T2D edition · Most recent type 2 diabetes conclusions
Last updatedMonday, November 2, 20266:43 AM ET
Today's headlineThe FDA approved Awiqli, a once-weekly insulin, for children 10 and older with type 2 diabetes (announced Oct 23); it rests mainly on adult trials plus a small single-dose study. In a company-funded trial of 2,749 adults with heart or kidney disease, the orforglipron pill was not worse for the heart than insulin glargine (Sept 30).
Type 2 diabetes has no cure, but for some people the research now points to remission, not just control.
Cure Checker's conclusion · Oct 2026
Most recent cure information
There is no cure for type 2 diabetes. The CDC estimates that 40.1 million people in the U.S. had diabetes in 2023, diagnosed or not, and says about 90% to 95% of people with diabetes have type 2. Some people can reach remission. A 2021 international expert consensus defines it as an HbA1c below 6.5% (48 mmol/mol) at least 3 months after glucose-lowering medicine has stopped. Remission is not a cure: diabetes can come back, so regular checks continue. In the UK DiRECT trial, adults diagnosed within the past 6 years followed a structured weight-loss program with medicines withdrawn by their care teams. 46% were in remission at 1 year and 36% at 2 years. By 5 years, 13% of those who kept getting support were still in remission. Our view: the biggest recent gains are medicines that protect the heart and kidneys and help with large weight loss, plus proof that remission is possible for some people, mostly early after diagnosis.
GLP-1-based medicines: strong effects on sugar and weight.In a 1,879-person trial, tirzepatide (a GIP and GLP-1 drug) lowered HbA1c more than semaglutide and led to 1.9 to 5.5 kg more weight loss (Lilly-funded). The experimental triple-hormone drug retatrutide led to average weight loss of up to 18.8% at 80 weeks in people with type 2 diabetes (Lilly-funded); it is not FDA-approved.
Remission through weight loss: real, but hard to keep.In DiRECT, remission rose with weight lost: 86% of people who lost 15 kg (33 lb) or more were in remission at 1 year, but none of those who gained weight were. Of those in remission at 2 years, 26% were still in remission at 5 years.
Protecting the heart and kidneys.In people with type 2 diabetes and kidney disease, the SGLT2 drug canagliflozin lowered the risk of kidney failure, worsening kidney function, or death from kidney or heart causes by 30% (CREDENCE, 2019). Semaglutide lowered a similar combined risk by 24% (FLOW, 2024). Both trials were company-funded.
Fewer shots, and new pills in testing.The FDA approved the first once-weekly insulins for adults with type 2 diabetes: Awiqli (March 26, 2026) and Onswik (September 23, 2026). In trials they lowered HbA1c about as well as daily insulin. The oral GLP-1 pill orforglipron lowered HbA1c in early type 2 diabetes, but its FDA approval (April 1, 2026) is for weight management only.
This is Cure Checker's editorial assessment of published evidence, not medical advice. Never stop or change a diabetes medicine on your own. Treatment decisions belong with your diabetes care team.
A possible missing link
Please read first. This is an AI-generated hypothesis, written by Cure Checker's AI from published research. It is speculation, not an established finding. It is not a recommendation, not a prediction that a cure exists, and not medical advice. No doctors or scientists have reviewed it, and it may be wrong. Never start, stop, change or delay any treatment because of it. Talk with your diabetes care team.
What looks like it is working
Large weight loss. In DiRECT, 86% of people who lost 15 kg or more were in remission at 1 year, compared with 7% of those who lost 0 to 5 kg (Lancet, 2018).
Insulin-making cells can recover. In 11 people on an 8-week very-low-calorie diet, insulin release and the liver's response to insulin returned to normal as fat in the liver and pancreas fell (Diabetologia, 2011). In a DiRECT subgroup, the return of the fast "first-phase" insulin response marked who reached normal blood sugar (Cell Metab, 2018).
