DIABETES
SYMPTOMS

Understanding Diabetes Symptoms

Diabetes Symptoms Nutrition

Diabetes is a very broad and confusing topic. For starters, it can all depend what type of diabetes you have, and most people aren’t aware there are 3 main different types of diabetes before we even mention prediabetes.

The 3 most common forms of diabetes are:

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

As mentioned, there is also prediabetes, which is often a precursor to type 2 diabetes if not managed correctly.

I am a qualified Nutritional Therapist and have been a prediabetes and type 2 diabetes nutritionist for a number of years helping many clients learn how to manage their prediabetes and type 2 diabetes so that they are in control of their health rather than the condition being in control. I have supported many people to balance their blood sugar levels and even get their levels down back into the prediabetes range from type 2 or from prediabetes into the ‘normal’ range.

I will help you learn about the different symptoms associated with diabetes and help you understand what you can do to help yourself if you find yourself struggling with any of them.

If you already know the difference between the different types of diabetes then you can click here to skip to the what are the main diabetes symptoms section.

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What Are The Different Types Of Diabetes?

Type 1 Diabetes

Type 1 diabetes is often known as juvenile diabetes. The type of diabetes that starts early on in life, in childhood, and that’s because there is often a genetic predisposition involved. However, it can still present at any age, but it is more likely in under 18’s. Type 1 diabetes is an autoimmune condition and occurs when your body attacks the cells in your pancreas stopping it from producing any insulin. The insulin is required to balance out the glucose within the blood as it allows the glucose to enter the cells within the body to be used as fuel for energy, any extra glucose is stored by the liver and even  muscles for a later date but when these become full there in more glucose available in our bloodstream.  Type 1 diabetics therefore suffer from a severe lack of insulin, which is quite different to type 2. With the lack of insulin, that is why the treatment for type 1 diabetes is replacing the missing insulin, often through injections.

Type 2 Diabetes

Type 2 diabetes is regularly referred to as adult onset diabetes. Historically, that has been true and it did only tend to affect the adult population, however, sadly the occurrence of type 2 diabetes within children is on the increase, and rapidly. Type 2 diabetes is the most common form of diabetes accounting for 90-95% of cases worldwide. It occurs due to something called insulin resistance. So whereas in type 1 diabetes the body doesn’t produce enough insulin at all, in type 2 the body becomes resistant to the insulin that is produced, which is often at quite a high level. This insulin resistance means that body no longer responds to the insulin and the blood glucose levels no longer remain at normal levels, which causes more insulin to be secreted, but as the body doesn’t react the blood glucose levels rise which lead to type 2 diabetes.

Click here to learn more about type 2 diabetes

Gestational Diabetes

Gestational diabetes is the type of diabetes that develops during pregnancy. It is still high level of blood sugar levels (or blood glucose) that lead to diagnosis and it can occur at any stage of pregnancy but is most common in the 2nd or 3rd trimesters. The main difference with gestational diabetes is that it can often be temporary and often disappears after childbirth. It can however increase the risk of developing type 2 diabetes in the future. If the high blood glucose levels remain after childbirth then it will generally be reclassified as type 1 or type 2 diabetes.

What is Prediabetes?

Finally, there is prediabetes with is where blood glucose levels are higher than normal but not yet high enough to be diagnosed with type 2 diabetes. If you have prediabetes then you are at a higher risk of developing type 2 diabetes, especially as many people are unaware they have it. You often don’t get any symptoms with prediabetes but will be told by a nurse or GP after having some blood tests done.  You can always request blood tests to be done by your GP if you are concerned that you may have or may be at risk of prediabetes.

You may however, be starting to show some of the symptoms associated with high blood glucose levels whilst in the prediabetes range and so if you have any of these you should definitely speak to your GP and arrange a blood test to be done.

The blood test that is most commonly done is one testing for something called HbA1c. This is your average blood glucose levels for around the last 3 months. Your target is to be below 42mmol/mol if you think you are at risk of type 2 diabetes.

Learn more about prediabetes here

The rest of the information on this page will only relate to type 2 diabetes and prediabetes.

What Are The Main Diabetes Symptoms?

Just because you might have some the diabetes symptoms below, it doesn’t necessarily mean you have diabetes but it is definitely worth getting in touch with your doctor to arrange for tests to be done to investigate the cause.

