What should you know about insulin not working in type 2 diabetes?

This reduced response is called insulin resistance. The pancreas may initially release extra insulin to compensate, but it may not keep up over time. Type 2 diabetes is a long-term condition, and symptoms can be mild or absent, so blood tests and regular reviews help guide care.

Insulin helps move glucose from the bloodstream into cells, where it can be used for energy. With insulin resistance, muscle, liver, and fat cells do not respond to insulin as well as they should. The liver can also continue releasing glucose when the body does not need as much, adding to the rise in blood glucose.

The body can become less responsive for several interacting reasons, including inherited factors, excess body fat, limited physical activity, some medicines, and other health conditions. Having one factor does not determine what will happen to you. Prediabetes can occur before blood glucose reaches the range used to diagnose type 2 diabetes; see [Prediabetes](/conditions/prediabetes/) to learn more.

Arrange a review with your clinician if readings remain above your agreed target, or if you are unsure how to take or monitor your treatment. Do not stop, double, or change diabetes medicine without advice. Your clinician may review your glucose records, meals, activity, injection or tablet technique, other medicines, and kidney function before adjusting the plan.

Regular movement, meals with suitable portions, adequate sleep, and stopping tobacco can support glucose management. A dietitian or diabetes educator can help adapt these steps to your routines and cultural preferences. If body weight is affecting glucose management, discuss a realistic plan; [Obesity](/conditions/obesity/) is a related health condition, not a personal failing.

Keep appointments for checks of blood pressure, eyes, feet, nerves, and kidneys. Persistently high glucose can contribute to problems such as [Chronic Kidney Disease](/conditions/chronic-kidney-disease/) and [Peripheral Neuropathy](/conditions/peripheral-neuropathy/), while foot skin breaks can become infected, including [Cellulitis](/conditions/cellulitis/).

Seek urgent medical help for severe thirst with frequent urination, vomiting, worsening weakness, confusion, unusual drowsiness, or difficulty breathing. These symptoms can signal a dangerous glucose problem, particularly during illness.

Get prompt advice for repeated low readings, sweating, shaking, palpitations, irritability, or confusion. These can be symptoms of [Hypoglycaemia](/conditions/hypoglycaemia/). If someone is unconscious or having a seizure, call emergency services and do not give food or drink by mouth. Sudden facial drooping, arm weakness, or speech difficulty requires emergency help because it may indicate a [Stroke](/conditions/stroke/).

Ask: What glucose range is right for me? How often should I check it? Could another medicine, illness, or injection technique be affecting my readings? What should I do when I am unwell or eating less? Which foot, eye, kidney, and nerve checks do I need, and when should we review my plan?