Type 2 diabetes has a new target: women in their 20s

For many people, type 2 diabetes is still seen as a condition that develops in middle age or later.

But new research suggests that picture is changing rapidly.

Researchers analysing more than a decade of NHS data have found that diagnoses are increasing among adults under 40, with women aged 20 to 29 experiencing one of the sharpest rises. While older generations are seeing fewer new diagnoses, younger adults are moving in the opposite direction.

The findings have prompted concern because developing type 2 diabetes at a younger age means living with the condition for much longer, increasing the lifetime risk of complications affecting the eyes, kidneys, heart and nerves.

A changing picture of type 2 diabetes

The research, led by Imperial College London, analysed data from England's National Diabetes Audit between 2011 and 2024.

Overall diagnosis numbers tell only part of the story.

When researchers looked at age groups separately, they found diagnoses had fallen among adults aged 60 to 79 but increased steadily in younger adults. Women aged 20 to 29 experienced the largest rise, with diagnosis rates increasing by almost 70% during the study period.

The researchers also found that younger adults diagnosed today generally have a higher body mass index (BMI) than those diagnosed a decade ago, suggesting severe obesity is developing earlier in life.

However, obesity alone does not explain the increase.

Family history, ethnicity, previous gestational diabetes, polycystic ovary syndrome (PCOS), physical activity, diet and wider social factors all influence someone's risk of developing type 2 diabetes.

Why so many women don't recognise the symptoms

One of the biggest challenges is that type 2 diabetes rarely arrives suddenly.

Unlike type 1 diabetes, where symptoms often develop over days or weeks, type 2 diabetes usually develops gradually. Many people live with symptoms for months before realising something is wrong.

For women in their twenties, those symptoms are particularly easy to dismiss.

Persistent tiredness can feel like a normal consequence of busy careers, university, young children or poor sleep.

Feeling thirsty may simply be blamed on exercising more or warm weather.

Blurred vision is often put down to spending too many hours looking at screens.

Needing the toilet more frequently can seem like a result of drinking more water.

Some symptoms are also commonly confused with other health conditions.

Women may wonder whether they're experiencing:

• iron deficiency or anaemia
• stress or anxiety
• depression
• hormonal changes
• polycystic ovary syndrome (PCOS)
• recovering from a viral illness

Recurring thrush or urinary tract infections may also have an underlying link to raised blood glucose.

Other symptoms can include:

• slow-healing cuts or grazes
• increased hunger
• recurring skin infections
• unexplained weight loss.

Because the symptoms often develop slowly and overlap with many other conditions, some people are only diagnosed during a routine blood test or after complications have already begun.

How is type 2 diabetes diagnosed?

If your GP suspects diabetes, you'll usually be offered an HbA1c blood test.

Rather than measuring your blood glucose at a single moment, HbA1c shows your average glucose levels over the previous two to three months.

An HbA1c result of 48 mmol/mol (6.5%) or above is generally used to diagnose diabetes in the UK.

If your symptoms suggest another type of diabetes, particularly if you're younger or have lost weight unexpectedly, your healthcare team may arrange additional tests to rule out type 1 diabetes or less common forms of diabetes.

Can type 2 diabetes be reversed?

The NHS prefers the term remission rather than cure or reversal.

Remission means blood glucose levels remain below the diabetes range for at least three months without diabetes medication.

For some people, particularly those diagnosed early, remission is possible through significant and sustained weight loss combined with healthier eating and increased physical activity.

However, remission isn't possible for everyone.

Some people will always need medication, while others may achieve remission for several years before blood glucose levels rise again.

Early diagnosis gives people the best opportunity to improve long-term outcomes.

How does the NHS treat type 2 diabetes?

Treatment is tailored to each individual.

Most people begin with support to improve diet, increase physical activity and manage weight where appropriate.

Many are also offered DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed), an NHS education programme designed to help people understand and manage their condition.

If blood glucose remains above target, medication may be introduced.

Common treatments include:

• metformin
• SGLT2 inhibitors
• DPP-4 inhibitors
• sulfonylureas
• GLP-1 receptor agonists for eligible patients
• insulin where required.

The aim is not only to reduce blood glucose but also to lower the long-term risk of heart disease, stroke, kidney disease and other diabetes-related complications.

Can people with type 2 diabetes use a CGM?

Yes, but for most people in the UK, a continuous glucose monitor (CGM) is not part of routine NHS treatment for type 2 diabetes.

Instead, NHS care focuses on lifestyle support, education and medication, with CGMs reserved for people who meet specific clinical criteria.

That hasn't stopped interest growing.

Many people choose to self-fund a CGM to better understand how food, exercise, sleep and stress affect their glucose levels throughout the day. For some, seeing those glucose patterns can help reinforce lifestyle changes and provide extra motivation alongside advice from their healthcare team.

What is Dexcom Stelo?

Dexcom Stelo is the first CGM designed specifically for adults with type 2 diabetes who do not use insulin.

Unlike traditional medical CGMs, its purpose is to help users understand how everyday factors such as meals, physical activity, sleep and stress influence their glucose levels, rather than helping people calculate insulin doses.

Its development reflects a growing shift in diabetes technology. Manufacturers increasingly recognise that glucose data can also help people with type 2 diabetes better understand their condition and support healthier lifestyle choices.

Stelo is not currently available in the UK, but its arrival marks an important milestone in the evolution of glucose monitoring beyond insulin-treated diabetes.

At a glance

• Designed for: Adults with type 2 diabetes who do not use insulin
• Purpose: Understand glucose patterns and support lifestyle changes
• Suitable for insulin dosing: No
• Available in the UK: No

A diagnosis in your twenties can change the decades ahead

The study doesn't mean every woman in her twenties is at risk of developing type 2 diabetes, nor does it mean the condition is inevitable.

What it does show is that the traditional image of type 2 diabetes is becoming outdated.

If symptoms such as unusual tiredness, persistent thirst, blurred vision or frequent urination don't seem to have another explanation, it's worth speaking to your GP rather than assuming they're simply part of modern life.

For many people, an earlier diagnosis creates the best opportunity to manage blood glucose well, reduce the risk of long-term complications and, for some, achieve remission.

As more younger adults develop type 2 diabetes, one thing is becoming increasingly clear: this is no longer a condition that only belongs to older generations.