Type 2 diabetes is a long-term condition where the level of sugar (glucose) in the blood is too high. It used to be thought of as a condition of older adults, but more and more younger people are being diagnosed.
How it works
Your pancreas makes a hormone called insulin, which lets sugar move from your blood into your cells to be used for energy. In type 2 diabetes, two things usually happen:
- Insulin resistance. The cells, mainly in the muscles, liver and fat, stop responding well to insulin. It is a bit like a lock that has become stiff.
- A tired pancreas. The pancreas makes extra insulin to push past the resistance. Over time it can’t keep up, and blood sugar rises.
Signs to look for
Type 2 diabetes often develops slowly, and many people have it for years without knowing. Signs can include:
- needing to wee more often and feeling very thirsty
- tiredness, especially after meals
- cuts and sores that are slow to heal
- blurred vision
- dark, velvety patches of skin in body folds such as the neck or armpits, a sign of insulin resistance.
If you are over 40, you can check your risk with the AUSDRISK questionnaire, and we can arrange a simple blood test.
Managing type 2 diabetes
Good care today looks beyond blood sugar alone. The aim is to protect your heart, kidneys, eyes and feet as well.
Everyday habits
- Eating well: a pattern of eating you can keep up, built around vegetables, wholegrains and lean proteins, rather than a short-term diet.
- Moving more: muscle is the body’s biggest user of glucose, so strength training as well as walking helps insulin work better.
- Sleep, stress and not smoking all play a part too.
Medicines
- Metformin is usually the first medicine. It helps the liver make less glucose and helps insulin work better.
- SGLT2 inhibitors are tablets that help the kidneys pass extra sugar in the urine. They also protect the heart and kidneys in some people.
- GLP-1 medicines, such as semaglutide, and the related medicine tirzepatide, are weekly injections. They help the body release insulin, reduce appetite and, in some people, lower the risk of heart disease.
- Some people need insulin.
The right mix is different for everyone, and we review it as things change.
Remission
For some people, especially early after diagnosis, losing a significant amount of weight can bring blood sugar back to the normal range without diabetes medicines. This is called remission. It does not happen for everyone, and it still needs regular checks, but it is worth talking about.
How we can help
Our GPs look after many people with type 2 diabetes. We can:
- confirm the diagnosis and explain what it means for you
- set up a GP chronic condition management plan, which can bring Medicare rebates for some visits to a dietitian, podiatrist or exercise physiologist
- register you with the NDSS for cheaper supplies
- arrange your yearly checks of eyes, feet, kidneys, cholesterol and blood pressure
- adjust medicines as your needs change.
Helpful resources
- Diabetes Australia: advocacy, education and support programs.
- NDSS: cheaper testing supplies, plus education programs and webinars. Ask us to help you register.
- Healthdirect: clear, government-funded information.
- The COACH Program: free phone coaching to help you reach your health goals.