Type 2 diabetes is the most common type with 85 – 90% of all people with diabetes falling into this category. It usually occurs in people over the age of 45 years but has increasingly been diagnosed in young adults as well as adolescents.
Type 2 diabetes is a condition in which a person has elevated blood glucose levels. This is because:
- the body has become resistant to the effects of insulin which is produced in the pancreas
- the pancreas gradually loses its ability to produce enough insulin
Insulin is a hormone which helps regulate blood glucose levels by acting as a key enabling glucose, produced from the breakdown of carbohydrates, to enter the cells where it is used for energy. Excess glucose is then stored in the liver.
Type 2 diabetes develops gradually over many years. It often begins with insulin resistance, where the body’s cells no longer respond effectively to insulin. To compensate, the pancreas produces increasing amounts of insulin, but over time, the insulin-producing cells become exhausted and begin to fail. By the time Type 2 diabetes is diagnosed, a person may have already lost 50–70% of these cells.
In South Australia in 2024, there were 106,389 people living with Type 2 diabetes and that number continues to climb each year. According to Diabetes South Australia, ‘for every 4 adults diagnosed with Type 2 diabetes, there is another person who has the condition but is undiagnosed. This means that there are a further 16% or 160,000 South Australians that are at risk of developing Type 2 diabetes’.[i]
What causes Type 2 diabetes?
Type 2 diabetes usually has a genetic component meaning that it runs in families.
According to Diabetes Australia[ii], people are at a higher risk of developing type 2 diabetes if they:
- Have a family history of diabetes
- Are over 55 years of age
- Are over 45 years of age and are overweight
- Are over 45 years of age and have high blood pressure
- Are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
- Are over 35 years of age and are from Pacific Island, Indian subcontinent or Chinese cultural background
- Are a woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant, or has a condition known as polycystic ovarian syndrome (PCOS)
- Have a mother who had gestational diabetes when they were in utero
- Have been prescribed long-term use of a steroid for treating some cancers, including leukemia, or conditions that cause inflammation such as severe asthma, cystic fibrosis, arthritis, and inflammatory bowel disease.
What are the symptoms?
Because Type 2 diabetes develops over time, people often dismiss symptoms that they may be experiencing as a normal part of ageing and do not speak to their General Practitioner about them.
Symptoms include:
- Thirst
- Passing more urine
- Feeling tired and lethargic
- Blurred vision
- Itchy skin
- Having cuts/wounds or skin infections that heal slowly
- Mood swings
- Headaches
If symptoms continue unchecked, a person may be experiencing the complications of Type 2 diabetes at the point of diagnosis.
How is Type 2 Diabetes Diagnosed?
To confirm a diagnosis of Type 2 diabetes, there are three laboratory tests that may be used:[iii]
- Fasting blood glucose – a result of ≥0 mmol/L indicates that Type 2 diabetes is likely
- Glycosylated haemoglobin (HbA1c) – a result of ≥ 6.5% indicates that Type 2 diabetes is likely
- Oral glucose tolerance test – before (fasting) and two hours after an oral 75-g glucose load is taken. Diabetes is diagnosed as a fasting blood glucose ≥7.0 mmol/L or two-hour post-challenge blood glucose ≥11.1 mmol/L.
Can Type 2 diabetes be cured?
Once a diagnosis of Type 2 diabetes is confirmed, a person will live with Type 2 diabetes for life. It cannot be cured or reversed.
However, the condition can be managed, and research shows that it is possible for some people with Type 2 diabetes to achieve remission. This term means that a person achieves a HbA1c of under 6.5% for at least three months without the need for glucose lowering medications.
It is important that all people with Type 2 diabetes, whether in remission or not, see their doctor at least annually and keep up their Annual Cycle of Care Checks.
Can Type 2 diabetes be prevented?
Prior to developing Type 2 diabetes, a person may be told that they have Prediabetes. This is when a person’s blood glucose levels are higher than normal but not high enough to have a diagnosis of Type 2 diabetes. According to Health Direct,[iv] ‘in Australia, 2 million people have pre-diabetes. About 1 in 10 of these people develops type 2 diabetes each year’.
The recommendations involve weight loss, healthy eating, increasing activity, reducing high cholesterol, and high blood pressure and stopping smoking.
What is the difference between Type 1 diabetes and Type 2 diabetes
Type 1 diabetes is less common in the community than Type 2 diabetes and represents around 10% of all cases of diabetes.
It is an auto-immune condition whereby the body’s own immune system destroys the cells in the pancreas which produce insulin. There is no known cause, but it is thought that environmental factors, such as an infection or high levels of stress, may potentiate the process. There is also a strong genetic link. There is no cure, and the condition is lifelong.
Type 1 diabetes usually affects children and adolescents, but it may also affect adults. The symptoms usually come on quickly. Because the pancreas is not producing any insulin at all, the person will need to have insulin administered via an insulin pen injection or the use of an insulin pump, several times during the day.