Some of the more classic signs and symptoms of diabetes (all types) include the following:

  • Weeing more often (scientifically known as polyuria) – Often noticed by people at night when they excrete larger amounts of urine. This happens when your body is trying to lower your blood sugar levels by flushing out extra sugar. This often leads to some of the other symptoms.
  • Thirsty – much thirstier than usual and often not quenched by drinking
  • Hunger – increasing hunger despite eating normally
  • Genital itching or thrush – this can happen because your urine contains a lot of sugar and can create a great environment for fungal infections to thrive.
  • Tiredness and fatigue – this can happen because the sugar can’t get into your cells to be converted into energy

Other symptoms also include:

  • Dry mouth
  • Itchy Skin
  • Blurred vision
  • Fatigue
  • Poor wound healing
  • Periodontal disease
  • Frequent infections
  • Slow wound healing

In type 2 diabetes, as the disease progresses weight gain, especially around the middle is often seen, whereas with type 1 diabetes weight loss is more common.

In type 1 diabetes the symptoms can come on really quickly and will be more obvious often appearing in a few days or weeks, whereas for type 2 diabetes it can take a lot longer for symptoms to develop often over many years. Some people may not even have any noticeable symptoms which is why many people can live with type 2 diabetes without even knowing they have it for years.

If you do notice any of these symptoms then you should contact your doctor or heath professional.

Further Complications or Symptoms of Diabetes

There are also a number of other factors which can result as a complication of diabetes. If the diabetes is currently undiagnosed then these can be classed as signs and symptoms of diabetes which will definitely need to be investigated further by your GP or health professional. The longer the diabetes goes undiagnosed or any increase in the severity of the condition can increase the chance of these long term complications which is why it is key to see your doctor or medical professional as soon as you have any symptoms or believe you may be at risk of developing diabetes.

Some of the long term complications include:

Cardiovascular Disease

Diabetes is sadly known to increase the death rates from cardiovascular disease with adults suffering from diabetes between two and four times more likely to die from cardiovascular disease than those without. Diabetes increases the risk of blood vessel abnormalities and these can still occur when the disease is being controlled. These abnormalities in the large blood vessels can lead to heart disease, strokes and peripheral vascular disease. The abnormalities in the small blood vessels is linked with:

  • Peripheral vascular disease – which can progress to gangrene and ‘diabetic foot’
  • Visual impairments (including diabetic retinopathy)
  • Kidney disease
  • Peripheral neuropathy (impacting nerves and sensation) which is where there may be sensory impairment and muscle weakness
diabetes and heart disease

Find out more about Diabetes and Your Heart from The British Heart Foundation

Gum Disease (Periodontal disease)

Gum disease can be a common occurrence with people that have diabetes and it can range in severity. Around one third of people with diabetes suffer from severe gum disease.

To understand more about gum disease I recommend starting here:

Infections

Diabetes can increase the risk of infection from bacteria and fungus which is why thrush or genital itching can be an early sign. Other infections caused can be boils and carbuncles, diabetic foot and kidney infections.

High Blood Pressure

High blood pressure, also know as hypertension occurs in around three quarters of those diagnosed with diabetes.

If you would like natural support with your blood pressure then get in touch with Helen

Eye Problems - Retinopathy

Diabetes is the leading reason for blindness among adults. Diabetes can also increase the risk of developing cataracts at an earlier age as well as other vision problems.

If you would like nutritional support for your diabetes then find out more about 121 consultations with Helen here.

Kidney Disease

Diabetes is a leading cause of kidney disease within adults requiring dialysis treatment and diabetes sufferers account for around 43% of all newly diagnosed kidney disease patients.

Depression

Clinical depression can start before diabetes might have even be diagnosed and is a common accompanying condition.

For more information and help with depression visit Mind

Autoimmune Conditions

Conditions of the immune system, where the body attacks itself can often develop in diabetes patients with thyroid disorders and inflammatory arthritis being common examples.

Pain

Many diabetes sufferers also struggle with chronic pain associated with the likes of, arthritis fibromyalgia, neuropathy and circulatory problems.

