Patient information · General health
Type 2 diabetes and prediabetes
including the part most people are not told: it can go into remission
Type 2 diabetes develops when the body stops responding properly to insulin. It is common, often silent for years, and disproportionately affects South Asian, Black African and Caribbean communities — at younger ages and at lower body weights. It is also, in many people diagnosed early, reversible.
Call 999 or seek emergency care if you have
- vomiting, abdominal pain and rapid deep breathing, with a sweet smell on the breath
- drowsiness or confusion with very high blood glucose readings
- signs of severe dehydration with very high readings
- a foot ulcer, or a foot that is red, hot, swollen or discoloured — same-day assessment
- sudden change in vision
Diabetic foot problems deteriorate fast and are a leading cause of amputation. Any new ulcer, break in the skin or change in foot colour or temperature in someone with diabetes needs assessing the same day, not next week.
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.
Prediabetes is a warning, not a diagnosis of failure
Around one in three people with prediabetes go on to develop type 2 diabetes, but that is far from inevitable. Structured lifestyle change roughly halves the risk. This is the single best point at which to intervene, and it is routinely dismissed as borderline and forgotten about. If you have been told your result was 'a bit high', find out the number and act on it.
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
Effective
- Losing 10–15% of body weight where there is weight to lose
- Reducing refined carbohydrate and sugary drinks
- 150 minutes of activity a week, plus resistance training twice weekly
- Sleeping properly — poor sleep worsens insulin resistance
- Stopping smoking, which independently raises complication risk
Worth knowing
- Weight loss medication is now an option for many people
- Metformin remains first-line medication and is well established
- Newer medicines protect the heart and kidneys, not just glucose
- Statins are usually recommended, because diabetes raises cardiovascular risk
- Blood pressure control matters as much as glucose control
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
Why come to us. We can test HbA1c, cholesterol, kidney and liver function in-house with results explained by a clinician in the same visit — not a phone call weeks later. We run diabetes screening for people with risk factors and no symptoms, full annual reviews for those already diagnosed, and a medical weight management service for anyone pursuing remission. Appointments are unhurried, available seven days a week, and you leave with a written plan. Many of our clinicians speak Bengali, Turkish, Urdu and other community languages.
HbA1c and full metabolic screening in-house
Results explained the same visit. Seven days a week, 9am–7pm.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.