Type 2 Diabetes
Type 2 diabetes is a chronic condition in which the body does not use insulin effectively, causing blood sugar to remain elevated. Sustained hyperglycemia damages blood vessels and nerves over years, raising the risk of heart disease, kidney failure, and neuropathy. Early and consistent management dramatically reduces complication risk.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Increased thirst and urination, unexplained fatigue, blurred vision, slow-healing cuts or bruises, tingling in hands or feet, frequent infections, and darkened skin in body folds (acanthosis nigricans). Many people have few or no symptoms in early stages.
Causes & Risk Factors
Insulin resistance develops when cells stop responding normally to insulin, prompting the pancreas to overproduce it until it can no longer keep up. Key risk factors include excess body weight especially visceral fat, physical inactivity, family history, prediabetes, prior gestational diabetes, PCOS, and age over 45.
How We Evaluate
Diagnosis requires a fasting glucose ≥126 mg/dL, a random glucose ≥200 mg/dL with symptoms, or an A1C ≥6.5% confirmed on a second test. We assess kidney function (eGFR, urine albumin), lipid panel, liver enzymes, thyroid (TSH), and foot and eye referral needs.
Treatment Options
Lifestyle modification — structured nutrition, weight loss, and regular exercise — is foundational. Metformin remains the first-line medication for most patients. GLP-1 receptor agonists and SGLT-2 inhibitors provide A1C lowering plus cardiovascular and kidney protective benefits. Insulin is added when A1C targets are not met. CGM can improve glucose awareness and outcomes.
When It Is Urgent
Go to the ER for symptoms of diabetic ketoacidosis — extreme thirst, vomiting, abdominal pain, fruity-smelling breath, or confusion. Also seek immediate care for blood sugar consistently above 400 mg/dL or below 70 mg/dL that is unresponsive to treatment.
Frequently Asked Questions
Can type 2 diabetes go into remission?
Yes. Significant weight loss — especially after bariatric surgery or intensive lifestyle change — can normalize blood sugar for years. Remission is defined as A1C below 6.5% for at least three months without diabetes medications.
What A1C should I be targeting?
Most adults aim for an A1C below 7%. Targets are individualized — a person with limited life expectancy or high hypoglycemia risk may target below 8%, while a young, healthy person may aim below 6.5%.
Is a continuous glucose monitor (CGM) right for me?
CGMs are beneficial for anyone on insulin and increasingly used by non-insulin users who want better insight into how meals, stress, and activity affect glucose. We discuss CGM options at your visit.
Get a Clear Plan for Type 2 Diabetes
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.