Diabetes and blood sugar

Type 2 diabetes doesn't begin at diagnosis. It develops over years, through a process that's silent for most of it — and that process is the same insulin resistance driving liver fat and central weight gain.

That's why diabetes sits alongside liver health and weight management on this site rather than in a separate category. The three share a mechanism, and they respond to overlapping treatment.

The progression

Insulin resistance — cells respond less readily to insulin. The pancreas compensates by producing more. Blood glucose stays normal, so nothing shows on a standard test. This stage can last years.

Prediabetes — compensation starts falling short. Glucose rises above normal but below the diabetes threshold. Still usually symptomless, still frequently reversible.

Type 2 diabetes — the pancreas can no longer keep pace and glucose stays elevated. Now diagnosable, and now carrying risk of complications.

The useful thing about this sequence: it's detectable long before the end of it, and intervention earlier is both easier and more effective. Most people diagnosed with type 2 diabetes passed through years of a reversible stage without knowing.

What raises risk

Age, family history, ethnicity (with substantially elevated risk in Aboriginal and Torres Strait Islander, South Asian, Pacific Islander and several other populations), central weight, physical inactivity, previous gestational diabetes, PCOS, and metabolic dysfunction-associated liver disease.

Several of these you can't change. Several you can. Knowing which apply to you is the point of assessment.

In this section:

• Prediabetes explained
• Type 2 diabetes explained
• Insulin resistance
• Diagnosis and monitoring
• Remission and reversal
• Diabetes care in Australia
• Type 2 diabetes and fatty liver

Tools: Type 2 diabetes risk check · FIB-4 calculator · Metabolic syndrome check Related: Metabolic syndrome · Liver health · Weight management Next: Find a GP or diabetes service →