast deep breathing, a fruity smell on the breath, marked drowsiness or confusion, seek emergency help immediately by calling 999. These can be signs of diabetic ketoacidosis. A low glucose reading with confusion or loss of consciousness is also an emergency.

Common questions

Do I need a GP referral to see a private endocrinologist?

Referral arrangements, and any requirements from private medical insurers, are confirmed when you make an enquiry. A GP letter and recent results are usually helpful to bring or send.

Can you take over my diabetes care from the NHS?

Many people use a private consultation for a defined review, a second opinion or a plan, and continue routine monitoring with their GP or NHS team. What is appropriate for you can be discussed at your appointment.

What should I bring to the appointment?

A list of your medicines, recent blood tests, letters from other clinicians, and your glucose meter or sensor data if you use one.

How often should HbA1c be checked?

It depends on your situation. For many people with diabetes it is checked every three to six months, and your diabetes team will advise you.

Can I lower my HbA1c quickly?

HbA1c changes slowly because it reflects several months, so meaningful change takes weeks to months. Do not change prescribed treatment without advice from your clinician.

Related patient guides

How to prepare for a virtual endocrinology appointment: A practical checklist for an online consultation: what to gather, how to set up and what to ask.
When should you see an endocrinologist?: Signs a hormone, thyroid, diabetes or bone problem may need a specialist, and how to prepare.

Diabetes & Metabolic Health