Type 2 Diabetes: What It Is, How It’s Diagnosed & How to Manage It

By Mamta Bhasin, a BC Registered Dietitian

Lately, I’ve been hearing from many clients who were recently diagnosed with diabetes or prediabetes (sometimes called “borderline diabetes”). What struck me is how young many of them are — in their 30’s, and even their 20’s. Typically, type 2 diabetes is more commonly diagnosed in people over 40¹, so seeing this shift in younger adults has been both concerning and eye-opening.

It’s honestly a mixed feeling. On one hand, diabetes needs to be properly managed to prevent serious complications — and uncontrolled diabetes can affect your body from head to toe, since that sugar-rich blood circulates through every organ:

• Stroke and heart disease
• Eye damage (including blindness)
• Kidney failure
• High blood pressure
• Mental health challenges (including anxiety and depression)
• Nerve damage (which, in serious cases, can lead to infection and amputation)

These are all conditions that most people want to avoid — and getting diagnosed at a young age means there are many more years ahead where those risks can compound.

On the other hand, an early diagnosis is actually an opportunity. For my clients with prediabetes, it opens the door to making meaningful changes to diet and lifestyle that can prevent diabetes from developing altogether. And for those already diagnosed, those same changes can significantly delay or reduce complications.

So I decided to write this post to help clarify what diabetes actually is — and what we can do to prevent or manage it.

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What Is Diabetes?

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Our bodies are made up of trillions of cells that group together to form our organs and tissues². Every single one of those cells needs glucose to function properly³. When we eat carbohydrates, our body breaks them down into glucose — but here’s the thing: glucose can’t just walk into a cell on its own.

Think of insulin as the key, and your cells as doors that need to be unlocked. Insulin is a hormone produced by the pancreas, and its job is to open those cell doors so glucose can get in. When everything is working as it should, the pancreas produces just the right amount of insulin after a meal, glucose enters the cells, and blood sugar (what you’ll see listed as blood glucose on your lab results) returns to a normal level.

But sometimes, things don’t go as planned. The pancreas may not produce any insulin, or not enough of it — or the insulin it does produce doesn’t work the way it should. When that happens, glucose can’t get into the cells properly, and it builds up in the bloodstream instead. That’s when blood glucose rises and stays high — and that’s the foundation of diabetes.

If you have diabetes, or live with someone who does, you may have heard them complain about feeling constantly tired, hungry, or craving something sweet. This actually makes a lot of sense — when glucose can’t get into your cells properly, your body is essentially running on empty, even though there’s plenty of sugar circulating in your bloodstream. Your cells aren’t getting the fuel they need, and they’re letting you know!

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Types of Diabetes

Diabetes is generally categorized into the following types:

• Prediabetes — Blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes.
• Type 1 — An autoimmune disease where the body mistakenly attacks its own pancreas, leaving it unable to produce insulin at all.
• Type 2 — Occurs when the body either can’t produce enough insulin or can’t use it properly.
• Gestational — Develops during pregnancy and typically resolves after delivery. However, it does increase the risk of developing type 2 diabetes later in life.

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Who Is at Risk?

Type 1

The exact cause isn’t fully understood, but having a parent or sibling with type 1 diabetes does put you at a slightly higher risk. Researchers believe that both genetics and environmental factors may play a role, though studies are still ongoing.

Type 2

Several factors can increase your risk of developing type 2 diabetes, including⁴:

• Family history — having a parent or sibling with diabetes
• Age — over 40 years
• Ethnic background — people of South Asian, African, Arab, Asian, Hispanic, or Indigenous descent are at higher risk
• Certain health conditions — such as high blood pressure, high cholesterol, carrying excess weight around the abdomen, PCOS, gestational diabetes, or having prediabetes

If any of the above apply to you, it’s worth having a conversation with your doctor about getting tested — early detection really does make a difference.

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Symptoms to Watch For

You may have heard people mention feeling unusually thirsty or needing to pee all the time before they were diagnosed. These are actually some of the most common early signs of diabetes. But what else should you be looking out for?

Here are some symptoms that may be less familiar⁵:

• Lack of energy or fatigue
• Blurry vision
• Unintended weight gain or loss
• Recurring infections
• Slow-healing cuts or wounds
• Tingling or numbness in the hands or feet

It’s also worth noting that some people may not experience any symptoms at all — which is exactly why regular screening is so important, especially if you have any of the risk factors mentioned above.

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How Is Diabetes Diagnosed?

Now that you know what to look for and when to get tested, you may be wondering what those numbers on your test results actually mean.

Diabetes is diagnosed using one of the following blood sugar measurements⁶:

Test	Diagnostic Threshold
Fasting blood glucose (no food or drink for at least 8 hours)	≥ 7.0 mmol/L
A1C (in adults)	≥ 6.5%
2-hour blood glucose during a 75g glucose tolerance test	≥ 11.1 mmol/L
Random blood glucose (any time of day, regardless of last meal)	≥ 11.1 mmol/L

Your doctor will determine which test is most appropriate for you.

