Type 2 diabetes is one of the most common chronic condition in the UK, affecting 4.6 million people – and that number is rising every year. While it has historically affected older adults, it’s now being seen more often in younger people and even children, largely due to changes in diet, physical activity, and obesity rates.

The good news? With the right support, it’s possible to live well with diabetes – staying healthy, active, and even achieving remission in some cases. This guide explores what type 2 diabetes is, how it’s diagnosed and treated, and the tools available to help you take control of your health.

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Contents

1. What Is Type 2 Diabetes, and Why Do So Many People have It?
2. What Are The Symptoms of Type 2 Diabetes?
3. How Is Type 2 Diabetes Diagnosed?
4. Can Medication Help?
5. Holistic Diabetes Management
   • Nutrition for Blood Sugar Balance – The Low GI Diet
   • Education and Support
   • Exercise and Movement
   • Stress Management
6. Sick-Day Rules
7. Complications of Type 2 Diabetes
8. Can Type 2 Diabetes Be Reversed?
9. In Summary

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DISCLAIMER:

While I am a practising doctor, the information on this site is for educational purposes only. It does not take into account your personal circumstances, which can significantly affect medical decision-making and treatment. This content therefore does not constitute medical advice, and should not be relied upon for diagnosis or treatment. Always consult a qualified healthcare provider regarding any health concerns.

This article was written on the 06/10/2025 using up-to-date sources at that time. Please be aware that medical information and guidelines change often.

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What Is Type 2 Diabetes, and Why Do So Many People have It?

In type 2 diabetes, your body does not produce enough of the hormone insulin, or your body doesn’t respond to insulin as it should (your body becomes insulin resistant). Your body needs insulin to use glucose (sugar) from the foods you eat, as your cells rely on glucose as fuel.

Insulin is made by the pancreas, a small organ behind your stomach. When insulin isn’t working properly or there isn’t enough, glucose builds up in the blood instead of being used by your cells.

This means that the levels of sugar in your blood become too high. A high blood sugar level can damage your heart, kidneys, nerves, and blood vessels.

Type 2 diabetes is different from type 1 diabetes, and 90% of people with diabetes have type 2. Type 1 is an autoimmune condition where the body cannot make insulin at all. Type 2 usually develops later in life and is often linked to lifestyle factors, genetics, and being overweight, although it can also affect people of a healthy weight.

It is far more common than type 1 diabetes, and rates have risen worldwide due to changes in diet, physical activity, and population ageing.

What Are The Symptoms of Type 2 Diabetes?

A lot of people with type 2 diabetes don’t have any symptoms, or don’t notice them. These are some of the common symptoms and signs:

How Is It Diagnosed?

There are a few ways your doctor can test for diabetes. These blood tests can show that your glucose levels are persistently raised (persistent hyperglycaemia), which can suggest diabetes:

1. HbA1c blood test – this gives an average blood sugar over the last 2-3 months.
   • 48 mmol/mol (6.5%) or higher cam suggest diabetes.
2. Fasting blood sugar – this measures your blood sugar after not eating for 8-10 hours.
   • 7.0 mmol/L or higher can suggest diabetes.
3. Random blood sugar – this is a check at any time, not necessarily fasting.
   • 11.1 mmol/L or higher can suggest diabetes.

If a diagnosis is suspected in a child or young person, they will be referred that day for assessment by a specialist paediatric diabetes team.

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Quick note: The HbA1c blood test is very useful for diagnosing diabetes in most adults, but it isn’t perfect for everyone, as there are a number of things that affect the result.

It shouldn’t be used alone for children, pregnant women, people who are on certain medications (like steroids), or anyone who has conditions affecting their blood or red blood cells, to name a few. In these situations, your doctor may use other tests to make sure the diagnosis is accurate.

Can Medication Help Type 2 Diabetes?

Absolutely, but it’s only part of a much bigger picture.

For people with type 2 diabetes, the goal of treatment is to keep blood sugar levels within a safe range to reduce the risk of long-term complications. This usually involves a combination of lifestyle changes and medication, tailored to each person’s age, health, and preferences.

Sometimes, people can manage their diabetes with lifestyle changes alone.

If medication is needed, most people start with metformin, which helps the body use insulin more effectively and reduces the amount of sugar your liver releases into the body.

The dose is gradually increased to reduce side effects like stomach upset, and if metformin isn’t tolerated, it may be switched to a slower acting form (modified-release) or a different medication altogether.

If blood sugar targets aren’t reached, doctors may add a second medication. Options include:

• Sulfonylureas (e.g., Gliclazide) – help your body make more insulin but can sometimes cause low blood sugar (hypoglycaemia).

• SGLT-2 inhibitors (e.g., Empagliflozin) – help lower blood sugar by helping your kidneys remove excess sugar in your urine. They may also slow kidney disease and reduce risk of heart problems. Side effects include urinary infections, and rarely, diabetic ketoacidosis or Fournier’s gangrene.

