Type 2 diabetes is by far the most common form of diabetes mellitus. The disease arises from a combination of Insulin resistance of the body's cells and an increasing relative Insulin deficiency the pancreas. In contrast to type 1 diabetes, there is not a complete loss of insulin production, but rather a disturbed insulin action.
Etiology and risk factors
Type 2 diabetes usually develops over many years. The main risk factors are:
- Genetic predisposition
- Excess weight, especially visceral belly fat
- Lack of exercise
- Unfavorable diet with a high proportion of quickly available carbohydrates
- Age (significant increase in risk from the age of 45)
- Smoking and chronic stress
Clinical manifestation
Type 2 diabetes often goes unnoticed for a long time or with non-specific symptoms:
- Severe thirst (polydipsia) and frequent urination (polyuria)
- Chronic fatigue and loss of performance
- Vision problems
- Slowly healing wounds
- Frequent infections (e.g. urinary tract infections or fungal infections)
- Tingling or numbness in the hands and feet (later stage)
Diagnostic limits
| Parameters | Diagnostic threshold |
|---|---|
| Fasting blood sugar | ≥ 126 mg/dl (7.0 mmol/l) |
| HbA1c value | ≥ 6.5% (48 mmol/mol) |
| 2-h value in the OGTT | ≥ 200 mg/dl (11.1 mmol/l) |
Therapeutic step scheme
- Basic therapy: Lifestyle measures such as losing weight, changing your diet and increasing exercise.
- Drug monotherapy: Often started with metformin.
- Combination therapy: Supplementation with SGLT2 inhibitors, GLP-1 receptor agonists or other oral antidiabetic agents.
- Insulin therapy: With advanced failure of the body's own insulin production.
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
Sources
- German Diabetes Society (DDG). S3 guideline “Type 1 diabetes”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
