What Is Type 2 Diabetes
Type 2 diabetes occurs when the body becomes resistant to insulin - the hormone that allows cells to take up glucose from the blood - and eventually cannot produce enough insulin to compensate. The result is chronically elevated blood glucose levels, which over time damage blood vessels and nerves throughout the body. The consequences of poorly managed diabetes include heart disease, kidney failure, vision loss, nerve damage, and an increased risk of stroke and amputation.
Unlike type 1 diabetes, which is an autoimmune condition present from childhood, type 2 diabetes develops gradually, usually in adulthood, and is strongly influenced by lifestyle factors - though genetics also play a significant role.
What Is Prediabetes
Prediabetes is a state where blood glucose levels are higher than normal but not yet high enough to meet the diagnostic criteria for type 2 diabetes. It is estimated that around two million Australians have prediabetes - and most do not know. Without intervention, prediabetes progresses to type 2 diabetes in a significant proportion of people within five to ten years. With intervention, that progression can often be prevented or substantially delayed. This is the key message: prediabetes is a warning, and acting on it genuinely works.
Who Is at Higher Risk
Several factors increase the likelihood of developing type 2 diabetes:
- Excess weight - particularly fat carried around the abdomen, which is more metabolically active and strongly linked to insulin resistance
- Physical inactivity - regular movement is one of the most powerful protective factors against diabetes
- Family history - having a parent or sibling with type 2 diabetes significantly increases risk
- Age - risk increases with age, particularly after 45
- Ethnicity - people of South Asian, East Asian, Middle Eastern, Pacific Islander, Aboriginal, or Torres Strait Islander descent have higher rates of type 2 diabetes at lower BMIs than people of European descent
- History of gestational diabetes - women who had diabetes during pregnancy have a significantly elevated lifetime risk
- Polycystic ovary syndrome (PCOS) - insulin resistance is central to PCOS and increases diabetes risk
- High blood pressure or abnormal cholesterol - these often cluster together with insulin resistance
- Sleep apnoea - independently associated with insulin resistance
Lifestyle Changes That Actually Work
The evidence from large clinical trials - including the landmark Diabetes Prevention Program - is clear: lifestyle intervention is more effective than medication alone at preventing or delaying type 2 diabetes in people with prediabetes. The most impactful changes are:
Losing a modest amount of weight
Losing 5 to 7 per cent of body weight - for someone weighing 90kg, that is just 4.5 to 6.5kg - reduces the risk of progressing from prediabetes to diabetes by around 58 per cent. The weight loss does not need to be dramatic to be meaningful.
Moving more
Aim for at least 150 minutes of moderate-intensity physical activity per week - such as brisk walking, swimming, or cycling. Exercise improves insulin sensitivity directly, independent of weight loss, and its effects are rapid. Reducing prolonged sitting, even by breaking it up with short walks, also helps.
Improving diet quality
No single "diabetes diet" works for everyone, but a few consistent principles have good evidence:
- Reduce refined carbohydrates and sugary foods and drinks - these cause rapid blood glucose spikes
- Increase fibre from vegetables, legumes, wholegrains, and fruit - fibre slows glucose absorption
- Choose healthy fats (olive oil, nuts, avocado) over saturated fats
- Limit ultra-processed foods, which are strongly associated with metabolic harm
- Watch portion sizes and limit alcohol
Prioritising sleep
Sleep deprivation directly impairs insulin sensitivity. Adults who consistently sleep less than six hours have a higher risk of developing diabetes. Addressing sleep disorders - particularly obstructive sleep apnoea - can significantly improve metabolic health.
What About Screening
Diabetes Australia recommends that all adults over 40 discuss diabetes risk with their GP. For people with risk factors - particularly those from higher-risk ethnic groups or with a history of gestational diabetes - screening should start earlier. The test is a simple fasting blood glucose or HbA1c (a measure of average blood glucose over the past three months). Medicare covers this test as part of a health assessment for people in relevant age groups.
If you are found to have prediabetes, your GP can refer you to structured lifestyle programs that have been shown to significantly reduce the risk of progression - including the national Life! program funded by the Victorian Government, and similar programs in other states.
When to Come In
If you have not had your blood sugar checked recently - particularly if you have any of the risk factors above - booking a health check is a good idea. Catching elevated blood sugar early, before it reaches the threshold for diabetes, gives you the best opportunity to act. Prevention is considerably easier than managing established diabetes.
Want to check your diabetes risk?
Book with Dr. Khushboo Paul at Glenwood or Hornsby for a comprehensive health check including blood sugar testing.
Disclaimer: This article is intended for general informational purposes only and does not constitute medical advice. Please consult your GP for advice tailored to your individual circumstances.