What Does Type 2 Diabetes Progression Mean?

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Type 2 diabetes happens when your body becomes resistant to insulin. Insulin is a hormone that helps your cells use sugar in the blood (glucose) to make energy. In people with type 2 diabetes, the cells do not respond to insulin properly. As a result, your blood sugar levels rise too high. This can lead to other serious health problems.¹

If blood sugar levels are not consistently managed, type 2 diabetes can get worse, or progress, over time. This puts you at higher risk for complications such as:¹

Heart disease
Nerve damage
Vision loss

When you are first diagnosed with diabetes, you may be able to manage it through diet and exercise. Over time, however, the condition will progress. Your doctor will likely need to prescribe medicines to help keep your blood sugar in a healthy range. Those medicines may change over time as your body ages.²

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What is prediabetes?

The first stage of type 2 diabetes is called prediabetes. This means that your blood sugar levels are high but you have not yet progressed to diabetes.³

Prediabetes is a very common condition. And it becomes more common as people age. In fact, about half of people over the age of 65 have prediabetes. About one-third of people under age 65 have prediabetes as well. But most people who have prediabetes do not know they have it. This is because it usually does not cause any symptoms.³

Research shows that some, but not all, people with prediabetes will progress to type 2 diabetes. For example, between 9 and 14 percent of 45-year-olds with prediabetes will develop diabetes within 10 years. Overall, people with prediabetes have a 50-50 chance of developing diabetes within 10 years.^3,4

What are the risk factors for prediabetes?

Like diabetes, prediabetes often results from insulin resistance. Insulin resistance can stem from lots of things. These include your genetics, certain medicines, and hormonal disorders.^3,4

Other factors that can put you at higher risk of developing prediabetes include:^3,4

Having a parent or sibling with diabetes
Smoking
Having an unhealthy body weight (overweight or obesity), especially when fat collects around your midsection
Exercising fewer than 3 times per week
Having high blood pressure or abnormal cholesterol levels
Having a history of diabetes during pregnancy (gestational diabetes)
Being over age 45

Luckily, prediabetes is reversible for many people. Eating a healthier diet and getting more exercise may be enough to control blood sugar levels. Obesity is a common cause of insulin resistance. So losing weight can help reduce your risk of progression to diabetes.^3,4

Also, doctors may prescribe medicines to help prevent prediabetes from progressing. The most common ones are metformin and acarbose.^2,3

What are the health risks of type 2 diabetes progression?

If blood sugar levels are not well controlled over time, prediabetes may progress to type 2 diabetes. But diabetes can still be treated at this point. Medicines like metformin, GLP-1 agonists, and insulin can help keep blood sugar levels in a healthy range.¹

Unfortunately, these medicines can start to work less well over time. You may need more or different medicines to manage your condition. Experts are not certain why this is, but your genes are likely part of the reason.²

Type 2 diabetes that is not treated effectively can lead to serious health complications, such as:⁵

Heart disease
Chronic kidney disease
Vision loss or blindness
Hearing loss
Nerve damage, often in the feet or hands
Stroke

Considerations for children

Prediabetes and diabetes in children is a special cause for concern. Type 1 diabetes is still more common than type 2 diabetes among children. But rates of type 2 diabetes are increasing in children and teenagers. Experts think this is a result of increasing rates of childhood obesity.⁶

Also, some research shows that type 2 diabetes progresses faster in children than in adults. Complications tend to occur more quickly, and medicines have to be changed earlier to prevent them. Researchers are not sure why this is. But they have identified some ways that children’s bodies work differently than adults’ bodies.⁶

For both children and adults, getting blood sugar levels under control as soon as possible is key to preventing diabetes progression. Faster diabetes progression in children makes early diagnosis and management even more important. If you or your child has any of the risk factors listed above, ask your doctor about diabetes screening.⁶

Looking for more information about living with type 2 diabetes?

Visit the type 2 diabetes journey hub

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T2Donna Member
My spouse is 5 ft 10 in and weighs 165ish - he has T2d and it is never going away. I am 4 inches shorter and weigh currently 160; I could stand to lose 10 pounds, but I am certainly not obese. None of this is his, or my, fault. We didn't give ourselves diabetes. A coworker is 5 ft 7 in and weighs about 145; she recently found out she has T2D - she was not advised to lose weight by her doctor, instead, she was prescribed Metformin. It isn't fair. You exercise, maintain a healthy weight, take your meds, eat right - and you cannot win against this disease. My friend's husband was T2d and is now dead. For years, with his T2d, he was taking insulin. He was short and weighted 120 pounds. He was about 90 pounds when he died. To me, sure, eat right, exercise, try to maintain a healthy weight (I also have hypothyroidism - I didn't cause myself to have that either) and it is insulting to be told our lifestyles have caused us to be sick. My GP told me to consider bariatric surgery - I was 2 pounds heavier at 162 - I literally jumped off the table and said NO DOCTOR WOULD seriously consider performing bariatric surgery on me at 162, and why on earth would I consider it? She replied "it would cure your diabetes." Sure, and I could eat 6 meals a day the size of a walnut. I saw an endocrinologist after that, recently to be honest, and she wants to put me on an injectable GLP1. I said no thanks. I see her again in October. I've been eating a little differently, trying to do modified a modified keto. Are my numbers better? Yes. Is this sustainable? I don't know as I've been down this road before. Meanwhile, I work with another woman who is 350 pounds. She is not diabetic. I'm sick of being blamed. Aren't you?
1. T2Donna Member
 <inline-mention username="Lori.Foster" user-id="8402045"/> -- thank you. So much of what you wrote, I feel that. For me, it isn't the sweets. It's the carbs. On my current quest/diet, I'm not even wanting carbs, so that's a good thing. Do I eat some, yes, but not much carbs. I know there's going to be a day when I'm wanting....Mac & cheese...or baked ziti - for a time, I wasn't eating gluten...and the substitutes for pasta are seriously lacking. I'm doing ok right now. I'm happier with my meter readings, and we'll see what happens. It's hard though, but I'm no spring chicken, and I don't see any other way. Nope to the GLP1s - there are already lawsuits about some of the more serious side effects. Yes, about the GP suggesting bariatric surgery - that was nuts. I'm done with her after many years - I just found her insulting and full of blame.
2. Lori.Foster Community Admin
 <inline-mention username="T2Donna" user-id="9831813"/> I'm glad you're not craving carbs right now and I hope you can stay on track, but be good to yourself if you fall off that wagon now and then. You have been eating one way your entire life. It can be very difficult to break old habits and develop new, more diabetic-friendly cravings. I am thrilled you ditched that GP. I hope you have a doctor now who gives you some level of confidence in your treatment plan even if you do have to advocate for yourself sometimes. Enjoy the weekend! - Lori (Team Member)