Overview
is a hormone that lets glucose (sugar) move out of the blood and into the cells, where it is used for energy. In type 2 diabetes the body does not respond to insulin properly, and over time it may not make enough of it either. Glucose then builds up in the blood.
It usually develops slowly, over years, and many people are diagnosed from a routine blood test rather than because they felt unwell.
Symptoms
Symptoms come on gradually and may be mild, and some people have none:
- Feeling very thirsty
- Passing urine more often, especially at night
- Feeling tired or weak
- Losing weight without trying
- Blurred vision
- Cuts and sores that heal slowly
- Numbness or tingling in the hands or feet
When to see a doctor
Book an appointment if you have the symptoms above, if a foot sore is not healing, or if home readings stay above the range your doctor set. Diabetes often causes no symptoms, so ask about a blood test if there is diabetes in the family or if you are overweight or inactive.
Causes
The central problem is : muscle, fat and liver cells stop responding well to . The pancreas makes more insulin to keep up, and after some years it can no longer produce enough.
Carrying extra weight, especially around the middle, and being inactive make insulin resistance more likely. Genes also play a large part, which is why it often runs in families.
Risk factors
- Being overweight, particularly around the waist
- Little physical activity
- A parent, brother or sister with diabetes
- Being aged 45 or older
- South Asian background
- Prediabetes, or diabetes during a past pregnancy
- High or abnormal
Complications
Blood sugar that stays high over years damages blood vessels and nerves, which can lead to:
- Eye damage, including diabetic retinopathy and loss of sight
- Kidney disease
- Nerve damage, with pain, tingling or numbness
- Foot ulcers and infections, which can become serious
- Heart disease and stroke
Prevention
The same steps that lower the risk also help after diagnosis:
- Reaching and keeping a healthy weight
- Being physically active on most days
- Eating more vegetables, pulses and whole grains, and fewer sugary drinks and fried foods
- Not smoking or chewing tobacco
- Having blood sugar checked if you are at higher risk
Diagnosis
Diabetes is diagnosed with a blood test. Doctors may use:
- , which shows the average blood sugar over about three months
- Fasting blood glucose, taken after not eating for several hours
- A random blood glucose test, taken at any time
After diagnosis, , , kidney tests, an eye check and a foot check become part of regular care.
Treatment
Treatment starts with changes to eating and activity, and with monitoring blood sugar. For many people that is combined with medicines. Metformin is usually the first tablet used. Other tablets and injectable medicines work in different ways, and some also help with weight.
is used when other treatments no longer keep blood sugar in range, and sometimes for a limited period, such as during pregnancy or a stay in hospital. Some medicines, including insulin, can cause low blood sugar, so knowing the warning signs matters.
Treating and is part of diabetes care, because it lowers the risk of heart disease and stroke.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Diabetes is caused by eating too much sugar.”What is true?
Fact
Type 2 diabetes develops when the body stops using insulin properly. Carrying extra weight, being inactive, older age and a family history of diabetes all raise the risk. Sugary food and drink add calories and help weight creep up, so cutting back does help, but sugar on its own is not the cause.
Myth“If I feel fine, my sugar cannot be a problem.”What is true?
Fact
Many people with type 2 diabetes have mild symptoms or none at all, which is why it is often found on a blood test. Meanwhile high blood sugar quietly damages the eyes, kidneys, nerves and blood vessels, so treatment and check ups continue even when you feel well.
Myth“Starting insulin means the diabetes has reached its last stage, and once you start you can never stop.”What is true?
Fact
Insulin is the same hormone the body already makes. It is one of several treatments, used when eating changes, activity and tablets are no longer enough to bring blood sugar into range. Treatment is reviewed over time. What harms the body is blood sugar that stays high, not the treatment that brings it down.
Myth“Diabetes medicines damage the kidneys.”What is true?
Fact
It is long standing high blood sugar that damages the kidneys, and kidney disease is one of the main complications of diabetes. Medicines are given to prevent that damage. Kidney blood and urine tests are part of routine diabetes care, so any change is picked up early.
Myth“Herbal remedies and supplements can replace diabetes medicines.”What is true?
Fact
For most supplements there is no good evidence of benefit in diabetes, and health authorities warn against products sold as a natural cure. Some can even harm the kidneys or interfere with diabetes medicines. Stopping prescribed treatment leaves blood sugar high and raises the risk of long term damage.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Can type 2 diabetes be cured?
There is no cure. It is a long term condition that is managed rather than cured. Some people bring blood sugar back into the normal range with weight loss and changes to eating and activity, and may need fewer medicines, but the tendency remains and regular checks are still needed.
Do I have to give up rice and sweets completely?
No single food is banned. What matters is the overall pattern: portion sizes, how often sugary foods and drinks appear, and eating more vegetables, pulses and whole grains. A dietitian can help build a plan around the food your family already cooks.
What should I do if I feel shaky, sweaty and confused?
These can be signs of low blood sugar, which some diabetes medicines can cause. Take a sugary drink or glucose straight away and then something starchy, and tell your doctor so the treatment can be reviewed. If the person cannot swallow safely, is having a fit or is unconscious, call for emergency help.
Is diabetes in pregnancy the same thing?
Diabetes that appears during pregnancy is called gestational diabetes and usually settles after the baby is born. It does raise the chance of type 2 diabetes later, so blood sugar should be checked again after pregnancy and from time to time afterwards.
