Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a chronic metabolic disorder in which the body becomes resistant to insulin or does not produce enough of it, leading to persistently high blood glucose. Its prevalence is rising in Tanzania alongside urbanisation and lifestyle changes.

• Increased thirst and frequent urination
• Unexplained weight loss
• Fatigue
• Blurred vision
• Slow-healing wounds and recurrent infections
• May be entirely asymptomatic and picked up on routine screening

• Overweight and obesity.
• Physical inactivity.
• Family history of diabetes.
• Older age.
• History of gestational diabetes.
• Coexisting hypertension and abnormal blood lipids.

• Fasting plasma glucose of 7.0 mmol/L or higher.
• Random plasma glucose of 11.1 mmol/L or higher in a person with symptoms.
• Elevated HbA1c where laboratory testing is available.
• Asymptomatic results are confirmed with a repeat test before diagnosis.

Lifestyle modification — a balanced diet, regular physical activity, and weight management — forms the foundation of care for everyone with type 2 diabetes.

Metformin is the first-line oral medicine for most patients and is usually started at diagnosis alongside lifestyle changes.

A sulfonylurea, such as glibenclamide, may be added or used as an alternative where metformin is not tolerated or is insufficient.

Insulin is introduced when oral medicines no longer achieve adequate control, during acute illness, or during pregnancy.

Regular monitoring of blood glucose, blood pressure, kidney function, and feet is recommended to detect complications early.

• Maintain a healthy body weight.
• Engage in regular physical activity.
• Follow a balanced diet with reduced sugar and refined carbohydrate intake.
• Attend routine screening if you have risk factors such as obesity or a family history of diabetes.