Diabetic Foot

This is a serious condition that often develops as a result of a number of factors involved with diabetes. The blood vessel abnormalities mentioned earlier can impair blood supply to the bodies extremities including the feet.  There is also reduced sensation in the feet when someone has diabetic neuropathy and so small cuts and injuries may not even be noticed, especially when coupled with visual impairment. Diabetes is known to make wound healing a lot slower and so these cuts and injuries can often get worse by being aggravated through shoes rubbing against them and then leading to infection. In extreme cases ulcers can form and may never actually heal which can cause them to enlarge and become gangrenous, and in some cases lead to amputation being required. You can find out more about how to perform your own foot checks here.

Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is something that people often associate with type 2 diabetes, however, there is little evidence to say diabetes causes a fatty liver but there is research to suggest a correlation between the two, as most people with non-alcoholic fatty liver disease are overweight or obese, something also seen in many type 2 diabetes of prediabetes patients.

People can have non-alcoholic fatty liver disease without having type 2 diabetes. A lot of people with NAFLD often have no or very few symptoms. The most common symptoms that patients talk about are fatigue, general malaise and a dull achey pain in the upper right part of the abdomen.

Non-alcoholic fatty liver disease is actually a cause of fatty liver. These two things are distinguishable and not quite the same as fatty liver can have other causes as well such as excessive alcohol consumption.

Fatty liver as a result of non-alcoholic fatty liver disease occurs, as the name suggests, when fat is deposited in the liver. There are several stages and ranges in severity associated with it going from a mild impairment of the functioning of the liver through to a type of inflammation of the liver which is called nonalcoholic steatohepatitis (or NASH) and this can then sometimes progress to cirrhosis of the liver and end-stage liver disease. Other factors that can play a role in liver impairment and the advancement to nonalcoholic steatohepatitis (NASH) include nutritional deficiencies and abnormalities, drugs and exposure to toxins.

The depositing of fat in the liver is closely associated with obesity, with statistics like 70% of people that have a bodyweight of 10% or more above their ideal body weight and nearly 100% of people classified as obese having a fatty liver.

The link between NAFLD and type 2 diabetes is because there is a link between NAFLD and insulin resistance which can sometimes be evident through obesity, diagnosis of type 2 diabetes or raised levels of blood triglycerides.

For dietary and lifestyle support with your diabetes and associated symptoms 

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Causes of Type 2 Diabetes

The main risk factor for type 2 diabetes is obesity. To be more specific though, it is excess body fat that is the major risk as obese is classified as anyone with a BMI (Body Mass Index) over 30, but there are also a number of variable that can also impact that such as height and muscle mass. Currently there are around 90% of adults with type 2 diabetes that are classed as obese or overweight.

When there is so much fat in the fat cells in the body and mainly around the abdomen, these cells then release hormones or messages that can reduce the impact of insulin, reduce the ability of glucose to be used by the muscles in the body, increase glucose production by the liver, and impact and reduce the level of insulin produced by the pancreas. There are also other body mechanisms that are impacted by the increased number and size of fat cells which all cumulatively stress the bodies blood glucose regulation mechanisms and can also lead to the other conditions linked to complication of insulin resistance and type 2 diabetes that we’ve already mentioned such as cardiovascular disease.

At the early stages of this metabolic stress there may be limited or no symptoms and blood glucose levels can actually appear normal because the pancreas is compensating for the increase in insulin resistance by producing more insulin. As this metabolic stress progresses and increases the insulin resistance increases and the pancreas isn’t able to compensate anymore and that’s when the rise in blood glucose levels happens.

Risk Factors For Prediabetes and Type 2 Diabetes

There are a number of key risk factors associated prediabetes and progression to type 2 diabetes and these include:

  • Family history and genetics
  • Obesity
  • Increased fat around the middle, and increased waist to hip ratio
  • Age (there is an associated risk with increasing age starting from around 45)
  • Race and ethnicity
  • History of gestational diabetes

Genetics

There is a fair amount of evidence to suggest there is a genetic factor involved in the occurrence of type 2 diabetes with some research showing that children with one parent who has type 2 diabetes have an increases risk of developing diabetes themselves and if both parents have it the risk is up to 40% that the child will develop it at some point in their lifetime. However, despite this being the case and the strong predisposition associated with it there is some argument that in some cases it is still the environment, dietary and lifestyle factors that the child is exposed to that can influence their chances or developing diabetes later on, and in the majority of cases, type 2 diabetes can be avoided.

