Type 2 diabetes: managing it day to day without myths

In short

• Type 2 diabetes means the body cannot use insulin properly, so blood sugar stays high. Many people have no symptoms at first.
• Managing it means more than glucose: blood pressure, cholesterol and weight matter too, because diabetes can damage the heart, eyes, kidneys, nerves and feet.
• An A1C test reflects your average blood sugar and is usually checked every 3 to 6 months. Your target is individual.
• Eye, kidney and foot checks should be kept on schedule even when you feel fine.
• Lifestyle changes can sometimes bring blood sugar back to a normal level, which is called remission. It does not mean the diabetes is gone for good.

What type 2 diabetes is

In type 2 diabetes the body does not make enough insulin or does not use it well, so glucose builds up in the blood. According to the CDC, it develops over many years and accounts for about 90% to 95% of diagnosed diabetes in the United States.

Symptoms can include increased thirst and urination, hunger, tiredness, blurred vision, numbness or tingling in the hands or feet, and sores that heal slowly. Symptoms can come on so slowly that many people have none, which is why testing matters if you have risk factors such as being overweight, being inactive, having prediabetes or a family history.

What to track besides blood sugar

• A1C: the NHS recommends checking average blood glucose with an A1C test every 3 to 6 months.
• Blood pressure and cholesterol: managing them is part of diabetes care, and some people take medicine for them as well.
• Kidneys: the NHS includes kidney checks in its yearly reviews.
• Eyes: diabetic eye screening looks for retinopathy, which can threaten sight. Ask your clinician how often you need it.
• Feet: nerve damage can dull feeling, and ulcers and infections can follow. See your provider about blisters or cracked skin on the feet.
• Weight and smoking: weight loss if you are overweight and quitting smoking both lower risk.

Your personal targets depend on age, other conditions and your risk of low blood sugar. Ask your clinician what your A1C target is and why.

Eating and moving

The NHS suggests eating plenty of fruit, vegetables, whole grains and pulses and cutting back on processed foods that are high in salt and sugar. Change your diet gradually. If you take insulin or other diabetes medicine, do not start a very strict, low-calorie diet without advice, because it can affect your blood sugar.

The WHO recommends at least 150 minutes of moderate exercise each week, and the NIDDK suggests at least 30 minutes of physical activity such as walking on at least 5 days a week. If you take insulin or medicines that can cause lows, ask your clinician how to adjust for exercise and keep a fast-acting carbohydrate with you.

Low blood sugar: the 15-15 steps

Low blood glucose can happen with insulin and with some pills, such as sulfonylureas. Signs include feeling shaky, hungry, tired, dizzy or irritable, a fast heartbeat and headache. Very low levels can cause loss of consciousness or a seizure.

1. Check.Check your blood glucose. If it is below your target, eat or drink 15 to 20 grams of glucose or carbohydrate right away.
2. Examples.Four glucose tablets, half a cup of regular fruit juice, half a can of regular soda, or a tablespoon of sugar or honey.
3. Wait.Wait 15 minutes and check again. If it is still low, repeat.
4. Snack.If your next meal is more than an hour away, have a snack once you are back in range.
5. Severe low.If someone passes out, give glucagon if it has been prescribed and call 911 right away, even without a glucagon kit.

Tell your clinician about repeated lows. They are a reason to review the treatment plan, not something to put up with.

Sick days

Ask your clinician for a written sick-day plan before you need it: what to do with each medicine, how often to check glucose and when to call. The NHS advises contacting your doctor urgently if you have vomiting, diarrhea or a high temperature while taking diabetes medicine. Do not stop your medicine unless a healthcare professional tells you to.

Can type 2 diabetes go into remission?

The NHS says lifestyle changes can sometimes bring blood glucose to a normal level and stop diabetes, which is called remission. The CDC says diabetes cannot yet be made to go away for good, so remission means ongoing monitoring rather than being finished with it. Any plan to cut back on medicine should be made with your clinician.

When to see a doctor, and red flags

Contact your provider about any sore, blister or cracked skin on a foot, vision that gets worse, repeated low blood sugar, or blood sugar that stays high despite treatment.

Red flags: call 911 if someone with diabetes is confused, has a seizure or loses consciousness. The NHS also advises emergency care for intense thirst, frequent urination and confusion, which can be signs of dangerously high blood sugar.

Medicines in general terms

Treatment usually starts with lifestyle changes and often adds medicine. The NHS describes metformin and SGLT2 inhibitors as common choices, a GLP-1 agonist for some people with heart disease or obesity, and insulin if other medicines are not enough. Many people also take medicine for blood pressure or cholesterol. Your clinician chooses and adjusts the medicines, and you should take them as prescribed.

Questions and answers

Sources

1. NIDDK — Type 2 Diabetes
2. CDC — About Diabetes
3. WHO — Diabetes
4. NHS — Type 2 diabetes: treatment
5. NHS — Type 2 diabetes: complications
6. NIDDK — Low Blood Glucose (Hypoglycemia)

Sources checked on 29 October 2026.