Feeling Well Doesn’t Always Tell the Whole Story
Most of us use symptoms as a kind of early warning system. Something hurts, something feels off, and that’s our cue to see a doctor.
Type 2 diabetes doesn’t always play by those rules. Blood glucose can sit above a healthy range for months, sometimes years, without producing anything a person would notice day to day. No dramatic symptom. No clear signal. Just ordinary life, continuing as normal — while, quietly, something is changing.
In Australia, an estimated 6.5% of adults — around 1.3 million people — were living with diabetes in 2022–24. Some had diabetes that had not previously been diagnosed.
That’s the idea at the heart of this feature: early action. Not alarm. Not assumption. Just the willingness to ask the question before symptoms force it.
The Short Version of Glucose and Insulin
Glucose is a form of sugar and one of the body’s main energy sources. It comes from the food we eat and circulates in the bloodstream, ready to be used by our cells.
Insulin is the hormone that makes that possible. Produced by the pancreas, it acts like a key — helping glucose move out of the blood and into cells, where it can be used for energy.
In type 2 diabetes, that system becomes less efficient. The body’s cells respond less readily to insulin (called insulin resistance), and over time the pancreas may also struggle to produce enough of it. The result is glucose that stays in the bloodstream longer, and in higher amounts, than is healthy.
Diabetes isn’t one condition
It helps to know that “diabetes” describes a small family of related but distinct conditions.
- Type 1 diabetes is an autoimmune condition in which the body’s immune system affects the cells that produce insulin. It isn’t caused by diet or lifestyle, and it can develop at any age.
- Type 2 diabetes is the most common form. It develops through a combination of insulin resistance and changing insulin production, shaped by genetic, biological, environmental and lifestyle factors together.
- Gestational diabetes is diagnosed during pregnancy. It needs pregnancy-specific care, and it can also point to a higher future likelihood of developing type 2 diabetes.
This feature focuses on type 2 diabetes — the form most relevant to everyday risk and everyday prevention.
Type 2 Diabetes Can Develop Quietly
Because type 2 diabetes tends to progress gradually, a person doesn’t necessarily wake up one day feeling “diabetic.” There often isn’t a single moment where the body announces that something has changed.
Some people do notice symptoms, which can include:
- feeling unusually thirsty
- urinating more often than usual
- persistent tiredness
- blurred vision
- infections that keep recurring
- cuts or wounds that take longer to heal
- unexplained changes in weight
But here’s the important part: not having these symptoms doesn’t mean blood glucose is fine. Many people with early type 2 diabetes, or with blood glucose above the healthy range, notice nothing unusual at all. This is precisely why type 2 diabetes is sometimes only found through a routine check — not because something felt wrong, but because someone thought to look.
A brief safety note
For most people, thinking about diabetes risk is an unhurried, ordinary conversation to have with a GP. Occasionally, though, very high blood glucose can become an acute medical problem. Seek urgent medical care if someone has a combination of symptoms such as:
- significant vomiting
- abdominal pain
- rapid or laboured breathing
- marked drowsiness or confusion
- signs of severe dehydration
- feeling seriously unwell alongside symptoms of very high blood glucose
If in doubt, don’t wait — seek medical assessment promptly, including via emergency services if symptoms are severe.
There’s No Single “Type” of Person Who Develops Type 2
Risk is built from a combination of things — some within a person’s control, many not. No one factor tells the whole story, and no combination of factors guarantees an outcome either way. Factors that can influence risk include:
- getting older
- a family history of type 2 diabetes
- previously recorded high blood glucose
- a history of gestational diabetes
- polycystic ovary syndrome (PCOS)
- cardiovascular disease
- high blood pressure
- some medicines, including certain antipsychotics
- body composition and waist circumference
- lower levels of physical activity
- smoking
- being from a population group with higher statistical risk
On that last point: some populations — including Aboriginal and Torres Strait Islander peoples, and people with South Asian, South-East Asian, North African, Latin American, Middle Eastern, Māori or Pacific Islander backgrounds — experience a higher statistical risk of type 2 diabetes. This isn’t destiny, and it doesn’t predict any individual’s outcome. Australian guidance recommends earlier and more regular screening for Aboriginal and Torres Strait Islander adults; your GP can explain what is appropriate for you.
A structured way to look at it: AUSDRISK
AUSDRISK (the Australian Type 2 Diabetes Risk Assessment Tool) is a short, validated questionnaire developed for use in Australian general practice. It estimates a person’s risk of developing type 2 diabetes over the next five years, drawing together age, sex, country of birth, family history, blood pressure history, smoking, physical activity, diet and waist measurement into a single score.