What is A1C?

Unlike a regular blood sugar test that captures a single moment in time, A1C reflects your average blood sugar control over the last 2–3 months. So that slice of birthday cake from last weekend? It’s not going to make or break your result. It’s the bigger picture that counts — which is also why your doctor will typically check it every 3 months, especially if your targets aren’t being met or if you’re making changes to your management plan.

A diabetes diagnosis can come as a complete shock for some, and for others it may have been expected — but still unwelcome. Either way, it’s completely normal to have a million questions running through your head.

What my clients ask me most

• “Now what?”
• “I don’t want to take medications. Is there any way to avoid that?”
• “What should I be eating now?”
• “Do I have to give up rice?”
• “I think I ate too much candy over the holidays — is that why this happened?”
• “Can I reverse it? What do I need to do?”

I hear you — these are all valid questions and concerns. Navigating a diabetes diagnosis doesn’t have to be overwhelming, and you don’t have to figure it out alone. As a Registered Dietitian, this is exactly the kind of guidance I’m here to provide. If you’d like personalized support, I’d love to help — feel free to reach out.

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Managing Diabetes: Where Do You Start?

Diet and lifestyle changes are the pillars of diabetes management — and before you worry, no, you don’t have to give up your favourite foods or the cultural dishes you love.

Let’s look at what matters most.

As you may already know, there are three main (macro) nutrients — carbohydrates, protein, and fat. And the one that has the biggest impact on your blood sugar?

You guessed it — carbohydrates.

Now before you panic, no, you do not have to stop eating carbs! If you recall from earlier, your cells actually need glucose to function — and carbohydrates are what provide that essential fuel. Cutting them out completely isn’t the answer, but understanding them better absolutely is.

Where Do Carbohydrates Come From?

Carbohydrates are found in a wide variety of foods — some that may surprise you! Here are the main sources:

• Grains and starches — rice, bread, pasta, noodles, roti, tortillas, quinoa, crackers, potatoes, corn, and more
• Fruits — all fruits, including fresh, frozen, dried, and fruit juices
• Dairy — milk and yogurt
• Legumes — lentils, chickpeas, kidney beans, and other pulses
• Sweetened foods and beverages — candy, chocolate, cookies, cakes, sugary drinks (pop, juices, etc.), and sauces

You’ll notice that many of these are everyday staples — including cultural foods that are central to so many of our lives. The goal is never to eliminate carbohydrates, but rather to choose healthier versions that are slow-digesting — think higher fibre and low glycemic index options. (More on both of these in upcoming blogs! And if you’re curious about fibre in the meantime, check out my blog on fibre and IBS for some helpful background.)

Portions matter too. Diabetes Canada recommends that roughly a quarter of your plate come from healthy carbohydrates¹. And in my experience, most clients are eating a much larger portion than that without even realizing it.

What About the Rest of the Plate?

Now that you know that a quarter of your plate should be made up of healthy carbohydrates, you might be wondering — what about the rest of the meal?

Here’s the simple breakdown:

• Half your plate — non-starchy vegetables (think leafy greens, broccoli, cauliflower, cucumbers, peppers, zucchini, and more)
• One quarter of your plate — protein-rich foods

Not sure which foods count as protein or how much you actually need? I’ve got you covered — check out my blog on protein to learn more about protein sources, how much your body needs, and easy ways to incorporate it into your meals.

In case you’re wondering why balancing your meals this way matters — the fibre from vegetables and the protein from protein-rich foods help slow down how quickly your body breaks down carbohydrates. This means a gentler, more gradual blood sugar response — no sharp spikes or crashes — which not only helps keep your blood sugar more stable throughout the day but also keeps you feeling fuller for longer.

📋 Image: Diabetes Canada Balanced Food Plate⁸

How Does Your Plate Compare?

So how does this compare to what your meals currently look like?

Take a moment to think about your typical dinner plate — what does it actually look like? How much of it is carbohydrates? How much of it is vegetables? And how much is protein?

• If your plate looks very different — that’s okay! Change doesn’t have to happen overnight. In fact, trying to overhaul everything all at once can feel overwhelming and even demotivating. Start small, make gradual shifts, and celebrate every step in the right direction.
• If your plate is pretty close — great work! You’re already on the right track. It may just be a matter of fine-tuning your portions and food choices to better align with the balanced plate.

Either way, every small change adds up.

Ready to take that first step? Here are some of the key changes to what you eat, when you eat, and how you eat that I recommend to my clients:

• Eat at regular, consistent times — skipping meals, especially breakfast, is not recommended. Diabetes Canada suggests leaving a 4–6 hour gap between meals to help keep blood sugar stable¹.
• Balance your plate — as we just covered, aim for half your plate filled with non-starchy vegetables, a quarter with protein, and a quarter with healthy, high-fibre carbohydrates. For a helpful visual of how different foods affect your blood sugar, check out this resource from Fraser Health⁷: How Food Affects Blood Sugar
• Eat slowly and chew well — this helps you stay more in tune with your hunger and fullness cues, and gives your body time to regulate blood sugar more effectively.

