NHS website content, Open Government Licence v3.0 (Crown copyright)

Question: What does the NHS say about Symptoms of gestational diabetes? Cite the source.

Answer:
Gestational diabetes does not usually cause any symptoms.

Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.

Some women may develop symptoms if their blood sugar levels gets too high (hyperglycaemia) , such as:

increased thirst needing to pee more often than usual a dry mouth tiredness blurred eyesight genital itching or thrush

But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you're worried about any symptoms you're experiencing.

— Source: www.nhs.uk/conditions/gestational-diabetes/
  Publisher: UK National Health Service (NHS)
  Page: "Overview - Gestational diabetes"
  Section: "Symptoms of gestational diabetes"
  License: NHS website content, Open Government Licence v3.0 (Crown copyright)
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


UK National Institute for Health and Care Excellence (NICE)

NICE guidance, Open Government Licence v3.0 (Crown copyright)

Question: What does NICE recommend about Rationale and impact — Initial medicines: people living with obesity? Cite the source.

Answer:
Recommendations 1.17.1 and 1.17.2

The evidence comparing antidiabetic therapies for people with no relevant comorbidities included people living with obesity. However, in most studies it was not possible to separate out this group from the larger study population and identify specific effects for people living with obesity. Given the limitations of the evidence, the committee recommended the same medicines for this group as for other people with type 2 diabetes and no other specific comorbidities.

The committee recommended these therapies for people living with obesity because of their glycaemic reduction properties, and cardiovascular and renal benefits. Weight reduction may be a side effect of some medicines (including GLP-1 receptor agonists and tirzepatide, SGLT-2 inhibitors, and metformin), which may be important to the person with type 2 diabetes and their healthcare professionals. However, if weight reduction is the primary aim of the treatment, the committee agreed that healthcare professionals should follow NICE's guideline on overweight and obesity management instead of this guideline.

For the wider population, therapy with metformin and an SGLT-2 inhibitor was more clinically effective at reducing HbA1c, weight and cardiovascular events than:

any other therapy combining metformin with 1 other medicine, and metformin alone.

any other therapy combining metformin with 1 other medicine, and

metformin alone.

Cardiovascular events covered included cardiovascular mortality, myocardial infarction, non-fatal stroke and hospitalisation for heart failure. Evidence showed that canagliflozin and dapagliflozin reduced the risk of end-stage renal failure.

The committee agreed that therapy combining metformin with an SGLT-2 inhibitor is the most clinically effective option for people living with obesity and recommended this as the standard initial treatment.

SGLT-2 inhibitors were cost effective for people living with obesity. Data on health inequalities also showed that people living in the most deprived areas experience the greatest benefits for their health from SGLT-2 inhibitors. The committee believe this is an important reason for ensuring universal access to SGLT-2 inhibitors.

During the 2026 update of the guideline, the committee was aware of the large reduction in price of dapagliflozin because generic versions of the medicine were becoming available. They did not make a recommendation for this specific medicine, acknowledging that other medicines in the same class were as effective and may become cheaper in the future. However, they support its use while it is the least expensive of the SGLT-2 inhibitors that may be suitable, because it is likely to reduce the cost of implementing the recommendation without impacting the quality of care for most people with type 2 diabetes.

GLP-1 receptor agonists were not cost effective in the health economic modelling for this population. Compared to people with early onset type 2 diabetes, the lifetime risk of cardiovascular disease is lower. Bearing in mind the cardiovascular protection already being provided by SGLT-2 inhibitors and metformin, GLP-1 receptor agonists and tirzepatide were not recommended as initial medicines and were instead recommended as treatment options if further medicines are needed.

The recommendations about the use of metformin may lead to a change in current practice but should not lead to a significant cost or resource impact. The price of modified-release metformin can fluctuate but, in December 2025, was lower than the cost of standard-release metformin.

SGLT-2 inhibitors were recommended by NICE in 2022. They were recommended for some people at high risk of developing cardiovascular disease.

However, real-world evidence shows that SGLT-2 inhibitors are under-prescribed throughout the UK. The recommendations may increase the number of people who are offered SGLT-2 inhibitors, which will increase prescribing costs. But broader access to SGLT-2 inhibitors may also result in long-term medicine costs being partially offset by fewer people needing treatment for atherosclerotic cardiovascular disease.

The recommendations may lead to an increase in the number of appointments required to optimise the medications being added. The committee believes this can be managed and will lead to reductions in the long term because:

SGLT-2 inhibitors can be prescribed at the same time as metformin, with a plan for starting medicines sequentially the cardiovascular and renal benefits of SGLT-2 inhibitors will reduce the number of appointments needed to treat atherosclerotic cardiovascular disease, established heart failure and chronic kidney disease.

SGLT-2 inhibitors can be prescribed at the same time as metformin, with a plan for starting medicines sequentially

the cardiovascular and renal benefits of SGLT-2 inhibitors will reduce the number of appointments needed to treat atherosclerotic cardiovascular disease, established heart failure and chronic kidney disease.

Return to recommendations

— Source: www.nice.org.uk/guidance/ng28/chapter/Rationale-and-impact
  Publisher: UK National Institute for Health and Care Excellence (NICE)
  Page: "Type 2 diabetes in adults: management"
  Section: "Rationale and impact — Initial medicines: people living with obesity"
  License: NICE guidance, Open Government Licence v3.0 (Crown copyright)
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


Healthdirect Australia (Australian Government)

Healthdirect Free Australian health advice you can count on.

Healthdirect Australia (Australian Government, CC BY)

Question: Per Healthdirect Australia guidance on Can obesity be prevented, what is the summary?

