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Type 2 diabetes - the Diabetes UK website is very clear

Diet and exerciseLots of people with Type 2 diabetes don’t take any medication, and they instead treat their diabetes by eating well and moving more, our latest research DiRECT has even shown that weight loss can put Type 2 diabetes into remission. We have loads of information and advice that will help you live a healthy life.

 WHAT IS TYPE 2 DIABETES?

There are two types of diabetes called, conveniently in an age in which all too many conditions have very fancy Latin or Greek names, type I diabetes and type 2 diabetes.  
  • Type I diabetes usually occurs in childhood but can occur in adult life and is a disease of unknown origin in which the cells in the pancreas that make insulin die and the person is dependent on insulin for the rest of their life.  
  • Type 2 diabetes is also caused by having insufficient insulin but in type 2 diabetes it appears the cause is decades of living in the modern environment in which energy rich food is cheap and plentiful and the requirement  to work hard physically becomes less and less. It is a disease of modern civilisation and although it is sometimes called a “lifestyle disease” it is better to think of it as an environmental disease because we are not genetically designed to live in a world with lots of food and no requirement to be active.  In type 2 diabetes the pancreas does not make enough insulin to respond to increases of blood sugar.  Usually the condition can be controlled either with diet and exercise alone or with diet and exercise plus oral drugs taken by mouth although some people with type 2 diabetes also need insulin.
 
Why is type 2 diabetes important?
Type 2 diabetes is important because it is a risk factor for a number of conditions.
Firstly there are complications from diabetes.  These can affect the eye, leading to visual impairment and blindness, the kidney, leading to kidney failure, and the blood vessels and nerves of the foot and leg that lead to ulcers and long term problems which occasionally result in the need for amputation.
Secondly type 2 diabetes increases the risk of heart disease and of course very often occurs along with heart disease because the risk factors are the same.
Thirdly, and this has emerged from recent research, type 2 diabetes is important because of the fact that it increases the risk of dementia.  The Lancet Commission on the prevention of dementia summarised all the evidence and ranked type 2 diabetes as one of the major preventable causes of dementia, perhaps the disease that most people fear now that cancer is a relatively treatable condition.  
 
Why is it important to understand the condition?
It is important to understand the condition because type 2 diabetes is a potentially curable condition in a way that type I is not.
The Diabetes UK website says that“Some people can manage it by healthier eating, being more active and losing weight. Eventually most people will need medication to bring their blood glucose down to a safe level.
Whatever the treatment, everyone with Type 2 diabetes needs to learn how to live with it.”
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Of course a good basic principle is that healthcare is what you do for yourself with the NHS delivering professional health services to support your health care.  It is only by accepting that type 2 diabetes is an end result of years or decades of being in a sitting job with easily available energy rich food around you that you can develop a strategy to control and perhaps cure it.  
 
Type 2 diabetes is a condition of modern life. Professional health services can support what people do for themselves but what people do for themselves is of vital importance.
 
Can progression be slowed, reduced or reversed?
The answer is that type 2 diabetes is a curable condition.  If it is not cured, it can certainly be made less severe thus  delaying or preventing altogether the possible complications.Here is what Diabetes UK says 
Diet and exerciseLots of people with Type 2 diabetes don’t take any medication, and they instead treat their diabetes by eating well and moving more, our latest research DiRECT has even shown that weight loss can put Type 2 diabetes into remission. We have loads of information and advice that will help you live a healthy life.

 
What can be done?
The key is to combine change in diet with increased activity.  
The change in diet is not a special diabetes diet but the diet we advise to cope with all the challenges of modern life sometimes called the Mediterranean diet or the Scandinavian diet.
There has been an introduction of very low calorie diets where people lose large amounts of weight very quickly, but this is not yet generally available and not generally prescribed at the moment although this may change.
Any form of activity is helpful, and thirty minutes of brisk walking every day is the core of a high energy activity programme and thirty minutes extra brisk walking daily for a year is equivalent to ten pounds of weight.  
In addition there are effective drugs to help control type 2 diabetes.
The key person is probably the practice nurse at your health centre once the diagnosis has been made.  It may be that a referral is made to a specialist diabetes team, but type 2 diabetes is so common that all primary care teams are familiar with it and have the skills to help people manage it effectively.

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