Private type 2 diabetes clinic in London, same-day endocrinology.

Symptoms — and why many people have none

Type 2 diabetes develops gradually and can be present for years before diagnosis. When symptoms occur they include: passing urine more often, especially at night; excessive thirst; tiredness; unexplained weight loss; blurred vision; cuts healing slowly; recurrent thrush or urinary infections; and tingling in the feet.

The numbers

HbA1c reflects average blood glucose over roughly three months. Diagnosis usually requires two abnormal results, or one in someone with symptoms.

Remission

Substantial weight loss, particularly within the first few years of diagnosis, can return blood glucose to the non-diabetic range without medication. Trial evidence supports this, typically with a loss of around 10 to 15kg. Remission is not the same as cure — the tendency remains and weight regain brings it back — but it is a genuine and realistic goal that many people are never offered.

What helps

The checks you should be having

• HbA1c every three to six months until stable, then at least annually
• Blood pressure, cholesterol, kidney function and urine albumin annually
• Foot examination annually, checking circulation and sensation
• Retinal screening annually
• Weight and BMI, and a review of medication
• Attention to mood — depression is significantly more common with diabetes and affects everything else