Treatment for Type 2 Diabetes

Treatment goals and HbA1c

Treatment aims to prevent problems affecting the eyes, kidneys, nerves and blood vessels and help you stay well in everyday life. Blood pressure, cholesterol, weight and smoking also matter.

HbA1c is a blood test that reflects recent blood sugar levels. Below 7.0% is a common target for preventing complications. Your own goal depends on age, the course of diabetes, kidney health and the risk of blood sugar becoming too low (hypoglycemia). A less strict target may be appropriate for some older people or those prone to low blood sugar.

Food: portions and balance

Aim for enough nutrition while reviewing portions that may be too large. The right amount depends on body size, activity, age and kidney health.

• Plan portions of rice, bread or noodles, with vegetables and protein foods such as fish, meat, eggs or soy.
• Review sugary drinks and how much and how often you snack. Start with changes you can maintain.
• Avoid skipping meals and then eating a large amount at once. Plan meals around your daily routine.

Activity you can keep doing

Activity helps muscles use glucose and improves the body's response to insulin. Start by adding short walks or more movement during everyday tasks.

For people whose health allows it, around 150 minutes or more of walking or similar activity a week is one goal. Build up from short sessions, add gentle strengthening exercises and break up long periods of sitting.

Tablets and injections

Medicines may be added when food and activity changes are not enough. Very high blood sugar or symptoms may require medicine or insulin from the start.

• Metformin mainly reduces excess glucose production by the liver. Stomach or bowel symptoms, kidney function and dehydration need attention.
• DPP-4 inhibitors prolong the action of gut hormones that help insulin release when blood sugar rises.
• SGLT2 inhibitors lower blood sugar by passing more glucose into urine. Dehydration and genital or urinary infections need attention.
• Sulfonylureas and glinides stimulate insulin release. They can cause low blood sugar.
• Other tablets slow carbohydrate absorption or help insulin action or release.

How injections and medicine choices fit your care

Insulin replaces insulin the body lacks. The type, dose and number of injections depend on your blood sugar pattern. Some people with type 2 diabetes use insulin temporarily; others need it long term.

GLP-1 and GIP medicines help insulin release in response to blood sugar. Examples include semaglutide (Ozempic) and tirzepatide (Mounjaro), which also affect appetite and weight. Some GLP-1 medicines are available as tablets.

The choice takes account of weight, insulin production, kidney and heart conditions, side effects, cost and the practical burden of tablets or injections. With heart failure or chronic kidney disease, benefits for the heart or kidneys may also guide the choice when the medicine is appropriate. Tell us about side effects or difficulties using your treatment.

Regular checks for complications

Complications can develop with few symptoms. Keep attending checks even when blood sugar is stable.

• Blood glucose, HbA1c, blood pressure, cholesterol and weight help assess treatment and risks to blood vessels.
• Kidney checks include eGFR blood testing and urine albumin.
• Have retinal checks with an eye specialist even if your vision seems normal.
• Foot and nerve checks look for numbness, reduced sensation, wounds and poor circulation. Continue dental and gum care.

Frequently asked questions

• Do food and activity still matter after starting medicine? Yes. They remain the foundation of treatment. We can help you find a plan that fits your abilities and routine.
• Does starting insulin mean I can never stop? Some people with type 2 diabetes can change to tablets or other treatment after severe high blood sugar settles. Others need ongoing insulin. Your doctor decides after reviewing the results.
• Can I stop attending when HbA1c improves? Regular review helps maintain the improvement. A dose reduction may be possible, but discuss it rather than stopping medicine yourself.

Low blood sugar and days when you are unwell

Sweating, shaking or palpitations may be signs of low blood sugar. If you are fully alert and able to swallow, take glucose following the plan explained by your care team. If consciousness is reduced, do not give food or drink by mouth; call 119.

Fever, vomiting, diarrhea or inability to eat can change what you should do with medicines. Do not stop insulin on your own; contact your care team promptly. Seek care without delay if you cannot drink, keep vomiting, have severe thirst or lose weight rapidly.

References and related information

Sources checked September 8, 2026. This is general information. Confirm your personal goals and medicine instructions during your consultation.