Type 2 Diabetes · Treatment
Treatment: Lifestyle and Medicine
? 5 min readReviewed: March 2024
Lifestyle Changes
Whether you have type 2 diabetes or prediabetes, lifestyle changes can help lower blood glucose levels, sometimes enough to avoid needing medicine, or even bring levels back to normal (remission). Helpful steps include eating a healthy diet with plenty of fruit, vegetables, wholegrains and pulses, making changes gradually if that feels easier, aiming for at least 2.5 hours a week of activity that leaves you slightly out of breath, losing weight if you're overweight, stopping smoking (since diabetes increases its harmful effects), limiting alcohol, and having regular dental check-ups, since diabetes raises the risk of gum disease. It's best to avoid very strict, low-calorie diets without professional advice first, particularly if you're taking insulin or other diabetes medicines.
Free diabetes education courses, such as Healthy Living for people with type 2 diabetes, are recommended for everyone with the condition, usually offered within a year of diagnosis, and the NHS also runs prevention and weight management programmes for those at risk.
Medicines
If medicine is needed and you have no other serious health conditions, you'll usually be offered a combination of metformin (which improves how your body uses insulin) and an SGLT2 inhibitor (which helps excess sugar pass out through urine) — if metformin causes side effects, an SGLT2 inhibitor alone may be recommended instead. If you have a history of heart disease, or are living with obesity and other treatments haven't controlled your blood sugar, a weekly injectable GLP1-agonist may also be offered. If these medicines aren't enough, insulin may be needed, taken by injection or pump, with your care team advising on dosing — taking too much can cause blood glucose to drop too low (a "hypo").
?? Ask for an urgent GP appointment or call 111 if:
You're taking diabetes medicine and have vomiting, diarrhoea, or a very high temperature. Never stop taking your medicine unless a healthcare professional tells you to.
Ongoing Appointments
You'll need regular check-ups, including an HbA1c blood test every 3 to 6 months, a foot check every 1 to 2 years, and annual checks of weight, BMI, cholesterol, blood pressure and kidney function. Diabetic eye screening is offered from diagnosis (or age 12) and repeated every 1 to 2 years. You may also need to carry a medical ID, plan ahead for travel with your medicines and a supporting GP letter, and tell the DVLA if you experience hypos or diabetes-related health problems that could affect driving. If you're planning a pregnancy, ask about referral to a pre-conception clinic and review your medicines with your doctor in advance, and discuss suitable contraception options with your care team in the meantime.
Page last reviewed: 6 March 2024 · Next review due: 6 March 2027