Type 2 diabetes is a chronic condition in which the body does not use its own insulin well, so blood sugar (glucose) stays higher than normal. It is the most common type of diabetes. According to the International Diabetes Federation (IDF), 589 million adults worldwide had diabetes in 2025, and about 252 million of them did not know it yet. That is because type 2 diabetes can go unnoticed for a long time.
Why type 2 diabetes develops
In type 2 diabetes, the body becomes less able to use insulin, the hormone that helps glucose get into cells. Your risk is higher if:
- you are overweight or have obesity, especially with fat around the belly;
- you are not very active;
- a parent, brother or sister has diabetes;
- you have high blood pressure, abnormal cholesterol or heart disease;
- you had gestational diabetes during pregnancy;
- you have polycystic ovary syndrome.
Symptoms of type 2 diabetes
- feeling very thirsty;
- urinating more often than usual;
- weakness and tiredness;
- blurred vision;
- losing weight without trying;
- cuts and wounds that heal slowly;
- itching around the genitals or repeated thrush.
Many people have no symptoms at all, or the symptoms build up so slowly that they get used to them. That is why diabetes is often found by chance, through a routine blood test, or only once complications appear.
Tests: how diabetes is diagnosed
Diabetes is diagnosed only with laboratory blood tests. Under the American Diabetes Association (ADA) Standards of Care 2026, diabetes is diagnosed when:
- glycated hemoglobin (HbA1c) is 6.5% or higher; it reflects your average blood sugar over about three months;
- fasting glucose (after at least 8 hours without food) is 7.0 mmol/L (126 mg/dL) or higher;
- glucose 2 hours into an oral glucose tolerance test is 11.1 mmol/L (200 mg/dL) or higher;
- a random glucose reading is 11.1 mmol/L (200 mg/dL) or higher together with typical symptoms.
If there are no clear symptoms, the result is confirmed with a repeat test. In-between values (HbA1c 5.7–6.4% or fasting glucose 5.6–6.9 mmol/L) are called prediabetes: the risk is high, but there is still a lot you can change.
The ADA advises all adults to get tested by age 35, and earlier if they are overweight and have at least one of the risk factors listed above. If the result is normal, the test is repeated at least every 3 years; with prediabetes, every year.
Why type 2 diabetes is dangerous
Years of high blood sugar damage blood vessels and nerves. WHO names diabetes as a cause of blindness, kidney failure, heart attacks, stroke and leg amputations. The areas most often affected are:
- the eyes: diabetic retinopathy;
- the kidneys;
- the nerves and blood vessels of the legs, which leads to loss of feeling and foot ulcers;
- the heart and the blood vessels of the brain.
Regular checkups help catch complications early, when they are easier to treat.
How type 2 diabetes is treated
Your doctor chooses the treatment and adjusts it over time. The foundation is lifestyle: a diet lower in sugar and saturated fat, at least 150 minutes of moderate activity a week and not smoking (WHO). If you carry extra weight, losing it is one of the main goals of treatment (ADA and EASD). In some people, significant weight loss leads to remission: blood sugar stays in the normal range without medication, though regular checkups are still needed.
Most people also need medication. WHO lists metformin, sulfonylureas, SGLT-2 inhibitors and insulin among the options, and GLP-1 medicines are used as well. Some of these drugs also protect the heart and kidneys. Your doctor decides which medicines you take and at what dose; do not change or stop them on your own. GLP-1 medicines are also used for weight loss; read more in our article Weight Loss Medications.
Besides blood sugar, your doctor will monitor your blood pressure and cholesterol and regularly check your eyes, kidneys and feet.
Georgia's state Diabetes Management program
Georgia runs a state program called Diabetes Management (Government Resolution No. 655 of December 31, 2025, Annex 13). In 2026, it includes:
- insulin and insulin analogs free of charge for adults with diabetes, within the program's budget. This part of the program covers Georgian citizens, permanent residents of Georgia and people living in the occupied territories;
- once a year, follow-up with an endocrinologist to adjust treatment, with tests (glucose, glycated hemoglobin, creatinine, urine tests, ECG and others) and, if the endocrinologist refers you, consultations with a neurologist, cardiologist, ophthalmologist and angiologist. The state pays 70% of the cost for people on insulin and 50% for people treated without insulin; the patient pays the rest;
- people who do not use insulin may need form IV-100/a from the family doctor they are registered with to join this part of the program.
The program terms are reviewed every year. Ask your family doctor or endocrinologist how to enroll.
When to call 112
Very high or very low blood sugar is an emergency. Call 112 if a person with diabetes:
- feels sick, is vomiting or has stomach pain;
- is breathing faster or has a faster heartbeat than usual;
- is very drowsy and struggling to stay awake;
- is confused or has trouble concentrating;
- has fruity-smelling breath;
- has passed out or is not responding normally.
If you take insulin or a sulfonylurea (such as gliclazide), your blood sugar can drop too low. This is hypoglycemia. Its signs include shaking, sweating, hunger, a pounding heartbeat, dizziness, irritability and confusion. Agree with your doctor in advance on what to do if it happens. Never give food or drink to someone who is unconscious, because they cannot swallow safely. Call 112. Do not drive yourself to the hospital in this state.
Which doctor to see
Diabetes is treated by an endocrinologist. You can also get your blood sugar checked and start testing with a general practitioner or family doctor. A dietitian can help you build an eating plan that is easy to stick to. If diabetes has affected your vision, see an ophthalmologist.
