Ajax Harwood Clinic
Type 2 diabetes
In type 2 diabetes the body still makes insulin but responds to it poorly, so glucose builds up in the blood — and the reason it is treated is what that does quietly to blood vessels, eyes, kidneys and nerves over years.
Get help straight away if
These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.
- Vomiting, deep rapid breathing, drowsiness, or breath that smells fruityCall 911 or go to an emergency department. This can happen even in type 2 diabetes, particularly during another illness.
- Confusion, seizure, or being unable to treat a low blood sugar yourselfFor anyone on insulin or a sulfonylurea. Someone should call 911 — this is not a wait-and-see.
Contact us promptly if
Not an emergency, but worth being seen sooner rather than waiting it out.
- Repeated low blood sugars, or lows without the usual warning symptomsApplies if you take insulin or a sulfonylurea. Losing the early warning signs is itself a reason to review treatment.
- A foot ulcer, or a break in the skin on the foot that is not healingFeet are the part where a small problem becomes a serious one quickly. Same-week, not next-visit.
What usually happens
It is progressive, and needing more treatment over time is not a personal failure. The condition changes; the response to it changes with it.
The number is not the point — what the number does to you over decades is. That is why blood pressure, cholesterol, kidney function, eyes and feet are all part of diabetes care, not separate from it.
Targets are individual. A tight target that suits a healthy fifty-year-old can be actively harmful for someone older or frailer, which is why we set yours rather than applying one figure to everyone.
Some treatments now do more than lower glucose — several also protect the heart and kidneys, and for some people that is the main reason to choose them.
At your appointment
We will look at the whole picture: glucose control, blood pressure, cholesterol, kidneys, weight, and what you are managing to do day to day.
Feet and eyes get checked on a schedule even when nothing hurts — both cause damage silently, and both are treatable if found early.
We will agree a target with you rather than for you, and be explicit about what we are trading off.
If treatment changes we will cover what it does, what to expect early, and — where relevant — whether it can cause lows.
Should I be tested?
Some patients hear about “insulin resistance” or “reactive hypoglycemia” testing from a naturopathic doctor or online. Here is what these mean, and what testing can and cannot tell you.
Last reviewed 2026-09-23
Insulin resistance
Insulin resistance means your body needs more insulin than usual to keep blood sugar steady. Over time, this can lead to type 2 diabetes. This concern is real and common. But there is no blood test that proves you have it. A fasting insulin level or a number called HOMA-IR can sound precise. They are not standard tests for one person. Doctors mostly use them in research, not for diagnosis. What matters more is what we can measure and act on. That includes your blood sugar, blood pressure, cholesterol, waist size, and liver health. If several of these are off, your metabolic risk is real, even without an insulin number. Working on food, activity, and weight helps this risk either way, whatever we call it.
Reactive hypoglycemia (sugar crashes after eating)
Some people feel shaky, sweaty, or foggy an hour or two after eating. This is often called a sugar crash. True low blood sugar after meals is real. But it is less common than people think. To count as true low blood sugar, three things need to line up: symptoms, a blood sugar reading that is actually low at that time, and feeling better once you eat something. Checking your blood sugar during an episode is the best way to find out. Most people with this pattern have a normal reading when tested. This is called idiopathic postprandial syndrome. It is not dangerous, but it is still worth sorting out. If you have had stomach or weight-loss surgery, true low blood sugar after meals is more likely, and worth checking sooner.
Tests you may hear about
Worth asking
- What is my target, and why that one for me?
- Can any of my medications cause low blood sugar?
- Which of my treatments protect my heart or kidneys, rather than just glucose?
- When were my eyes and feet last checked, and when are they next due?
Curious what your doctor is weighing up? The clinical tool we use for diabetes is open to anyone — it is detailed and written for clinicians, and you are welcome to read it.
Open the clinician reference →General health information for Ajax Harwood Clinic patients and the public — not medical advice, and not a substitute for seeing your own doctor. In an emergency call 911.