Where the links are missing
Same fat loss, different outcome. In that subgroup, liver and pancreas fat fell whether or not blood sugar returned to normal. People who responded looked similar at the start, except they had had diabetes for less time (2.7 vs 3.8 years) (Cell Metab, 2018). Our inference: no test has been shown to tell, ahead of time, whose insulin-making cells can still recover.
Relapse follows fat returning. People who relapsed regained pancreas fat and lost the first-phase response by 24 months (Cell Metab, 2020). Only 26% of people in remission at 2 years were still in remission at 5 years (Lancet Diabetes Endocrinol, 2024).
Medicines versus diet. A 16-week program using an insulin and liraglutide combination, with 3.3% average weight loss, did not lead to lasting remission (Diabetes Obes Metab, 2024). A pooled analysis found tirzepatide raised the odds of near-normal HbA1c more than 16-fold while people were taking it (J Diabetes Complications, 2024). Our inference: normal blood sugar while on a medicine is not remission, and we found no large trial that measured whether the same cell recovery seen after diet-driven weight loss also follows medicine-driven weight loss, though we may have missed one.
Our hypothesis
Could measuring the first-phase insulin response, or pancreas fat, after large weight loss (however that weight loss was reached) show which people have regained enough insulin-making ability to stay in remission, better than how long they have had diabetes? If so, researchers could design remission trials around it. No such validated test exists for patients today; this is an idea for research to test.
What would prove it wrong: if, in larger studies, the first-phase insulin response measured after weight loss does not predict who stays in remission better than the amount of weight lost and the years since diagnosis, or if people whose response recovered relapse just as often as people whose response did not.
Hypothesis written October 11, 2026. Cure Checker's AI will revisit it when major new evidence appears.
Latest studies & what they concluded
Newest first. Updated each morning as results, trial launches and papers are published.
Infection risk with SGLT2 pills vs DPP-4 pills (meta-analysis)
A review of 18 real-world studies compared severe infections in adults with type 2 diabetes taking SGLT2 pills or DPP-4 pills. Across the studies that could be pooled, pneumonia (ratio 0.65) and sepsis (ratio 0.65) were less common with SGLT2 pills, but the certainty was very low and the studies disagreed a lot. The authors conclude the evidence did not show a higher infection risk with SGLT2 pills and say the lower numbers should not be read as a protective effect.
Combo insulin plus GLP-1 shots beat insulin alone (network meta-analysis)
A review that pooled 30 randomized trials with 17,862 adults with type 2 diabetes compared fixed-ratio combinations of a long-acting insulin and a GLP-1 drug against insulin alone. All combinations lowered A1C and body weight more than insulin alone, and more people reached A1C under 7%, often without weight gain or serious low blood sugar. The authors say comparisons among the combinations are low to very low certainty and the rankings should be read with caution.
Community health workers did not prevent diabetes in people with prediabetes
In a cluster-randomized trial at a New York VA and Bellevue Hospital, a 12-month program with community health workers was compared with usual care in adults with prediabetes. New diabetes appeared in 5.9% of the program group vs 4.3% of the usual-care group, not a significant difference. A1C, weight, blood pressure and cholesterol also did not differ, though the program group had more primary care visits (77.6% vs 62.5%). This is about preventing type 2 diabetes, not treating it.
Comparing three SGLT2 pills on kidney outcomes (insurance-claims study)
Using U.S. insurance claims for about 131,000 adults with type 2 diabetes, researchers found major kidney events were slightly less common with dapagliflozin (HR 0.91) and empagliflozin (HR 0.93) than with canagliflozin, with no difference between the first two. This is an observational study that tries to mimic a trial, so it cannot prove cause.
UBT251, a once-weekly triple-hormone injection: Phase 2 in China
In 211 Chinese adults with type 2 diabetes, 24 weeks of UBT251 lowered A1C by 1.98% to 2.16%, vs 1.77% on semaglutide 1 mg and 0.66% on placebo. Weight loss was greater than with semaglutide or placebo. Stomach side effects were the most common. This is a mid-stage trial; Phase 3 is the next step and the drug is not approved.