Managing Type 2 diabetes
Receiving a diagnosis of Type 2 diabetes often comes as a shock and people usually need time to adjust to the lifestyle changes that need to occur, as well as becoming educated on all aspects of diabetes management. A team of health professionals such as an Accredited Practicing Dietitian (APD), Credentialed Diabetes Educator (CDE), Podiatrist, Credentialed Exercise Physiologist (CEP) and General Practitioner will work with the person with diabetes to ensure optimal diabetes care and education is available.
Initially healthy eating, exercise and weight control are the lifestyle measures that are suggested for managing Type 2 diabetes[v]
Healthy eating – is a cornerstone of managing Type 2 diabetes. Often people are referred to an APD to learn about what, when and how much to eat. The goal is always about managing blood glucose levels so keeping these levels within the recommended range is key to the prevention of diabetes related complications down the track.
According to Diabetes Australia [vi] healthy eating is about enjoying a variety of foods such as:
- vegetables, legumes/beans
- fruit
- wholegrain breads, cereals, rice and pasta
- lean meat, fish, poultry, tofu, nuts
- milk, yoghurt, cheese or non-dairy, calcium fortified plat alternatives
Exercise – everyone benefits from regular exercise, and it is one of the best things to do to maintain overall health and well-being. For good health, people should aim for at least 30 minutes of moderate physical intensity activity every day. This means raising the heart rate, breathing harder whilst still being able to hold a conversation.
Examples include brisk walking, cycling, swimming, gardening and water aerobics.
People with Type 2 diabetes may be referred to an AEP to develop their own personal exercise plan. The AEP also plays an important role in helping with a person’s motivation to commence and maintain exercise goals.
According to Diabetes Australia[vii], for people with Type 2 diabetes, exercise can help with the following:
- reducing insulin resistance, thereby lowering blood glucose levels
- enabling insulin to work more effectively
- maintaining a healthy weight
- improving mental health
- sleeping better
- lowering blood pressure and cholesterol, thereby reducing the risk of heart disease
- improving mobility, strengthening bones and reducing the risk of falls
Monitoring Blood Glucose Levels (BGL’s)
In conjunction with the lifestyle measures mentioned above, a person with Type 2 diabetes will be advised to test their blood glucose levels regularly to ensure that they are within the normal range.
To help with blood glucose monitoring, a person with Type 2 diabetes may be referred to a CDE who can educate patients on how to test, the equipment that is to be used, and importantly, how to interpret the results. For instance, a person will be educated in how food, drink, exercise, medications and stress impact on blood glucose levels and how to manage this.
Blood glucose levels can be measured using a blood glucose meter, or by continuous glucose monitoring which involves a small sensor being implanted under the skin.
The goal is to aim for a BGL before meals of 4.0 – 7.0mmol/L and a level 2 hours after starting meals of 5.0 – 10.0mmol/L.
(It is worth remembering that a person who does not have Type 2 diabetes has a glucose level in their blood of between 4.0 and 7.8 mmol/L throughout the day).
Medications
A glycosylated haemoglobin (HbA1c) will usually be measured 3 months following the initial diagnosis of Type 2 diabetes. Although targets need to be individualised according to patient circumstances, a general rule is that the reading needs to be ≤7%.
If the reading is above this target, medications which are glucose lowering may be prescribed by the doctor.[viii]
In time, some people with Type 2 diabetes will require insulin given subcutaneously with an insulin pen or via an insulin pump.
Conclusion
Optimal management of Type 2 diabetes means maintaining blood glucose levels, blood pressure, and cholesterol within an acceptable range, as well as exercising regularly, reducing stress, maintaining a healthy weight for age and smoking cessation (if relevant).
If a person can achieve this, then the risk of long term complications is reduced.
References:
[i] Diabetes South Australia, Annual Report 2023 – 2024, accessed 7th October 2025 – https://www.diabetessa.com.au/wp-content/uploads/2025/08/DSA-Annual-report_23_24_web-4.pdf Pg 6
[ii] Diabetes Australia website 2025, accessed October 8th 2025 – www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes
[iii] Royal Australian College of General Practitioners and Diabetes Australia: 2025, Management of Type 2 Diabetes: A handbook for general practice, Pg 74
[iv] Health Direct website 2025, accessed 12th October 2025 – https://www.healthdirect.gov.au/pre-diabetes
[v] Australian Diabetes Society website 2025, accessed 8th October 2025 – https://treatment.diabetessociety.com.au/plan/
[vi] Diabetes Australia website 2025, accessed 8th October 2025 – https://www.diabetesaustralia.com.au/living-with-diabetes/healthy-eating/
[vii] Diabetes Australia website 2025, accessed 8th October 2025 – https://www.diabetesaustralia.com.au/living-with-diabetes/exercise/
[viii] Australian Diabetes Society website 2025, accessed October 8th 2025- https://treatment.diabetessociety.com.au/plan/