Diabetes is a progressive disease. In the beginning, diet and exercise may help control diabetes Type 2. However, over time you may need to adjust your management routine and add medication and eventually a combination of medications, including insulin.
Such changes in managing diabetes are normal because of the progression of the disease and changes in your body. Regarding the latter, this may depend on genetics. Researchers have connected more than 70 different genes to Type 2 diabetes, but still have not determined what the interaction is between them. This is why the progression of diabetes Type 2 varies from person to person. 
Stages of Type 2 diabetes
By understanding the various stages of Type 2 diabetes, you will be in a better position to prevent it and manage it to avoid complications, if it develops.
The first sign of blood sugar issues is insulin resistance. This can begin before you develop Type 2 diabetes and might go unnoticed. In this stage, muscle, fat, and liver have trouble bringing glucose into your cells. The pancreas compensates by releasing more insulin to help keep blood sugar within the normal range. If your body is resistant or does not properly respond to insulin, blood sugar starts to rise.
This stage is known as prediabetes. Blood glucose levels become higher than normal, but not high enough to be considered diabetes. Without lifestyle changes, including diet and exercise, adults and children with prediabetes have a high risk of developing Type 2 diabetes. The estimate for prediabetics is 96 million. 
With blood sugar levels remaining abnormally high, the diagnosis is Type 2 diabetes. Some with Type 2 diabetes may not show symptoms or the symptoms may be mild, though worsen progressively. Symptoms include:
Frequent urination and thirst: Because of excess glucose levels, the kidneys are not able to reabsorb all the glucose and return it to the bloodstream. As a result, the excess glucose exits the body through urine where its presence draws additional water from the blood. This results in increased thirst.
Fatigue: Fatigue is one of the major symptoms of diabetes. High blood glucose impairs your body’s ability to use glucose for energy. Dehydration from excessive urination also can cause fatigue. 
Feeling very hungry — even though you are eating: You lose calories through frequent urination. Also, because diabetes keeps glucose from your food reaching your cells, you can experience constant feelings of hunger.
Blurry vision: Elevated blood sugars can damage blood vessels in the retina.
Tingling, pain, or numbness in the hands/feet: The National Institute of Health (NIH) National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) estimates about one-third to one-half of people with diabetes have peripheral neuropathy due to high blood sugar. That’s because high blood glucose or blood sugar and high levels of fats in the blood from diabetes can damage nerves and the small blood vessels that nourish them. Diabetic peripheral neuropathy usually presents itself in feet and legs first and may occur in hands and arms later. 
Cuts/bruises that are slow to heal: Poor circulation is common among those with diabetes. Poor circulation makes it hard for blood – needed for skin repair – to reach areas of the body affected by sores or wounds. Slow-healing cuts and wounds can be especially troublesome if they affect the feet. If not properly treated, foot wounds can lead to more severe complications, which can result in amputation.
The final stage of diabetes Type 2 involves vascular complications caused by years of high blood sugar. This can lead to:
- Albuminuria (A condition in which you have the protein albumin in your urine, increasing the risk of kidney failure and stroke.)
- Chronic kidney disease
- Coronary artery disease
- Heart failure
There is no cure for diabetes but you can prevent or slow the progression with healthy eating, exercise, weight loss and taking medications prescribed by your health care provider.
 “How Type 2 Diabetes Progresses,” American Diabetes Association, Accessed August 11, 2023. https://diabetes.org/diabetes/type-2/how-type-2-diabetes-progresses
 “By the Numbers: Diabetes in American,” CDC, Accessed August 21, 2022. https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html
 “Diabetes symptoms: When diabetes symptoms are a concern,” Mayo Clinic, Accessed August 21, 2023. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-symptoms/art-20044248
 “Diabetic Neuropathy,” NDDK, Accessed August 21, 2023. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
 Heitz, David, “Symptoms of Diabetic Peripheral Neuropathy,” healthline, April 13, 2022. https://www.healthline.com/health/diabetic-peripheral-neuropathy-symptoms
 “Slow Healing of Cuts and Wounds,” Diabetes.co.uk, June 10, 2022. https://www.diabetes.co.uk/symptoms/slow-healing-of-wounds.html
 Lockett, Eleesha, “What Are the Stages of Diabetes,” healthline, August 11, 2021. https://www.healthline.com/health/diabetes/stages-of-diabetes