Type 2 diabetes
Type 2 diabetes develops when the body stops responding properly to insulin and the pancreas can no longer make up the difference.
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Medicines commonly prescribed for Type 2 diabetes
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 1000 mgActive substance: metforminManufacturer: Biofarm Sp. Z O.O.Prescription requiredDosage form: TABLET, 1000 mgActive substance: metforminManufacturer: Almus Farmaceutica S.A.U.Prescription requiredDosage form: TABLET, 850 mgActive substance: metforminManufacturer: Medochemie Iberia S.A.Prescription required
Type 2 diabetes develops when the body stops responding properly to insulin and the pancreas can no longer make up the difference. Glucose builds up in the blood and, over years, damages blood vessels, nerves, kidneys and eyes without causing any discomfort at all. That silence is the point: the condition is picked up by a simple blood test, and the earlier it is found, the more of it can be reversed.
Symptoms
Often there are none at first. By the time symptoms appear, glucose has usually been high for a while.
- constant thirst and a dry mouth;
- passing urine often, including at night;
- tiredness and lack of energy;
- losing weight without trying;
- persistent hunger;
- blurred vision that comes and goes;
- wounds that heal slowly, repeated skin infections;
- recurrent genital thrush;
- tingling or numbness in the feet;
- dark, velvety patches on the neck and in the armpits.
Who should be tested
Even with no symptoms at all. This is the practical heart of the article.
- age over 45;
- excess weight, particularly around the abdomen;
- a parent or sibling with type 2 diabetes;
- previous gestational diabetes, or a baby weighing over 4 kg at birth;
- polycystic ovary syndrome;
- high blood pressure, high cholesterol or high triglycerides;
- a sedentary lifestyle;
- known prediabetes;
- long-term treatment with corticosteroids or certain antipsychotics;
- sleep apnoea;
- fatty liver disease.
How it is diagnosed
By blood test: fasting glucose, HbA1c — which reflects the average over the past two to three months — and, if needed, an oral glucose tolerance test. A single reading on a home glucose meter is not enough: a laboratory test is required, usually repeated.
Guide values: fasting glucose of 7.0 mmol/L or above, or HbA1c of 48 mmol/mol (6.5%) or above. Fasting glucose between 5.6 and 6.9 mmol/L indicates prediabetes, and that is the stage where the most can be done.
When to see a doctor
- you have any of the symptoms above;
- you are in a risk group and have never been tested;
- you have been told you have prediabetes;
- you already have diabetes and your readings have drifted;
- you have wounds on your feet that will not heal;
- you notice tingling or loss of sensation in your feet;
- your vision has changed.
Seek urgent care: intense thirst with vomiting, deep rapid breathing, fruity-smelling breath, drowsiness or confusion. Also for a low blood sugar: shaking, cold sweat, palpitations, confusion — in that case take fast-acting sugar straight away.
What works
Lifestyle change is not an add-on to treatment. In type 2 diabetes it is the treatment, and in the early stages it can push the condition into remission.
- losing 5–10% of body weight already improves glucose noticeably; there is no need to set enormous targets;
- 150 minutes of activity a week — brisk walking, swimming, cycling — plus two strength sessions: muscle takes glucose out of the blood;
- break up sitting at least every hour;
- drop sugary drinks — the single highest-return change;
- more vegetables, pulses, wholegrains, fish and olive oil; fewer ultra-processed foods and refined flour;
- watch portion size rather than counting calories;
- sleep 7–9 hours: poor sleep worsens insulin resistance;
- stop smoking;
- limit alcohol, and never drink on an empty stomach if you take glucose-lowering medication.
Medication
Medication is added to lifestyle change, not instead of it. The choice depends on your readings, your weight, your kidneys and your cardiovascular risk.
- metformin — usually the first drug;
- SGLT2 inhibitors — lower glucose and also protect the heart and kidneys;
- GLP-1 receptor agonists — lower glucose, help with weight and reduce cardiovascular risk;
- DPP-4 inhibitors;
- sulfonylureas — effective and inexpensive, but can cause hypoglycaemia;
- insulin — when other treatment is not enough, or from the outset if glucose is very high;
- alongside this: blood pressure control, statins where indicated and, in some cases, antiplatelet treatment.
Checks worth keeping
- HbA1c every 3–6 months;
- a foot check at least once a year, and your own look every day;
- retinal screening once a year;
- kidney function and urine albumin annually;
- blood pressure and lipid profile;
- flu and pneumococcal vaccination as advised;
- dental review: gum disease and diabetes make each other worse.
Foot care
This is the part that prevents the most damage and gets neglected the most.
- look at your feet every day, including between the toes and the soles, using a mirror if needed;
- wash with warm water and dry thoroughly, especially between the toes;
- moisturise, but not between the toes;
- cut nails straight across;
- never walk barefoot, including indoors;
- check inside your shoes with your hand before putting them on;
- do not treat hard skin or corns yourself with blades or medicated plasters;
- report any wound, blister or colour change without waiting.
Common questions
Can type 2 diabetes be reversed? In the early stages, yes: with significant weight loss many people reach remission. That is not the same as a cure — monitoring continues.
Is it caused by eating sugar? It is more complex than that. Genetics, weight, activity and the overall diet all play a part.
If I start insulin, is it forever? Not necessarily. It is sometimes used temporarily to bring very high readings down.
Can I eat fruit? Yes, whole fruit in sensible amounts. Fruit juice is what to avoid.
Do supplements help? None replaces treatment or lifestyle change.
Online consultation
In an online consultation the doctor reviews your results, explains what your HbA1c and fasting glucose mean in your particular case, assesses your cardiovascular and kidney risk, reviews your medication and helps you build a realistic plan for the next three months.
This material is for information only and does not replace a medical consultation.
Consult with a doctor about Type 2 diabetes
Discuss your symptoms and possible next steps with a doctor online.
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Reviewed on Jul 14, 2026
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Discuss your symptoms and possible next steps for Type 2 diabetes with a doctor online.