Intact vs milled whole grains for blood sugar (12-week trial)
In 160 adults with type 2 diabetes who were given whole-grain foods, those eating the less processed (unmilled) grains had a slightly lower A1C than those eating milled whole grains: a 2.2 mmol/mol difference (95% CI 4.2 to 0.1), with no weight difference. The result was borderline and short-term.
FDA approves once-weekly Awiqli insulin for children 10 and older with type 2 diabetes
Novo Nordisk announced the FDA approved Awiqli (insulin icodec) for children aged 10 and up, as an add-on to diet and exercise. It cuts basal insulin shots from 7 a week to 1. The approval leans on the adult ONWARDS trials (about 2,680 adults) and one single-dose study in 18 young people aged 10 to under 18, which showed the drug behaves in the body much as it does in adults. There was no full trial of blood-sugar control in children. The approval covers type 2 diabetes only, and safety and effectiveness are not established under age 10. Low blood sugar is a known risk.
HRS-7535 pill added to metformin plus an SGLT2 drug (Phase 2, China)
155 adults whose blood sugar was not controlled on metformin and an SGLT2 drug. After 16 weeks, A1C fell by about 1.5 and 1.8 points on the two doses versus 0.4 on placebo. Weight loss was small (2.4% on the higher dose vs 0.7%). Most side effects were mild to moderate and stomach-related. This was a short, mid-stage trial run in China and funded by the maker, Jiangsu Hengrui; the drug is not approved.
SGLT2 inhibitors and heart and kidney outcomes: new pooled analysis of 14 trials
A meta-analysis of 14 placebo-controlled trials (76,969 adults with type 2 diabetes) found SGLT2 inhibitors (such as empagliflozin and dapagliflozin) cut the combined risk of heart-failure hospitalization or cardiovascular death by 23% and kidney outcomes by 31%, with no clear effect on stroke. The authors note differences between trials, including how kidney outcomes were defined. It pools existing trials rather than testing anything new.
Once-a-month MariTide vs weekly semaglutide (Amgen, Phase 3)
A new trial will compare maridebart cafraglutide, a shot given once a month, with weekly semaglutide in about 1,300 adults with type 2 diabetes who take metformin. The main question is whether it lowers blood sugar (A1C) at least as well after 68 weeks. Not yet recruiting; planned start November 2026.
Safiglipron, a GLP-1 pill taken without fasting (OUTSTAND-2, Phase 3, China)
810 adults on metformin. After 32 weeks, all three doses lowered A1C at least as well as dapagliflozin, and the top dose did slightly better (about 0.25 to 0.4 points more). Stomach side effects were more common with safiglipron. The trial was run only in China and several authors work for the maker, Hengrui.
Survodutide for weight in people with type 2 diabetes (SYNCHRONIZE-2, Phase 3)
752 adults with type 2 diabetes and overweight or obesity. After 76 weeks, weight fell 8.2% and 9.8% on the two doses versus 3.9% on placebo. A1C fell about 0.8 to 0.9 points versus 0.2. About three in four people on the drug had stomach side effects, mostly mild. Funded by Boehringer Ingelheim; not yet approved.
How semaglutide may protect the kidneys (biopsy and scan study)
106 people with type 2 diabetes and kidney disease got semaglutide or placebo for a year. The main kidney scan measures did not change. Secondary results hinted at less scarring and healthier blood vessel cells in the kidney. This explains how the drug may work; it is not a new treatment result.
Orforglipron pill and heart safety vs insulin (ACHIEVE-4, Phase 3)
2,749 adults with type 2 diabetes and heart or kidney disease, followed about 2 years. Major heart events happened in 4.2% on orforglipron and 5.0% on insulin glargine, which met the goal of showing the pill is not worse for the heart. Low blood sugar was less common (6.8% vs 19.2%), but stomach side effects were far more common (62% vs 14%). The trial was open-label and funded by Eli Lilly.
