Almost 1.2 million Australians live with type 2 diabetes, and roughly 125 more are diagnosed every day (AIHW type 2 diabetes facts). For most of them, the day after diagnosis is a mix of questions. What can I eat? Do I need to exercise differently? Will I have to take medication forever? A Dietitian and an Exercise Physiologist can help with the parts of those questions that food, movement, and weight change can actually influence.
01 · The basics
What type 2 diabetes is
Diabetes is a group of long-term conditions that affect how the body regulates blood glucose. There are three main forms. Type 1 diabetes is a smaller share of cases and involves the body producing little or no insulin. Gestational diabetes is glucose intolerance first picked up during pregnancy. Type 2 diabetes is the most common form, around 85 to 90 per cent of cases, and is the focus of this guide.
In type 2 diabetes, the body still produces insulin but the cells do not respond to it effectively. The result is higher-than-typical blood glucose levels, which over time can affect the eyes, kidneys, nerves, and blood vessels. The condition is shaped by a mix of genetics, body composition, activity levels, diet, age, and other factors, and it tends to develop gradually.
In Australia, the scale is significant. The Australian Institute of Health and Welfare reports that almost 1.2 million Australians were living with type 2 diabetes in 2021, with around 125 new diagnoses each day. The national peak body, Diabetes Australia, is a useful first stop for general information, support, and the National Diabetes Services Scheme.
02 · Pre-diabetes
Pre-diabetes and why early action matters
Pre-diabetes is diagnosed when blood glucose is higher than typical but not yet in the type 2 range. Many people with pre-diabetes go on to develop type 2 diabetes if the underlying drivers are not addressed. The encouraging part is that this early stage is also where structured lifestyle change has been most clearly shown to help, and one landmark trial shows why.
The Diabetes Prevention Program randomised 3,234 adults with pre-diabetes to one of three approaches: a placebo, the medication metformin, or a structured lifestyle program targeting at least 7 per cent weight loss and at least 150 minutes of physical activity per week. Over a mean follow-up of about three years, the lifestyle program reduced the incidence of type 2 diabetes by 58 per cent compared with placebo. Metformin reduced it by 31 per cent (Knowler et al, 2002). In that trial, the lifestyle program was significantly more effective than the medication.
That finding is the basis for the strong international focus on diet and activity at the pre-diabetes stage. If you have been told you have pre-diabetes, our companion guide on being diagnosed with pre-diabetes walks through what it means and what to do next.
03 · The dietetics angle
How a Dietitian helps manage type 2 diabetes
Food sits at the centre of type 2 diabetes management because what you eat directly shapes your blood glucose. A Dietitian works with you on three things: the foods you eat across the week, how those foods are timed and combined, and the longer arc of weight change where that is part of the plan.
Carbohydrates are usually the focus. The type of carbohydrate (bread, rice, pasta, fruit, sweets, drinks), the amount, and the timing through the day all influence how steeply blood glucose rises after eating. A Dietitian helps you read your own response, plan meals that suit your routine and food preferences, and keep the plan sustainable. Cultural food preferences, household budget, and family meal patterns are part of that work.
Weight change is the other lever where the evidence has moved sharply in the last decade. The DiRECT trial, run across 49 primary care practices in the UK, randomised people with type 2 diabetes to a structured weight-management programme (total diet replacement, then staged food reintroduction, then weight-loss maintenance) or best-practice care. At 12 months, 46 per cent of the intervention participants were in remission to a non-diabetic state, off all diabetes medication, with remission strongly linked to the extent of sustained weight loss (Lean et al, 2018). Remission is not the goal for every person, and structured weight management is one option among several, but the trial reset the expectation that type 2 diabetes is always a one-way path.
Our Dietetics team at Optimum Health Solutions works with people across all of these scenarios, from first diagnosis to long-term management.
04 · The exercise angle
How an Exercise Physiologist helps manage type 2 diabetes
Physical activity is the other major lever in type 2 diabetes management. Exercise increases the muscles’ ability to take up glucose during and after activity, improves insulin sensitivity, and supports weight management, blood pressure, and heart health. These benefits matter because cardiovascular complications are a major part of why type 2 diabetes is taken so seriously.
The American Diabetes Association position statement on physical activity and diabetes (Colberg et al, 2016) recommends a combination of aerobic and resistance training for people with type 2 diabetes. The headline numbers are at least 150 minutes per week of moderate-to-vigorous aerobic activity, spread across at least three days, with no more than two consecutive days without activity. The statement also recommends two to three resistance training sessions per week on non-consecutive days, plus breaking up long sitting periods with short movement breaks.
An Exercise Physiologist translates those numbers into a plan that works for one person. That includes the safety considerations that often sit alongside type 2 diabetes (joint pain, heart conditions, foot health, fatigue), the realities of work and family schedules, and the gradual build needed when someone has not exercised in a while. Our Exercise Physiology team at Optimum Health Solutions runs these sessions one-to-one and in small groups, including hydrotherapy where it is the right fit.
05 · Coordinated care
How a coordinated plan works at Optimum
Type 2 diabetes management is rarely a one-discipline problem. Evidence supports plans that combine medical oversight by a GP or endocrinologist, food and weight support from a Dietitian, structured movement from an Exercise Physiologist, and, depending on the person, input from Podiatry (foot health) and Physiotherapy (pain and movement). The day-to-day load of a long-term condition can also weigh on people emotionally. Where mental wellbeing support is part of the picture, your GP can connect you with the right person outside our team.
At Optimum Health Solutions, our diabetes care is built around that team approach. You can read more about the model on our diabetes management page. If you have a GP Chronic Disease Management Plan, your GP can refer you for Medicare-supported sessions with our team. NDIS, DVA, and private health funding pathways all work as well, depending on your situation. Our team includes Dietitians and Exercise Physiologists at clinics across New South Wales and Tasmania, including Blacktown, Liverpool, and Croydon Park.
A good time to ask for help is when something has changed: a new diagnosis, a change in medication, a recent blood test that has moved in the wrong direction, a weight goal that has stalled, a new injury or condition that is making the old plan hard to follow, or a stretch of months where life has got in the way. You do not need to wait until things feel out of control. An early conversation often saves a longer one later.
Over about three years, structured lifestyle change cut the incidence of type 2 diabetes by 58 per cent compared with placebo. That is why early action matters.
