Most people file type 2 diabetes under "something that happens later in life." In my own practice, I'm seeing that assumption catch people out. People in their 30s - and sometimes in their 20s - sitting across from me with a result they never expected, because they thought they were too young to worry about it.
It isn't just my clinic. Globally, new cases of type 2 in people aged 15 to 39 rose by more than half between 1990 and 2019 (Global Burden of Disease data, BMJ), part of a clear shift towards younger adults. And the Australian picture adds a sharper point: when type 2 starts young, it tends to be more serious, not less, with more years ahead for complications to develop. The old idea of who gets type 2, and when, is out of date.
The standard advice is to start checking your risk around 40. That's a reasonable general rule, but your body doesn't read the guidelines, and if type 2 runs in your family, or a few of the things below apply to you, the number that matters is your risk, not your age.
So this National Diabetes Week, I want to do more than list warning signs. Let's go through who's actually at risk, which is younger and broader than most people think, how you'd really know, and the handful of changes that move the needle.
It's common, and it's quiet
Type 2 isn't rare, and it isn't someone else's problem. About 1.3 million Australians live with diabetes, roughly 1 in 15 of us, and most of that is type 2, with the number nearly tripling over the past twenty years. Another two million or so sit in the prediabetes zone, where blood sugar is creeping up but hasn't crossed the line yet.
Here's the part I most want to land. A lot of it is silent, and in the latest national health survey, for every six people who already knew they had diabetes, roughly one more was found only because someone ran a blood test. No symptoms, no warning, just picked up because somebody looked.
That's the whole case for checking. Type 2 rarely taps you on the shoulder early, so you don't wait to feel it, you go looking.
Who's at risk
Risk isn't random, and it isn't a character flaw, and some of it you didn't choose at all. The ones worth knowing:
- Age, but not the way you think. Risk does climb as we get older, and the usual guide is to start checking around 40, but treat that as a starting point rather than a cut-off, because if anything else on this list is you, earlier makes sense.
- Family history. A parent or sibling with type 2 moves the needle.
- Where your body stores fat. Weight around the middle matters more than the number on the scales.
- Ancestry. Some backgrounds carry higher baseline risk, including people of Aboriginal and Torres Strait Islander, South Asian, Chinese, Pacific Islander, Maori, Middle Eastern and North African heritage.
- Movement. Long days of sitting, not much activity.
- A couple of medical things. Higher blood pressure, or diabetes during a pregnancy (gestational diabetes), both raise the odds.
If you're Aboriginal or Torres Strait Islander, the advice is simpler and earlier: a blood test every year from 18, rather than the questionnaire, because risk tends to start sooner.
Plenty of that list will apply to most of us, and that's the point, because knowing where you stand is what lets you do something about it.
The good news is you don't have to guess. There's a free, official tool called AUSDRISK (the Australian Type 2 Diabetes Risk Assessment Tool), eleven questions and about two minutes, and it estimates your risk over the next five years. It's government-run with nothing to buy, and a score of 12 or more is your cue to see your GP and probably get a blood test. A high score isn't bad news, it's useful news, found early.
Check your own risk
The AUSDRISK tool is free, run by the Australian Government, and takes about two minutes. A score of 12 or more is your cue to see your GP and probably get a blood test.
"But I feel completely fine"
That's the most common thing I hear, and usually, you do feel fine. Early type 2 often has no symptoms at all, which is exactly why feeling fine proves nothing.
When symptoms do show up later, they're easy to brush off - more thirst than usual, needing to pee more often (especially overnight), tired in a way the day doesn't explain, blurry vision, cuts that heal slowly - none of it dramatic, which is the trap. So feeling okay is the one thing that can't reassure us here, and that's the blood test's job.
Acting early works, and I mean it
This is the part I wish was the headline. If you're at higher risk, or already in the prediabetes range, what you do genuinely changes what comes next.
We're not guessing. Two landmark studies, one in Finland and one in the US, took people at high risk and gave them structured support to move more and eat better, and both cut the number who went on to develop type 2 by more than half, with the benefit lasting for years after the programs ended. Diabetes Australia, looking at the same evidence, puts it plainly - a large share of type 2 can be prevented or delayed. Prediabetes is not a one-way street.
So what actually moves the dial? Start with the heavy hitters.
Strong Movement. The strongest lever most of us have, and it isn't the gym, it's more of whatever you'll keep doing, plus breaking up long stretches of sitting. Working muscles pull sugar straight out of your bloodstream.
Moderate Food quality, not less food. Here's the biggest myth, and I want to correct it gently. Type 2 isn't simply "you ate too much sugar," and the answer isn't starving yourself, it's the overall pattern - more whole foods, enough fibre and protein to actually keep you going, and fewer ultra-processed foods (the packaged stuff with long ingredient lists) and sugary drinks. The goal is better fuel, not less of it.
Emerging Sleep and stress, and I rate these higher than the headlines do. The diabetes-specific trial evidence is still emerging, and I'll be honest about that, but poor sleep and relentless stress quietly wreck how your body handles sugar, and they make every other change harder, so I'd optimise them anyway. Protect your sleep and find a way to actually switch off, because they matter more than the evidence has caught up to yet.
Wherever you're starting from, the only direction that counts is up, so pick the one change you'll actually stick with and build from there.
What a check involves
If any of this has you wondering, the check itself is genuinely simple - a conversation about your risk, plus a blood test your GP orders. Usually that's an HbA1c, which averages your blood sugar over about three months (handy, because you don't have to fast for it), or a fasting glucose, and occasionally a glucose tolerance test, where they check before and after a sweet drink. That's it. If you want the longer version of which blood tests are worth asking for, I've covered which blood tests are actually worth getting.
And if a result lands in the prediabetes range, that's not a diagnosis of diabetes, it's a heads up with time still on the clock. I've explained what prediabetes actually means, and what to do about it.
This Diabetes Week, do one thing
You don't need a symptom or a scare to act. Spend two minutes on AUSDRISK today, and if it flags something, or if you're honestly just not sure where you stand, book a check. The people who do best with this aren't the ones who felt the worst, they're the ones who looked early.
If you'd like to do that with us, here's how we approach diabetes and prediabetes care, or book an appointment and we'll take a proper look together.
Not sure where
you stand?
Book an appointment and we'll talk through your risk together, and arrange a simple blood test if it makes sense for you.
Common questions about type 2 diabetes
Clinical information in this article draws on the RACGP Guidelines for preventive activities in general practice, the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK, Australian Government), AIHW Diabetes: Australian facts, a Global Burden of Disease analysis (BMJ, 2022), and the ADS/ADEA/APEG consensus on young-onset type 2 diabetes (MJA, 2022). This is general information only - your GP can advise on what's relevant for your individual situation.