Retatrutide for weight in type 2 diabetes (TRIUMPH-2, Phase 3)
1,152 adults with obesity and type 2 diabetes. After 80 weeks, weight fell 11.9%, 16.8% and 18.8% on the three doses versus 5.1% on placebo. Stomach side effects, low blood pressure and skin tingling were more common on the drug, and up to 12% stopped because of side effects. Funded by Eli Lilly; not yet approved.
The FDA approved insulin efsitora alfa (Onswik, Eli Lilly) for adults with type 2 diabetes, based on four QWINT trials where it controlled A1C about as well as daily insulin. It is not for type 1 diabetes. Drugs@FDA lists the approval on September 23; news reports dated it September 24.
Which second drug protects the kidneys? (75,000-person records study)
In people who already had protein in their urine, GLP-1 drugs or SGLT-2 drugs went with a 40% lower 5-year risk of serious kidney decline than DPP-4 drugs. In people without urine protein, no clear kidney benefit was seen. This used health records, not a randomized trial.
Zenagamtide (formerly amycretin) vs insulin glargine (AMBITION 7, Phase 3)
Novo Nordisk is testing its weekly GLP-1 and amylin shot against daily insulin glargine in about 1,778 adults with type 2 diabetes and higher heart risk. The main result is A1C at 52 weeks. Recruiting.
Weight-loss surgery for obesity and type 2 diabetes (Cochrane review)
18 studies, 15,282 people. Gastric bypass and some other operations may give more long-term weight loss, lower A1C and more partial remission than lifestyle and medicine alone. But evidence on full remission, serious side effects and deaths is very uncertain because studies were small.
Lifestyle program and fewer chronic illnesses 20+ years later (DPP follow-up)
1,173 people from the Diabetes Prevention Program, which began in 1996 with people at high risk of diabetes. Those in the lifestyle group had a 21% lower risk of later having two or more chronic conditions than the placebo group. Metformin showed no difference. Only part of the original group could be followed.
262 adults on metformin. After 36 weeks, A1C fell by 0.9 to 1.7 points depending on dose, more than placebo. Most side effects were stomach-related and mild to moderate. This was a dose-finding trial; Phase 3 trials are now running. Funded by Novo Nordisk.
Type 2 diabetes can be controlled for many years, and newer medicines now do more than lower blood sugar. Some also protect the heart and kidneys or bring large weight loss. A small number of people reach remission (normal blood sugar without diabetes medicines) after major weight loss, but blood sugar can rise again, so it is not a cure.
Tirzepatide (Mounjaro)
Approved
Weekly shot · GIP and GLP-1 · SURPASS-2 · SURPASS-CVOT · FDA May 13, 2022
It acts on two gut hormones that help control blood sugar and appetite. In a head-to-head trial, A1C fell 2.01 to 2.30 points, compared with 1.86 on semaglutide, and people lost more weight. In a large heart trial of 13,165 adults with heart disease, heart attack, stroke or heart-related death happened in 12.2% versus 13.1% on dulaglutide. That showed it was at least as good, but not clearly better. Stomach side effects were more common.
Semaglutide (Ozempic shot, Rybelsus pill)
Approved
GLP-1 · FLOW · SOUL · FDA Dec 5, 2017 (shot) · FDA Sep 20, 2019 (pill)
In people with diabetes and kidney disease (FLOW), the weekly shot lowered the risk of serious kidney events by 24% and death from any cause by 20%. In people with heart or kidney disease (SOUL), the daily pill cut major heart events to 12.0% from 13.8% on placebo over about 4 years.
SGLT2 inhibitors (empagliflozin, dapagliflozin and others)
Approved
Daily pills · EMPA-REG OUTCOME · DECLARE-TIMI 58 · FDA Aug 1, 2014 (empagliflozin)
These pills make the kidneys pass extra sugar in the urine. In EMPA-REG OUTCOME, deaths from heart disease fell to 3.7% from 5.9%, and hospital stays for heart failure fell to 2.7% from 4.1%. DECLARE found fewer heart-failure hospital stays and kidney events, but no drop in heart attacks or strokes. Genital infections are more common.
Orforglipron (Foundayo), a GLP-1 pill
Approved for weight · U.S.
