Newly diagnosed with type 2 diabetes: what happens next in the UK

Insulin is a hormone that helps sugar move from the blood into the body's cells. In type 2 diabetes, the NHS explains, insulin does not work properly or there is not enough of it, so glucose builds up in the blood. It affects adults and sometimes children.

Type 2 diabetes is not the same as type 1 diabetes. The NHS says the symptoms can be similar but type 1 usually develops more quickly and is more common in younger people. Blood tests confirm which type you have.

The NHS also describes prediabetes, where blood glucose is higher than normal but not high enough to diagnose diabetes. People with prediabetes are at higher risk of developing diabetes in future, and lifestyle changes can help prevent it.

The NHS lists the most common symptoms as feeling very tired, peeing more than usual, feeling thirsty all the time and losing weight without trying. Others can include blurred vision, cuts or wounds that take longer to heal, and itching around the penis or vagina or recurrent thrush. Symptoms are the same for adults and children and many people have none, which is why risk checks matter.

According to the NHS, you may be more at risk if you are white and over 40, or over 25 and from a South Asian, Chinese, Black African or Black Caribbean background; if a parent, brother or sister has it; if you are overweight and not very physically active; or if you have a condition that increases risk, such as high blood pressure. The NHS Health Check, for people aged 40 to 74 without an existing health condition, may show whether you are at higher risk.

Type 2 diabetes is diagnosed with a blood test that checks how high blood glucose levels are, and results usually take a few days. Once diagnosed, the NHS says there will be doctors, nurses and other health professionals in your diabetes care team who can answer questions about treatment and what happens next.

Lifestyle changes are the foundation of treatment. The NHS says they can lower blood glucose, help manage diabetes and possibly avoid having to take medicine, and can sometimes lower glucose to a normal level and stop diabetes (remission).

• Eat a healthy diet that includes fruit, vegetables, wholegrain foods and pulses, improving it slowly if you find it difficult.

• Spend at least 2.5 hours across the week walking or doing another activity that leaves you out of breath.

• Try to lose weight if you have been told you are overweight.

• Stop smoking, because diabetes increases the harmful effects of smoking.

• Limit alcohol, and have regular dental check-ups to help prevent gum disease.

• Do not move to a very strict low-calorie diet without speaking to a health professional first, because that type of diet may not suit people on insulin or other diabetes medicine.

The NHS says diabetes courses are recommended for everyone with type 2 diabetes. They are designed to give you the confidence and skills to manage the condition, and you should be offered a free course within 1 year of diagnosis. Online options exist, and the NHS names DESMOND and X-PERT Health as examples of courses.

If you have type 2 diabetes or are at risk of developing it, you may be eligible for the NHS Diabetes Prevention Programme or the Digital Weight Management Programme, which your doctor or nurse can discuss with you.

If you need medicine and have no other serious health conditions, the NHS says you will usually be offered a combination of 2 medicines. These are metformin, which lowers blood sugar by improving how the body handles insulin, and an SGLT2 inhibitor, which lowers blood sugar by letting extra sugar pass out in the urine.

If metformin causes side effects, you may be recommended an SGLT2 inhibitor alone. If you have a history of heart disease, you may also be offered a GLP-1 agonist, which is usually injected once a week, and the NHS says a GLP-1 agonist may also be offered if you live with obesity and other treatments cannot lower blood sugar enough.

If other medicines do not help, you may need insulin, taken by injection or through a pump. The NHS says taking too much insulin can cause blood glucose to go too low, which is known as hypoglycaemia or a "hypo". It also says that if you are taking diabetes medicine and become ill, with vomiting, diarrhoea or a very high temperature, you should ask for an urgent GP appointment or call NHS 111, because you may be advised to stop medicines temporarily. Do not stop them unless a healthcare professional tells you to.

The NHS says you will need check-ups to make sure treatment is working. These include an HbA1c test (average blood glucose) every 3 to 6 months, a foot check once every 2 years if the last check was fine or once a year if needed, and checks of weight, BMI, cholesterol, blood pressure and kidneys at least once a year.

You or your child (aged 12 and over) will also be offered diabetic eye screening at diagnosis and then every 1 or 2 years as part of the NHS diabetic retinopathy screening programme.

Other practical points from the NHS include wearing a medical ID wristband, carrying medicines in hand luggage on holiday, and contacting the DVLA if you have health problems caused by diabetes or get hypos. If you are planning a pregnancy, the NHS advises asking to be referred to a pre-conception clinic or diabetes care team and changing to medicines that are safe in pregnancy.

The NHS says type 2 diabetes increases the chance of long-term problems including damage to blood vessels (which can lead to coronary heart disease and stroke), foot problems such as ulcers and infections, sight problems such as retinopathy, kidney problems and gum disease. Managing blood glucose and making healthy lifestyle changes lowers the chance of complications, and going to all appointments helps problems be found early.

See a GP or diabetes nurse if you have blisters or cracked skin on your feet; pain, tingling or numbness in your body, problems having sex, constipation or diarrhoea, which could be signs of nerve damage; or if your vision gets worse.

Call 999 or go to A&E if you have type 2 diabetes and are peeing a lot, feel very thirsty, feel sick, confused or very sleepy, drowsy or short of breath. The NHS says these could be signs of hyperosmolar hyperglycaemic state or diabetic ketoacidosis, both of which can be life threatening.

The NHS says you will have a diabetes care team of doctors, nurses and other health professionals, and that children with type 2 diabetes are under specialist care. Eye screening is offered through the NHS diabetic retinopathy screening programme.

Some people choose a private consultation for a second opinion or additional dietetic input. The core approach of lifestyle measures, education, medicines and regular checks is the same whichever route you use.