Race and Ethnicity

There are some racial and ethnic groups that do appear to have a greater predisposition to developing type 2 diabetes. Groups which have a higher tendency to develop type 2 diabetes include Black African, African Caribbean and South Asian (Indian, Pakistani and Bangladeshi). It’s not exactly know why this happens and with South Asian populations there is a greater risk of diabetes occurring at a much younger age and is possibly linked to where the fat is deposited and stored round the middle of the body. Similarly with People Black African, African Caribbean, all these groups of people have an increased risk of developing type 2 diabetes from a much earlier age. Whereas for the white population the risk increases from the age of 40, in these other population groups the risk actually starts to increase from the age of 25.  There is still a lot that is now known as to why this is and more research is being conducted to understand these correlations but changes to diet and lifestyle can still often lower the risk.

Diets High in Refined Carbohydrates

Dietary and lifestyle factors are known to be the biggest contributors to the development of type 2 diabetes and also through implementing often simple changes have the best chance of lowering the risk of the disease developing in the first place.

In a large American study it was found that 62% of people with diabetes ate less than 5 portions of fruit and vegetables a day, 65% got more than a third of their daily calories from fat (and more than 10% of all calories from saturated fat) and 82% were overweight or obese.

Dietary carbohydrates are often discussed in great length at all stages of the type 2 diabetes journey from prevention through to treatment and are known to be a major factor in the cause of the onset of type 2 diabetes in many people.  Refined carbohydrates which are the ones stripped of their natural fibres and are far more processed such as white breads and pasta, pastries and cakes and sugars play a huge role in the modern western diet.  This modern western diet is full of processed foods, poor quality fats (more saturated fats than unsaturated) and very little fibre and it is this standard diet that so many people live on that is thought to be such a big contributor to prediabetes, type 2 diabetes and other chronic health conditions such as heart disease.

Lifestyle and Exercise

One study in America found that 69% of people with type 2 diabetes did not exercise at all or did not engage in any regular exercise. Lifestyle changes alone have also been shown to reduce the risk of developing diabetes by 58%. A sedentary lifestyle with little or no exercise can often lead to being overweight and therefore increases the risk of developing prediabetes and type 2 diabetes.

How Is Type 2 Diabetes Diagnosed

Type 2 diabetes is generally diagnosed through blood tests. Quite often with type 2 diabetes, the blood tests done aren’t necessarily arranged to look at diabetes specifically but it often gets picked up as a result of other investigations for something else. This diagnosis can therefore often come as a bit of a surprise to people.

However,  the only way to confirm a diagnosis of type 2 diabetes is through a blood test, symptoms alone will not be enough to confirm diabetes. So if you have gone to the doctor with symptoms such as weeing more often and excessive thirst then they will likely conduct one or more of a number of possible blood tests to diagnose the condition.

The tests can come back telling you don’t have diabetes now but they can also highlight your potential risk of developing type 2 diabetes. The doctors will decide which of the below tests will be best for you dependent on your symptoms and consultation. They are fairly standard blood tests but some may need you to fast for a certain period of time beforehand, but your GP or medical professional will tell you everything you need to know.

For more information about Diabetes diagnosis visit the NHS website.

Different Blood Tests Used

HbA1c

This is the most common test used by doctors to diagnose type 2 diabetes. This works by looking at your average blood sugar levels over the last 2-3 months.  This test is often then used to continue to monitor your condition. It is only conducted every 3 months as blood cells only last in the body this long and so you need to wait for the current blood cells to be replenished to understand the progress.

HbA1c tests aren’t normally used to diagnose type 1 diabetes but they can be when they are used alongside other tests. They are also not used to test for gestational diabetes.

The guidelines as suggested by The World Health Organisation (WHO) are:

  • HbA1c levels below 42 mmol/mol (6.0%) mean you do not have diabetes
  • HbA1c levels between 42 and 47 mmol/mol (6.0-6.4%) mean you have prediabetes
  • HbA1c levels of 48mmol/mol (6.5%) or above mean you have type 2 diabetes

You can see your results displayed in either mmol/mol or the percentage but in the UK it is generally more common to see them written as mmol/mol.