Answer:
Here are some steps that you can take to help reduce the likelihood of obesity:

Eat well : Review how many high-energy, low-nutrition snack foods and sugary drinks you consume, including juice, soft drink and flavoured milk. Consider how often you get takeaway. Engage in physical activity : Only half of Australians do enough physical activity for good health. Limit alcohol : Review how much alcohol you drink — alcohol has many kilojoules with no nutritional benefits.

Stress, low mood, poor-quality sleep, changing emotions and poor access to healthy food can all cause people to take in more kilojoules than they need. Addressing these risk factors as much as possible can reduce your chance of obesity.

— Source: www.healthdirect.gov.au/obesity
  Publisher: Healthdirect Australia (Australian Government)
  Page: "Healthdirect Free Australian health advice you can count on."
  Section: "Can obesity be prevented?"
  License: Healthdirect Australia (Australian Government, CC BY)
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


Diabetes Australia, open patient education

Question: How does Diabetes Australia describe Drink water? Provide the verbatim source.

Answer:
Staying hydrated is essential for health, and water is the best choice.

Sugary drinks like soft drinks, flavoured waters, and energy drinks are a major source of added sugar and can quickly raise blood glucose levels. Regularly drinking these can increase your risk of type 2 diabetes, weight gain, and tooth decay.

Tips to drink more water:

Keep a reusable water bottle with you Add slices of lemon, cucumber, or berries for flavour Replace juice and soft drinks with sparkling water.

— Source: www.diabetesaustralia.com.au/prevention/healthy-living/eating-well/
  Publisher: Diabetes Australia
  Page: "Diabetes Australia"
  Section: "Drink water"
  License: Diabetes Australia, open patient education
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


UK National Health Service (NHS) — Medicines A-Z

About dapagliflozin - Brand name: Forxiga

NHS website medicines A-Z, Open Government Licence v3.0 (Crown copyright)

Question: How does the NHS describe Key facts? Provide the verbatim source.

Answer:
Dapagliflozin works on your kidneys. It increases the amount of sugar removed from your body when you pee. It can also reduce the amount of work your heart needs to do to pump blood around the body. Dapagliflozin usually starts to work (reduce your blood glucose levels) after about 2 hours, but it may take up to a week for it to take full effect If you're taking dapagliflozin with other diabetes medicines, it can sometimes cause low blood sugar (hypoglycaemia) . It's a good idea to always carry sweets or fruit juice with you in case this happens. Unlike some diabetes medicines, dapagliflozin does not make you put on weight. In fact, some people find they lose weight. If you have diabetes, you're entitled to free prescriptions for all of your medicines, not just your diabetes ones.

— Source: www.nhs.uk/medicines/dapagliflozin/about-dapagliflozin/
  Publisher: UK National Health Service (NHS) — Medicines A-Z
  Page: "About dapagliflozin - Brand name: Forxiga"
  Section: "Key facts"
  License: NHS website medicines A-Z, Open Government Licence v3.0 (Crown copyright)
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


UK National Health Service (NHS) — Medicines A-Z

Pregnancy, breastfeeding and fertility while taking simvastatin

NHS website medicines A-Z, Open Government Licence v3.0 (Crown copyright)

Question: According to the NHS Medicines A-Z, on the topic of "simvastatin and fertility"

Answer:
There's no clear evidence that taking simvastatin reduces fertility in either men or women.

However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.

trying to get pregnant pregnant breastfeeding

— Source: www.nhs.uk/medicines/simvastatin/pregnancy-breastfeeding-and-fertility-while-taking-simvastatin/
  Publisher: UK National Health Service (NHS) — Medicines A-Z
  Page: "Pregnancy, breastfeeding and fertility while taking simvastatin"
  Section: "Simvastatin and fertility"
  License: NHS website medicines A-Z, Open Government Licence v3.0 (Crown copyright)
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.


Differences between type 1 and type 2 diabetes

There are differences in the causes, onset of symptoms and treatment of type 1 diabetes and type 2 diabetes. If you have type 1 or type 2 diabetes, it means there's too much glucose (a type of sugar) in your blood due to a problem with the hormone insulin. Both are serious conditions that can lead to serious health complications.

Diabetes UK, registered charity, patient education content

Question: Per Diabetes UK patient guidance on There are differences in the causes, onset of symptoms and treatment of type 1 diabetes and type 2 diabetes. If you have type 1 or type 2 diabetes, it means there's too much glucose (a type of sugar) in your blood due to a problem with the hormone insulin. Both are serious conditions that can lead to serious health complications, what is the summary?

Answer:
When you've got type 1 diabetes, your body cannot make any insulin at all. The insulin-producing cells have been attacked and destroyed by your immune system. This is why type 1 diabetes is known as an autoimmune condition.

Type 2 diabetes isn’t an autoimmune condition. Your body isn’t making enough insulin or what it makes isn’t working properly. This can be for many reasons.

Type 1 diabetes affects 8% of people living with diabetes and type 2 diabetes affects 90% of people living with diabetes. There are also lots of other types of diabetes .

Whatever type of diabetes you have, you need the information, treatment and support to help you manage it.

— Source: www.diabetes.org.uk/diabetes-the-basics/differences-between-type-1-and-type-2-diabetes
  Publisher: Diabetes UK
  Page: "Differences between type 1 and type 2 diabetes"
  Section: "There are differences in the causes, onset of symptoms and treatment of type 1 diabetes and type 2 diabetes. If you have type 1 or type 2 diabetes, it means there's too much glucose (a type of sugar) in your blood due to a problem with the hormone insulin. Both are serious conditions that can lead to serious health complications."
  License: Diabetes UK, registered charity, patient education content
  Retrieved: 2026-05-14

Note: This is public-health information from an authoritative international body. It reflects population-level guidance, not individualized medical advice. For decisions about your own health, please discuss with your healthcare provider.