If You Ask Your GP About Diabetes Risk
There’s no need to arrive with a self-diagnosis, or even a specific concern. A conversation about risk is a completely normal thing to raise at a regular appointment. A GP may:
- talk through personal and family health history
- review any current medicines or existing health conditions
- check blood pressure and broader cardiovascular risk
- use a validated tool such as AUSDRISK to estimate risk
- decide, based on all of this, whether blood testing is a reasonable next step
If testing is appropriate, it may involve one of the following:
- HbA1c — reflects average blood glucose over roughly the past two to three months.
- Fasting blood glucose — measures glucose after a period without food, usually overnight.
- Oral glucose tolerance test — used in some circumstances to see how the body processes glucose over a couple of hours.
No single test is automatically “better” than the others — the right one depends on individual circumstances, and that’s a decision for a GP to make, not something to work out in advance.
RACGP guidance recommends that GPs assess diabetes risk in the general population from age 40, generally every three years — with different, often earlier, screening recommended for people at higher risk. That’s a general guide for population-level screening, not a rule that applies identically to every person, which is exactly why the conversation with a GP matters more than the number itself.
Elevated, But Not Yet Diabetes
Sometimes testing shows blood glucose above the healthy range, without meeting the criteria for a diabetes diagnosis. This is often referred to as impaired fasting glucose or impaired glucose tolerance, and it’s sometimes described in everyday conversation as “prediabetes.”
This is not an inevitable countdown to diabetes. It’s information — and information creates options that weren’t visible before.
For some people, this is a moment to work with their GP, and potentially other health professionals, on changes that may reduce future risk or slow any progression. For others, it may simply mean more regular monitoring. Either way, an elevated result is a starting point for a conversation, not a verdict.
Small changes still count
If increased risk is identified — whether that’s an elevated result or simply a higher AUSDRISK score — it doesn’t mean an instruction to overhaul your entire life overnight. Health professionals typically work with individual, achievable changes across areas such as:
- movement and daily activity
- everyday food patterns
- sleep
- smoking, where relevant
- weight, where appropriate and only as one part of a broader picture
- blood pressure and cholesterol
- medicines, where indicated
This is often genuinely a team effort. A GP may work alongside credentialled diabetes educators, accredited practising dietitians, exercise physiologists, pharmacists or endocrinologists — bringing in the right expertise for the person, not a one-size-fits-all plan.
Removing the Blame
One of the most persistent myths about type 2 diabetes is that it reflects a personal failing — that someone “did this to themselves” through diet or lack of willpower. That framing doesn’t reflect the evidence. Type 2 diabetes develops through a complex interaction of genetics, ageing, metabolism, environment, socioeconomic circumstances, other health conditions, medicines and lifestyle factors — often working together over many years.
Lifestyle can matter. It is one thread among many, not the entire explanation. The purpose of talking about risk isn’t to assign blame — it’s to open up opportunities for better health, earlier, while there’s more room to act.
Myth or reality?
- “I’d know if I had diabetes.” Not necessarily. Type 2 diabetes can develop gradually, and it may not produce obvious symptoms — especially in its earlier stages.
- “If I don’t eat much sugar, I can’t get diabetes.” It’s not that simple. Risk isn’t determined by sugar intake alone. Genetics, age, metabolism, overall dietary patterns, physical activity and other health conditions can all contribute.
- “Only people who are overweight develop type 2 diabetes.” No. Body weight can influence risk, but people across the full range of body sizes can and do develop type 2 diabetes.
- “Once you’re diagnosed, complications are inevitable.” No. Modern diabetes care is built around reducing that risk and protecting long-term health — not simply managing an inevitable decline.
- “Prediabetes means I will definitely get diabetes.” No. An elevated result increases the importance of monitoring and, where relevant, making changes — but progression to diabetes is not automatic.
Why Earlier Recognition Matters
Persistently high blood glucose can, over time, affect several parts of the body — the heart, kidneys, eyes, nerves and feet among them. It would be easy to turn that into a frightening list. It’s more useful to think of it the other way around.
Earlier recognition gives GPs and their patients more opportunity to protect all of these systems — through monitoring, targeted treatment, and everyday changes that add up over time.
Diabetes care, when it’s needed, is rarely only about glucose. Ongoing care typically also looks at blood pressure, cholesterol, kidney function, eye health, foot health and broader cardiovascular risk. That’s part of why continuity with a regular GP matters so much — not a single test, but an ongoing relationship that keeps watching the whole picture.
This is what “early action” means in practice: not urgency, not fear, just the decision to look a little sooner rather than a little later.
Wondering About Your Own Risk?
Your GP can help you look at your personal risk factors — history, lifestyle, family background and any relevant health conditions — and work out, together, whether any testing or follow-up makes sense for you.
There’s no need to have symptoms. There’s no need to be certain something is wrong. Curiosity is a perfectly good reason to start the conversation.