Education courses
NICE says everyone newly diagnosed with type 2 diabetes should be offered a free education course, such as DESMOND or X-PERT. They help you understand diabetes and how to manage it. Many are available online. Ask your GP surgery.
Healthy changes
- eat well, with plenty of vegetables and fibre, and fewer sugary drinks and refined carbohydrates
- be active, aiming for 150 minutes of moderate activity a week
- lose weight if you need to. Even a small loss helps
- stop smoking and keep alcohol within 14 units a week
Medicines
| Medicine | What it does | Notes |
|---|---|---|
| Metformin | Helps your body use insulin | Usually the first medicine. Can upset your stomach at first |
| SGLT2 inhibitors (such as dapagliflozin, empagliflozin) | Remove extra sugar through your urine | Also protect the heart and kidneys, so often offered if you have heart disease or kidney disease |
| Gliclazide | Helps your body make more insulin | Can cause hypos |
| DPP-4 inhibitors (such as sitagliptin) | Help your body release more insulin after meals | |
| GLP-1 medicines (such as semaglutide) | Help control blood sugar and appetite | Usually injections, and can help with weight loss |
| Insulin | Replaces the insulin your body cannot make | Some people need it over time |
Most people start on one medicine and add others if needed. Your GP or nurse will review your treatment at least once a year.
Remission
For some people, losing a significant amount of weight can put type 2 diabetes into remission. In England, the NHS Type 2 Diabetes Path to Remission Programme offers a low calorie diet using soups and shakes for 12 weeks, with support for a year. It is for some adults diagnosed in the last few years. Ask your GP if you might be eligible.
Some people achieve remission through weight loss surgery.
Hypos
If you take insulin or gliclazide, your blood sugar can go too low (a hypo). Signs include shaking, sweating, hunger and confusion. Treat it with 15 to 20g of fast-acting sugar, such as a glass of fruit juice, and check again after 10 to 15 minutes.
Looking after your feet
Diabetes can reduce feeling in your feet. Check your feet every day for cuts, blisters or colour changes, and see your GP or podiatrist the same day if you notice a problem.
Next, read about living well with type 2 diabetes.
Common questions
Does needing insulin mean I have failed?
No. Type 2 diabetes often changes over time, and many people need insulin at some point. It is just another treatment to keep you well.
Sources we used
- NHS, Type 2 diabetes treatment
- NICE guideline NG28, Type 2 diabetes in adults
- NHS England, Type 2 Diabetes Path to Remission Programme
We check this page at least once a year, and sooner when the rules change. Read how we check our facts, or tell us if something looks wrong.