• DPP-4 inhibitors (e.g., Sitagliptin) – block an enzyme that breaks down incretins, which increases insulin and lowers blood sugar. Side effects include diarrhoea, nausea, vomiting, and headaches.

• Thiazolidinediones (e.g., Pioglitazone) – help your body respond better to the insulin it makes. Side effects include leg swelling, higher fracture risk, and a small increased risk of bladder cancer.

• GLP-1 receptor agonists (e.g., Tirzepatide/”Mounjaro”) – may also support weight loss and are used if other medications aren’t enough. Side effects include reduced appetite, nausea, diarrhoea, and constipation.

If two or three medications aren’t enough to control blood sugar, insulin therapy may be considered. Some medications may need dose adjustments or careful monitoring if combined, especially insulin or sulfonylureas, to reduce the risk of hypoglycaemia.

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Quick tip: Understanding HbA1c targets

48 mmol/mol (6.5%) – This is usually the target for people managing type 2 diabetes with lifestyle changes alone, or with lifestyle plus a medication that doesn’t cause low blood sugar (like metformin).

53 mmol/mol (7.0%) – This is often used if you take medications that can cause low blood sugar (like sulfonylureas).

Holistic Type 2 Diabetes Management

Nutrition for Blood Sugar Balance – The Low GI Diet

When it comes to managing diabetes, diet is key. This is because carbohydrates are broken down into sugars. One tool that can help is the glycaemic index (GI).

What is The Glycaemic Index?

The GI measures how quickly a carbohydrate-containing food raises your blood sugar.

Foods are ranked from 0–100:

• Low GI (55 or below): More slowly digested, so raises blood sugar slowly
  • Examples = tomatoes, spinach, lentils, peas, strawberries, pears.
• Medium GI (56-69): Raises blood sugar moderately
  • Examples = pineapple, new potatoes, basmati rice, sweet potato, couscous.
• High GI (70+): More quickly digested, so raises blood sugar quickly
  • Examples = white bread, bakery items like doughnuts, fizzy drinks, sweets.

Low GI foods help keep blood sugar steadier after meals, which can improve long-term control (HbA1c) in type 2 diabetes. You can use this website to search the GI status of different foods.

GI values are a useful guide, but focusing only on GI can lead to an unbalanced diet that’s higher in fat and calories. This can make weight management harder and increase heart disease risk. Also, not all low GI foods are “healthy” – most chocolates tend to have a low-medium GI due to their fat content (which slows down the absorption of sugars). So this means we can’t just eat chocolate… Sadly…

The key is everything in balance. NICE clinical guidelines advise a diet that is:

• Is high in fibre.
• Includes low-fat dairy products.
• Contains low GI sources of carbohydrates over high GI sources.
• Includes 2 portions of oily fish a week.
• Limits trans and saturated fat intake e.g. through processed foods, and foods with a high salt content.

Read more here: A Healthy Balanced Diet with Diabetes – Diabetes UK

Education and Support

Your GP can refer you to a structured diabetes education program, which will help you and your family understand your diagnosis. For example:

• DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed) – a course that usually runs over a couple of weeks, that helps you learn more about how you can self-manage your diabetes.
• NHS Type 2 Diabetes Path to Remission Programme – a 3 month weight-loss programme to help people lower their blood sugar levels and lose weight, and in just under 50%, remission within 12 months.

More information and support:

• Diabetes UK offers support, advice, and a confidential helpline for anyone affected by diabetes: 0345 123 2399.
• NHS website signposts to various resources you may find useful.

Exercise and Movement

Exercise can help lower your blood sugar levels, because glucose is needed for energy when you workout.

Aim to move regularly throughout the day, break up long periods of sitting, and choose activities you enjoy – whether that’s walking, swimming, cycling, or dancing.

If you are on insulin or blood sugar-lowering medications, check blood sugar before and after exercise and have fast-acting carbs handy in case of hypoglycaemia (where your sugars drop). Here is some more guidance on managing blood sugar levels when exercising from Diabetes UK.

Stress Management

If you’re feeling stressed, your body releases stress hormones like cortisol and adrenaline as part of the “fight or flight” response. Both of these hormones increase our blood sugar levels.

Simple strategies can help, like deep breathing, mindfulness, gentle exercise, or even short walks. Staying connected with family, friends, or support groups can also improve your mood and reduce stress.

If stress, low mood, or anxiety feels overwhelming, talk to your GP, support is available – managing your mental health is an important part of controlling diabetes.

Alcohol and Smoking

Alcohol can make low blood sugar (hypoglycaemia) harder to notice and may cause delayed episodes hours later.

It’s always a good idea to eat a carbohydrate-rich snack before and after drinking, and to stick to the recommended alcohol limits. It’s also important to carry diabetes identification, like a medic alert bracelet, in case you become unwell when you’re drinking.

