Symptoms of T2D often develop gradually and may include:

• Increased Thirst & Urination (polydipsia and polyuria).
• Unexplained Hunger (polyphagia) despite eating.
• Fatigue: Due to ineffective glucose utilization.
• Blurred Vision: Fluid imbalances affecting eye lenses.
• Slow-Healing Sores: Particularly on the feet.
• Darkened Skin Patches: Acanthosis nigricans in body folds (Mayo Clinic).

Note: Many individuals remain asymptomatic for years, underscoring the need for regular screening, especially in high-risk groups (WHO).

1. Insulin Resistance:
   • Cells fail to respond to insulin, leading to elevated blood glucose (Lippincott Review of Pathology).
2. Genetic Predisposition:
   • Family history increases risk; specific genes (e.g., TCF7L2) are implicated.
3. Lifestyle Factors:
   • Obesity, sedentary habits, and diets high in processed sugars/refined carbs.
4. Comorbid Conditions:
   • Polycystic Ovary Syndrome (PCOS), hypertension, and dyslipidemia (Lange Textbook of Clinical Pharmacology).

Key Insight: Unlike Type 1 Diabetes, T2D is preventable and manageable through lifestyle modifications (WHO).

1. Dietary Changes:
   • Emphasize whole grains, lean proteins, and vegetables; limit added sugars. The Mediterranean diet is strongly recommended (Mayo Clinic).
2. Physical Activity:
   • Aim for ≥150 minutes/week of moderate exercise (e.g., brisk walking).
3. Weight Management:
   • Even a 5–7% weight loss can reduce diabetes risk by 58% (WHO).
4. Screening:
   • Annual blood glucose tests for adults over 45 or those with risk factors (BNF).

1. Lifestyle Modifications:

• First-line therapy includes diet, exercise, and smoking cessation.

2. Oral Medications(BNF Guidelines):

• Metformin: Reduces hepatic glucose production; first-line unless contraindicated (e.g., renal impairment).
• SGLT2 Inhibitors (e.g., Empagliflozin): Promote glucose excretion via urine.
• DPP-4 Inhibitors (e.g., Sitagliptin): Enhance insulin secretion.

3. Injectable Therapies:

• GLP-1 Receptor Agonists (e.g., Semaglutide): Improve glucose control and support weight loss.
• Insulin Therapy: Required in advanced cases (basal or bolus regimens).

4. Monitoring:

• HbA1c: Target <7% for most adults (Mayo Clinic).
• Self-Monitoring: Blood glucose checks and continuous glucose monitors (CGMs).

5. Emerging Treatments:

• Tirzepatide: Dual GIP/GLP-1 agonist showing superior glycemic control (Lippincott Textbook of Pharmacology).

• Acute: Hyperosmolar Hyperglycemic State (HHS), hypoglycemia from medications.
• Chronic:
  • Cardiovascular Disease: Leading cause of mortality (2–4x higher risk).
  • Retinopathy/Nephropathy: Leading to blindness/kidney failure.
  • Neuropathy: Pain or numbness in extremities (WHO).

• Psychological Support: Address depression/anxiety linked to chronic disease.
• Education Programs: Structured courses (e.g., Diabetes Self-Management Education).

Regular Check-Ups: Annual eye exams, foot exams, and renal function tests

Type 2 Diabetes is a preventable and manageable condition with proactive lifestyle changes and medical care. Advances in pharmacotherapy, such as GLP-1 agonists and SGLT2 inhibitors, offer new hope for reducing complications.

Checklist for Patients:

• Monitor blood glucose and HbA1c regularly.
• Adopt a balanced diet and exercise routine.

Stay informed about new treatments and guidelines