Fasting Blood Sugar Test

This can also be known as a fasting plasma glucose (FPG) test or a fasting glucose test (FGT) and is another form of blood test. This requires fasting for 8 hours before hand meaning no food or drink except water as foods will interfere with the results. These tests are generally done in the morning so that the majority of your fast is completed overnight.

For this test the results that will determine if you have type 2 diabetes are:

  • Below 5.5mmol/l means your levels are normal
  • Between 5.5 and 6.9mmol/l means you are in the prediabetes range with impaired fasting glucose
  • 7mmol/l or above means you have diabetes

Glucose Tolerance Test

The glucose tolerance test (GTT) can also be known as the oral glucose tolerance test (OGTT). This test is used to see how your body handles the sugar (glucose) it receives from food.

There are 2 parts to this test. The first part is a fasting glucose test blood test (mentioned above) and the second part involves having a sweet sugar based drink with a standard amount of sugar in it and then another blood test 2 hours later so you get two different readings for the different glucose levels before and after the sweet drink which helps doctors understand how your body copes with the intake of sugar.

For people with normal levels and without diabetes the results would be:

  • 1st (Fasting) test: under 6mmol/l
  • 2nd (after 2 hours): under 7.8mmol/l

For people with prediabetes or impaired glucose tolerance the results would be:

  • 1st (Fasting) test: between 6mmol/l and 7.0mmol/l
  • 2nd (after 2 hours): between 7.9mmol/l and 11.0mmol/l

For people with diabetes the results would be:

  • 1st (Fasting) test: over 7.0mmol/l
  • 2nd (after 2 hours): over 11.0mmol/l

This is the most common test used for gestational diabetes.

Other Tests Associated With Diabetes

Urine tests – used to determine whether there is any glucose in your urine. This can give doctors an indication but can’t be used to diagnose diabetes alone as it isn’t able to tell how much sugar is in your urine or why.

Eye tests – Opticians are able to identify damage to the eyes associated with diabetes. This will not lead to a diagnosis but they will be able to advice you to visit your GP to get tested. Regular eye tests are also an important part of living with diabetes.

At home testing – You can buy glucose monitors from most pharmacies and other retailers. These are generally used by people already diagnosed with diabetes to monitor their blood sugar levels and keep track of their condition. These tests cannot be used to diagnose diabetes as they only ever show your blood glucose level at that moment in time.

Everyone in the UK aged between 40 and 74 is entitled to have an NHS Health Check. This health check is used to looks out for the presence of, or can highlight the risk of, certain diseases such as hear disease, stroke, kidney disease and type 2 diabetes. So this would be a good place to start if you haven’t had one yet and fall within this age range. However, do not wait for one of these tests if you have any concerns or symptoms at all then contact your GP to discuss and for them to arrange any tests that might be necessary.

Everything you’ve read here is for general information and in no way is meant to replace any advice you receive from a medical professional. If you have any concerns at all about yourself or a loved one and want to know more about diabetes then you should always contact your GP or medical professional.

For more information and support on living with diabetes, whether Type 1, Type 2 or your have prediabetes or are worried about your risks or a family member then visit Diabetes UK for lots more help and advice.

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Most Common Questions About Diabetes Symptoms

These are the 10 most most common questions I get asked about diabetes symptoms.  As we’ve seen above there are many symptoms associated with diabetes and that’s why people are often unsure whether what they’re feeling has anything to do with diabetes or not. So these are some of the more common questions about diabetes symptoms outside of the more obvious of thirst, increased urination, and hunger.

Is nausea a symptom of diabetes?

Nearly everyone will feel sick or have nausea at some point in their life. For those with diabetes in can be hard to know if this is related to their diabetes or if it is something else completely. Nausea can be associated with both type 1 and type 2 diabetes and can be a result of a number of different reasons such as high or low blood sugar levels, low blood pressure and quite often medication such as Metformin have nausea as a side affect.

If you are suffering from nausea and are concerned in any way then you should always consult your GP or medical practitioner to understand the cause and receive any appropriate treatment.

Are headaches a symptom of diabetes?

