The primary indicator of type 2 diabetes is insulin resistance, when the body cannot fully respond to insulin. In many cases, the condition can be delayed or prevented. 

Because insulin cannot work properly, blood glucose levels keep rising, releasing more insulin. Unfortunately, for some people with type 2 diabetes, this can eventually exhaust the pancreas. As a result, the body produces less and less insulin, causing even higher blood glucose levels (hyperglycaemia).

Accounting for around 90% of all diabetes, type 2 diabetes is the most common type of diabetes. Changes in diet and physical activity related to rapid development and urbanisation have led to sharp increases in people with type 2 diabetes. Previously, mainly older adults developed the condition. However, due to rising levels of obesity, sedentary lifestyles and poor diet, type 2 diabetes is increasing in children, adolescents and younger adults.

Symptoms of type 2 diabetes

The symptoms of type 2 diabetes are similar to those for type 1 diabetes and include:

  • Excessive thirst and dry mouth
  • Frequent urination
  • Lack of energy, tiredness
  • Slow healing wounds
  • Recurrent infections in the skin
  • Blurred vision
  • Tingling or numbness in hands and feet.

These symptoms can be mild or absent, so people with type 2 diabetes can live several years with the condition before being diagnosed.

Person with a home blood pressure monitor.

Risk factors for type 2 diabetes

  • Family history of diabetes
  • Overweight
  • Unhealthy diet
  • Physical inactivity
  • Increasing age
  • High blood pressure
  • Ethnicity
  • Impaired glucose tolerance (IGT)*
  • History of gestational diabetes
  • Poor nutrition during pregnancy

*IGT is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes.

Know your risk of type 2 diabetes

IDF has developed an online risk assessment to predict a person’s risk of developing type 2 diabetes within the next ten years. The test is based on the Finnish Diabetes Risk Score (FINDRISC) developed and designed by Adj. Prof Jaana Lindstrom and Prof. Jaakko Tuomilehto from the National Institute for Health and Welfare, Helsinki, Finland.

Test your risk

Managing type 2 diabetes

The cornerstone of type 2 diabetes management is a healthy diet, increased physical activity, not smoking and maintaining a healthy body weight. Oral medication and insulin are also frequently prescribed to help control blood glucose levels.

Over time, a healthy lifestyle may not be enough to keep blood glucose levels under control, and people with type 2 diabetes may need oral medication. If treatment with a single medication is insufficient, combination therapy options may be prescribed.

When oral medication is insufficient to control blood glucose levels, people with type 2 diabetes may require insulin injections.

Oral medicines for type 2 diabetes

The most commonly used oral medications for type 2 diabetes include:

  • Metformin: a medicine that reduces insulin resistance and allows the body to use its insulin more effectively. It is regarded as the first-line treatment for type 2 diabetes in most guidelines worldwide.
  • Sulfonylureas: a medicine that stimulates the pancreas to increase insulin production. Sulfonylureas include gliclazide, glipizide, glimepiride, tolbutamide and glibenclamide.

Continuous Glucose Monitoring (CGM)

Continuous Glucose Monitoring (CGM) has emerged as one of the pivotal advancements supporting diabetes management. Unlike self-monitoring of blood glucose (SMBG), which involves finger pricking and blood drawing, CGM devices offer a more user-friendly and less intrusive solution to measure glucose levels. For people living with type 1 diabetes, CGM devices can improve quality of life and well-being by providing real-time data that helps make informed decisions about diet, insulin dosing and overall lifestyle.

The benefits of physical activity

Recent studies examining the benefits of physical activity on blood glucose levels in people with type 2 diabetes show that, although any form of exercise is beneficial, specific activities and their timing can significantly enhance your health.

With so many different exercise types available, deciding which is the most effective can be overwhelming. The best solution is to choose one that works best for you. This may depend on factors such as your current fitness level, preferences and any other health conditions you may have.

Always consider factors like fitness level and preferences when choosing your activity.

One highly recommended exercise for people with diabetes is cardio which includes walking, jogging, swimming or cycling. Cardio helps improve cardiovascular health and aids in weight management, both essential for managing diabetes. It also helps increase insulin sensitivity, allowing your body to regulate blood sugar levels better.

Strength training also has its advantages. You can increase muscle mass and improve insulin sensitivity and blood sugar control by using weights or resistance bands to strengthen muscles. Additionally, strength training helps prevent muscle loss, which is common in people with diabetes.

Along with cardio exercise and strength training, flexibility exercises are also beneficial. These exercises focus on stretching and improving joint mobility. They can help to reduce the risk of injury and improve overall physical performance. Examples of flexibility exercises include yoga, Pilates and stretching routines.

As for how often to exercise, consistency is key. You should aim for at least 150 minutes of moderate-intensity aerobic exercise per week, spread out over several days, possibly in shorter bouts of 10-15 minutes. Aim to do strength training at least twice weekly, targeting all major muscle groups. 

To reap the benefits of your routine, consider the time of day you exercise. According to studies, moderate to vigorous physical activity in the afternoon and evening significantly impacts blood sugar control more than morning exercise and may help reduce insulin resistance and liver fat content.

In short, any movement is good, and more is generally better, especially when well-timed.

Delaying or preventing type 2 diabetes

Several factors influence the development of type 2 diabetes. The most significant are lifestyle behaviours commonly associated with urbanisation. Consistent evidence shows that a relatively modest intentional weight loss achieved through a healthy diet and regular physical activity can prevent or delay type 2 diabetes.

A healthy diet includes:

  • reducing calories if you are overweight
  • replacing saturated fats (eg cream, cheese, butter) with unsaturated fats (eg avocado, nuts, olive and vegetable oils)
  • eating dietary fibre (eg fruit, vegetables, whole grains)
  • controlling portion sizes to avoid overeating
  • avoiding tobacco use, excessive alcohol and added sugar
  • choosing healthier cooking methods such as baking, grilling, steaming, or sautéing instead of frying

Regular health check-ups are also recommended as early detection of the risk factors can help take proactive steps to prevent or delay type 2 diabetes.