What is Type 2 Diabetes?

Type 2 diabetes is more common than type 1 diabetes and usually develops after the age of 40.

Risk factors include the following:

• Being overweight
• Having a blood relative with diabetes
• Being of South Asian or African-Caribbean origin
• Having had diabetes during pregnancy (gestational diabetes)

Insulin is produced in the pancreas and is used to transfer glucose from the bloodstream to the cells of the body where it can be used as fuel. If there is not enough insulin to do this, the glucose builds up in the bloodstream.

People with type 2 diabetes can still produce insulin but either they do not make enough of it to meet the body's needs or the insulin they do produce is not used properly.

How is type 2 diabetes treated?

Type 2 diabetes may be treated in the following ways:

• A healthy diet: low in sugar, low in fat and high in fibre
• Maintaining a healthy weight
• Taking regular exercise
• Good blood pressure control
• Tablets, although these are not a substitute for a healthy diet and lifestyle
• Insulin, which may be necessary when tablets are not sufficient

If not properly controlled, type 2 diabetes can cause serious long-term complications. Type 2 diabetes should never be regarded as ‘mild diabetes’.

Maintaining near-normal blood glucose readings along with leading a healthy lifestyle will help to prevent long-term damage to the eyes, kidneys, nerves, heart and major blood vessels.

Diabetes and tablets / non-insulin injections

There are several types of tablets for diabetes which work in different ways. In addition, there are injections available that are not insulin. For more information on this see Non-insulin Medication (Tablets and Injectables).

The following are important points to note:

• You must take your tablets as instructed.
• Do not stop taking your tablets unless you are told to do so by your diabetes care team.
• Do not double your dose if you miss a tablet.
• If you are unwell follow the sick day guidance.
• Ensure you have a continued supply of tablets and that you do not run out.
• If you hold a driving licence, you are required by law to inform the DVLA and your insurance company if you start taking tablets or insulin to control your diabetes.

You are entitled to exemption from prescription charges if you are taking medication for your diabetes and you normally pay prescription charges. You should ask your GP about an exemption request form.

If you suffer from any side effects from the tablets you should talk to your diabetes care team.

Diabetes and combination therapy

You may need to take a combination of different tablets, or even a combination of tablets and injectable treatment (which may include insulin) to control your blood glucose levels. For more information on this see Non-insulin Medication (Tablets and Injectables) and Insulin information.

Over time, your treatment may need to be adjusted and so it is very important to attend regular check-ups for your diabetes, either with your diabetes care team or your GP.

Diabetes and insulin therapy

The majority of people who live with type 2 diabetes for more than ten years will find that their pancreas will stop being able to produce enough insulin for tablets alone to be effective. If this happens, you may require insulin, which is given by injection (see Insulin Injection Technique).

How quickly after diagnosis you will need insulin injections depends on your diet, activity level and how well you manage your diabetes overall. Your diabetes care team will be able to give you all the advice and support you need.

Hypoglycaemia

Hypoglycaemia occurs when your blood glucose level drops to less than 4 mmol/L, causing what is known as a hypoglycaemic episode (commonly called a ‘hypo’). It will only occur if you are treated with insulin or a type of tablet called a sulphonylurea. For more information on this see Hypoglycaemia.

How do I stay as healthy as possible?

• Attend all your clinic appointments where you will receive help and advice and will be screened for any complications which can then be treated promptly.
• Not all patients with type 2 diabetes need to monitor their blood glucose levels, but if you are advised to do this then you must do so as instructed. Your diabetes care team will show you how.
• Take any medication as directed.
• Eat a healthy diet.
• Try to maintain a healthy weight, losing weight if necessary.
• Exercise regularly. Staying active will help you to keep your blood glucose levels within a normal range and has many other health benefits.
• Do not smoke. Smoking significantly increases your risk of developing complications from your diabetes, especially heart disease.
• Stick to sensible amounts of alcohol. 
• Have your eyes tested regularly at the optometrist and be sure to attend your annual eye screening appointment. See Diabetic Eye Disease for more details.
• Inspect your feet daily. See Footcare and Diabetes for further information.
• It is very important that you maintain your blood pressure within a normal range. You may require medication for this.
• Other medications such as steroids and some diuretics (water tablets) can cause higher blood glucose levels. Your diabetes treatment may need to be altered if you start taking these. Always let your diabetes care team know about any medication you are taking.