Headaches can be associated with diabetes, especially if you are newly diagnosed because it can mean that the blood sugar levels aren’t under control and the highs and lows from either hyperglycaemia or hypoglycaemia can trigger a headache. If you’ve had diabetes for a while then you could also get headaches when changes in blood sugar occur.

If you have recently started getting headaches and you haven’t had them investigated by a medical practitioner then you should seek medical advice to understand why you are getting them.

Can leg pain be a symptom of diabetes?

With diabetes leg pain can occur as a result of diabetic neuropathy which is caused by damage to the nerves from high blood sugar. Leg pain can be a symptom of neuropathy if you have diabetes and other symptoms of neuropathy include numbness, tingling and burning feelings.

You should always consult your doctor if you start getting any symptoms of neuropathy.

Is sweating a symptom of diabetes?

Sweating can be a result of a number of conditions. Women in particular may struggle with sweating in relation to hot flushes and night sweats as a consequence of menopause or their reproductive cycle. Sweating can also be caused by the fluctuations in blood sugar levels and is often a symptom people with diabetes have but overlook. With diabetes there can be different causes of the sweating and so you should speak to your GP or medical practitioner to understand the underlying cause.

Is brain fog a symptom of diabetes?

Brain fog can happen as a result of fluctuating blood sugar levels. As the brain main source of energy is glucose, changes in its supply to the brain can cause brain fog and problems concentrating. Brain fog can also occur if you have not consumed enough water. Similar to a number of these symptoms, brain fog can also be a result of many other conditions and for women is a main symptom of menopause.

If you care concerned about your brain fog and concentration then you should consult your GP.

Are heart palpitations a symptom of diabetes?

There can often be a link between diabetes or the regulation of blood sugar levels and heart palpitations. People may get palpitations when blood sugar levels drop or if they eat a meal high in sugar or carbohydrates while glucose levels are low. There can also be some more serious complications and links between heart palpitations and diabetes so you should always get these investigated by your doctor quickly.

Is dry mouth a symptom of diabetes?

For people with diabetes dry mouth can be a very common symptom. As well as being a main symptom it can sometimes be a side effect of medication. Other reasons for getting dry mouth with diabetes can be dehydration, elevated blood sugar levels, or possible kidney conditions.

If you struggle with dry mouth then you should talk to your GP to understand what can be done to support the underlying condition or discuss the medication.

Is feeling dizzy and lightheaded a symptom of diabetes?

Dizziness can be a symptom of diabetes but also of many other conditions and so should always be investigated by a medical professional.  With diabetes the main reasons for spells of dizziness can include low blood pressure, low blood sugar levels and dehydration.

Always consult your doctor if you are concerned about any of your symptoms

Is having the shakes a symptom of diabetes?

Shaking can be symptom of hypoglycaemia (low blood sugar levels) which mainly affects people with diabetes. Other symptoms of hypoglycaemia include sweating, tiredness, dizziness and hunger. People living with diabetes may know what to do when this comes on but if you are not diagnosed, this is a new symptom for you or you are concerned then you should book an appointment with you GP to understand the underlying causes.

Are UTI’s a symptom of diabetes?

People with diabetes can be more prone to getting UTI’s (urinary tract infections) or bladder problems. UTI’s are generally a bacterial infection and can happen more in people with diabetes because the high sugar levels which then lead to sugar in the urine can create a great environment for bacteria to grow.

Always contact your doctor or medical professional for help with UTI’s to understand what medication you may need.

How I Can Help You

If you are looking to understand how you can balance your blood sugar levels and support your prediabetes or type 2 diabetes then I am here to help you.

Whatever your budget, I have the support for you.

  • You can join my FREE Facebook community to receive hints, tips, recipes and more on how to balance blood sugars for a healthier and happier life 
  • Join one of my 6 week blood sugar balancing online groups. These involve weekly calls, resources, education, Q&As and all the support you need to get you on track for balancing your blood sugar levels through diet and lifestyle changes and creating new healthier habits.

Get in touch to find out more details and when the next group will be being run

  • If you want more personalised support and 121 guidance then one of my consultation packages will be best for you. You get 121 support, personalised dietary and lifestyle plans, resources and handouts to inspire you and accountability based on the level you require.

Please get in touch to find out more or take a look at the different packages on offer on my consultations page here