Smoking increases your risk of cardiovascular disease (as does type 2 diabetes). It is therefore important to try and stop smoking if you currently do. Click here to learn more about how smoking cessation services can help you today.

Sick-Day Rules

If you have type 2 diabetes and get sick, your blood sugar can become harder to control.

Being unwell may increase your blood sugar even if you eat less, and it can put you at risk of serious complications like:

• Diabetic ketoacidosis (DKA), where your body produces ketones (which can build up in the blood and make it more acidic), or;
• Hyperosmolar hyperglycaemic state (HHS), where blood sugar becomes extremely high and you become very dehydrated.

Both are medical emergencies and need hospital care.

Most people can manage minor illnesses at home by following simple “sick-day rules”:

• Speak to your diabetes team, doctor, or pharmacist about your anti-diabetic medications, and whether you should continue taking them or stop them temporarily.
  • You may need to pause medications like metformin or GLP-1 receptor agonists if there’s a risk of dehydration.
  • You may need to pause sulfonylureas if your appetite is low, to reduce the risk of low blood sugar (hypoglycaemia).
  • You may need to check your ketones or pause an SGLT-2 inhibitor due to the risk of DKA. Always contact your healthcare team first.
  • Never stop insulin if you are unwell. You may need to adjust the dose – speak to your specialist diabetes team straight away.

• Try to eat and drink as normally as possible. If you can’t manage solid food, replace meals with carbohydrate-containing drinks like milk, milkshakes, or fruit juice. If your blood sugar is high, sip sugar-free fluids.

• If you check your blood sugars at home (which you’ll be advised to do on certain medications like Insulin), then increase the frequency of testing to every 3-4 hours, including through the night.

• Have easy access to sugary drinks, glucose tablets, or oral gels in case your blood sugar drops.

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Seek urgent medical advice immediately if you:

• Can’t eat or drink at all.
• Are vomiting persistently.
• Are (or are becoming) dehydrated.

Complications of Type 2 Diabetes

Type 2 diabetes can affect different parts of the body:

1. Eyes – Retinopathy

• Diabetes can damage the small blood vessels in your eyes, which may affect your vision.
• Everyone with type 2 diabetes should have regular eye screening. Usually this is:
  • At diagnosis
  • Every 2 years if no problems are found
  • Every year if any signs of damage are detected
• Seek urgent care if you notice sudden changes in your vision, via an optometrist, NHS 111, or your GP.

2. Feet – Diabetic Foot Problems

• Diabetes can cause nerve damage (neuropathy, leading to reduced sensation in the feet) and poor blood flow, which can make foot injuries harder to notice and heal.
  • In untreated, this can lead to ulcers, infections, limb ischaemia (where the blood supply to the feet is cut off), and more.
• Foot checks should happen at diagnosis and at least once a year.
• Daily self-checks, good hygiene, proper footwear, and careful nail care are important.

3. Kidneys – Diabetic Kidney Disease (nephropathy)

• High blood sugar can affect the kidneys over time, so they don’t work as well. The kidneys are important as they help remove waste products from the body in urine.
• Annual screening helps catch kidney problems early.

4. Heart and Blood Vessels – Cardiovascular Risk

• People with type 2 diabetes are at higher risk of heart disease and stroke.
• Regular checks include blood pressure, cholesterol, weight, and smoking status.
• Lifestyle changes, blood pressure control, and statins may be recommended.

5. Nerves – Peripheral and Autonomic Neuropathy

• Peripheral neuropathy can cause numbness, tingling, or pain in hands and feet.
• Autonomic neuropathy can affect digestion, bladder, sexual function, and blood pressure regulation.
• Tell your healthcare team if you notice symptoms, as early management can help.

6. Oral Health – Periodontitis

• People with type 2 diabetes are at higher risk of gum disease.
• It’s important to have regular dental check ups for this reason.

Can Type 2 Diabetes Be Reversed?

It may be possible to go “into remission” with type 2 diabetes. Remission means your blood sugar levels return to the non-diabetic range without the need for diabetes medication.

In Summary

Type 2 diabetes is a common chronic health condition, but with the right support, it is possible to live well with it. Lifestyle changes, medication, regular monitoring, and education are key to controlling blood sugar levels and reducing the risk of complications.

If you’re concerned about your risk, try the free Diabetes UK risk calculator. If you notice any symptoms or are worried you might have diabetes, speak to your healthcare practitioner today – early action makes a difference long-term.

Ask yourself:

• Could I benefit from checking my risk of type 2 diabetes today?
• When was the last time I had a check-up with my GP?
• Are there lifestyle changes I could start now to support my long-term health?

I’d love to hear your thoughts too! If you or someone you know has been affected by type 2 diabetes, what strategies have helped you manage it day-to-day? Have you discovered any lifestyle changes, tips, or resources that made a real difference?

Share your experiences and let’s learn from each other.