Diabetes

In type 2 diabetes the body still makes insulin but responds to it poorly, and over time the pancreas cannot keep up with the extra demand. Glucose then stays high in the blood instead of moving into the cells that need it.

It builds up over years without symptoms, so many people are found on a routine test. Thirst, passing urine at night, tiredness and slow-healing skin appear only once the level has been high for some time.

The diagnosis is made on blood glucose, either fasting, two hours after a glucose drink, or as an HbA1c, which reflects the average over the preceding three months. One abnormal result in someone without symptoms is repeated before the diagnosis is made.

At diagnosis your doctor also checks blood pressure, cholesterol, kidney function and the urine for protein, and examines the feet and arranges an eye check. These set the baseline that later reviews are measured against.

Diabetes is managed instead of cured, though weight loss soon after diagnosis puts a proportion of people into remission with normal readings off medication.

An HbA1c is repeated three months after any change and then every three to six months once stable. The target is set individually: tighter for someone young and newly diagnosed, more relaxed for someone older or prone to low readings.