The First Steps With Type 2 Diabetes
Type 2 Diabetes: the few things that matter most, and the mistakes that catch people out early.
A condition in which blood glucose runs persistently high because the body responds poorly to insulin and produces less of it over time.
Key takeaways
- Diagnostic HbA1c: 48 mmol/mol (6.5%) or above
- Non-diabetic hyperglycaemia: 42-47 mmol/mol
- Most useful single change: Attend every annual check, particularly eyes and feet.
- Commonest mistake: Assuming no symptoms means no progression.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
It develops gradually and often causes no symptoms for years, which is why it is usually found on a routine blood test rather than by feel.
Start here
Two things, and nothing else until both feel routine.
- Attend every annual check, particularly eyes and feet
- Ask about structured education, which is offered and under-used
Then add these
Next, once the first two have stopped feeling like effort.
- Treat weight, activity and diet as part of the treatment, not an alternative
- Know your HbA1c number and your target
The numbers, in one place
| Measure | Figure |
|---|---|
| Diagnostic HbA1c | 48 mmol/mol (6.5%) or above |
| Non-diabetic hyperglycaemia | 42-47 mmol/mol |
| Share of UK diabetes cases | roughly 90 per cent are type 2 |
| Usual first medicine | metformin |
| Routine annual checks | eyes, feet, kidneys, blood pressure, cholesterol, HbA1c |
Common early mistakes
- Assuming no symptoms means no progression
- Stopping medicines because your numbers have improved
- Ignoring foot changes, which can progress quickly
Where to go next
- Answers to the Common Questions on Type 2 Diabetes
- Type 2 Diabetes at a Glance
- Type 2 Diabetes — the reference entry
- Prediabetes: Sorting the Evidence From the Noise
- What the Guidance Really Says About HbA1c
When to speak to a doctor
Seek urgent medical help for vomiting with abdominal pain, deep or rapid breathing, breath smelling of pear drops, or drowsiness and confusion, which can indicate diabetic ketoacidosis. See a GP urgently for any foot ulcer, colour change, numbness or wound that is not healing.
Where this comes from
- NICE — Type 2 diabetes in adults: management
- Diabetes UK — diagnosis and management
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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