And remember, you don’t have to figure this out on your own.

A Registered Dietitian can help assess your current diet and provide recommendations that are meaningful, practical, and tailored to your lifestyle. If you’d like personalized guidance, I’d love to support you on this journey — feel free to reach out or book a consultation!

I want to pause and check in. How are you feeling so far? There is so much to learn about managing blood sugar, and I’ll do my best to keep sharing useful, practical information to help you along the way.

Have questions or thoughts so far? Drop a comment below — I’d love to hear from you!

For now, let’s zoom out and look at the big picture — because beyond what you eat, there are a few other key habits that can make a real difference.

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It’s Not Just About Food

Diet and nutrition usually gets the attention it deserves when it comes to diabetes management, and while it absolutely matters, it’s not the whole picture. Here are a few other key factors that can significantly impact your blood sugar levels:

Medications

People with Type 1 diabetes need to take insulin since their bodies don’t produce it at all. For those with Type 2, medications, insulin, or a combination of both may be needed. I’ve had clients who were incredibly hard on themselves when they were prescribed medication, feeling as though they had somehow failed. Please be kind to yourself — diabetes is a progressive condition, and needing medication is not a personal failure. It is simply part of managing it.⁹

Stress

Did you know that stress can actually make your blood sugar worse? When you’re stressed, your body releases cortisol and adrenalin, hormones that cause blood sugar to rise.¹⁰ And to make things more complicated, managing diabetes itself can be a source of stress — the appointments, the monitoring, the constant awareness. It’s a cycle that can be hard to break. But finding ways to manage stress isn’t just good for your mental health, it’s good for your blood sugar too.

Physical Activity

Regular physical activity is one of the most powerful tools for managing blood sugar, and it doesn’t have to mean an intense gym session. Aim for a walk after meals and/or when you can, and try to add some muscle-strengthening exercises at least twice a week. Both can help your body manage blood sugar more effectively.¹¹ As always, check in with your doctor before starting any new exercise routine to make sure it is safe for you.

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A Note on Diabetes Remission

Before we wrap up, let’s talk about something that many of my clients are curious about — diabetes remission.

Can diabetes be reversed? I get asked that a lot. The honest answer is that diabetes cannot be cured, but some people with Type 2 diabetes may be able to reach remission — meaning their blood sugar levels return to a normal range without the need for medication. This is more likely in people who were diagnosed recently, carry extra weight, and are not yet on insulin. That said, remission requires significant and sustained lifestyle changes, and it doesn’t work the same way for everyone. There is also a risk of relapse, which can be discouraging. If this is something you’re interested in exploring, the best place to start is an honest conversation with your doctor to understand whether it may be a realistic goal for your situation.¹²

Managing diabetes can feel overwhelming at first but remember — you don’t have to change everything at once, and you don’t have to do it alone.

Every small step you take towards a healthier diet and lifestyle is a step in the right direction. Be patient with yourself, and celebrate your progress along the way.

There is so much more to explore on this topic, and I look forward to diving deeper in upcoming blogs — including a closer look at the glycemic index, label reading, meal planning and more. Stay tuned!

In the meantime, if you have questions or would like personalized support, I’d love to hear from you. Feel free to reach out or book a consultation — I’m here to help.

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References

1. Diabetes Canada. Home. https://www.diabetes.ca
2. Canadian Cancer Society. What is cancer? The human body. https://cancer.ca/en/cancer-information/what-is-cancer/human-body
3. National Library of Medicine. Physiology, Glucose. https://www.ncbi.nlm.nih.gov/books/NBK545201/
4. Diabetes Canada. Type 2 Diabetes Risk Factors. https://www.diabetes.ca/type-2-risks/risk-factors-assessments
5. Diabetes Canada. Type 2 Diabetes Symptoms. https://www.diabetes.ca/about-diabetes/type-2/symptoms
6. Diabetes Canada. Clinical Practice Guidelines – Chapter 3. https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-3
7. Fraser Health. How Food Affects Blood Sugar. https://fraserhealth.patienteduc.ca/file/how-food-affects-blood-sugar-506515.pdf
8. Diabetes Canada. Balanced Food Plate. https://www.diabetes.ca/DiabetesCanadaWebsite/media/FilesUploaded/Balanced-Food-Plate.pdf
9. Diabetes Canada. Getting Started with Insulin. https://www.diabetes.ca/about-diabetes/medication-management/getting-started-with-insulin
10. Diabetes Canada. Stress and Diabetes. https://diabetes.ca/about-diabetes/impact-stories/stress-sos
11. Canadian Society for Exercise Physiology. Physical Activity Guidelines for Adults 18-64. https://csepguidelines.ca/guidelines/adults-18-64/
12. Diabetes Canada. Remission of Type 2 Diabetes.https://guidelines.diabetes.ca/cpg/sa-remission-of-type-2-diabetes-users-guide