ACHIEVE-1 · FDA Apr 1, 2026 (weight management only) · UK diabetes approval Aug 10, 2026
A daily pill that is not a protein, unlike earlier GLP-1 medicines. In people with early type 2 diabetes, A1C fell 1.24 to 1.48 points over 40 weeks, compared with 0.41 on placebo, and weight fell up to 7.6%. In the U.S. it is approved only for weight management so far. The UK has authorised it for type 2 diabetes.
Retatrutide
Promising · Phase 3
Eli Lilly · TRIUMPH-2 (The Lancet, Sep 29, 2026) · TRANSCEND-T2D-1 · not approved
A weekly shot that acts on three hormone receptors (GIP, GLP-1 and glucagon). In adults with obesity and type 2 diabetes, weight fell 11.9% to 18.8% over 80 weeks, compared with 5.1% on placebo. A second trial found A1C drops of 1.7 to 2.0 points, but those results are company-reported and not yet in a journal. Up to 12% stopped treatment because of side effects.
Remission through major weight loss
Proven in trials
DiRECT · UK family doctors · The Lancet 2017 · 5-year follow-up 2024
A medically supervised program of meal-replacement shakes for 3 to 5 months, then slow return to food. After a year, 46% were in remission, compared with 4% with usual care, and 86% of those who lost 15 kg (33 lb) or more were in remission. Remission often faded: at 5 years, 13% of those still in the program were in remission.
Standard treatment today
Treatment
For
What it does
Healthy habits + diabetes education (DSMES)
Everyone
Food, activity, sleep and self-care skills are part of every treatment plan. Losing more than 10% of body weight can bring remission in some people.
Metformin
Most adults, often first
A cheap, long-used pill that lowers blood sugar without causing lows by itself. Stomach upset is common, and vitamin B12 should be checked over time.
SGLT2 inhibitors
Heart failure, kidney disease or heart disease
Pills that lower blood sugar and reduce heart-failure hospital stays and kidney decline.
GLP-1 receptor agonists
Heart or kidney disease, or when weight loss is a goal
Shots or a pill (semaglutide, dulaglutide, liraglutide) that lower blood sugar and weight. Guidelines generally prefer them over insulin when more treatment is needed.
Tirzepatide (GIP + GLP-1)
When large blood-sugar and weight drops are needed
A weekly shot. Guidelines rate it and semaglutide as the strongest for lowering both blood sugar and weight.
DPP-4 inhibitors
Some adults needing an added pill
Pills such as sitagliptin with a smaller blood-sugar effect. Not used together with GLP-1 medicines.
Sulfonylureas or pioglitazone
When cost matters, or for fatty liver disease (pioglitazone)
Low-cost pills. Sulfonylureas can cause low blood sugar and weight gain. Pioglitazone can cause weight gain and is not used in heart failure.
Insulin
When other medicines are not enough
Many people with type 2 diabetes eventually need it. A once-weekly insulin (icodec) was approved in the U.S. in 2026.
Metabolic (bariatric) surgery
BMI 30 or more (27.5 or more in Asian American people)
Stomach surgery for weight and blood sugar. In one trial of 150 people, 29% after gastric bypass and 23% after sleeve surgery reached an A1C of 6% or less at 5 years, versus 5% with medicines alone.
Natural remedies & supplements
No supplement, herb or diet product cures type 2 diabetes. Some interact with diabetes medicines, and some can push blood sugar too low. We rate each by the strength of human evidence. Ask your care team or pharmacist before you try anything, and never stop a prescribed medicine on your own.
Good human evidenceObservational / mixedLab only, or possible harm
Claims you'll see online
Structured diet & weight loss
The best-tested "natural" approach. In the DiRECT trial, a supervised weight-loss program put 46% of people into remission at 1 year and 36% at 2 years, compared with 4% and 3% on usual care. Remission depended on keeping the weight off, and this was done with medical supervision, not alone.
Regular physical activity
The American Diabetes Association (ADA) says structured exercise programs of at least 8 weeks lowered A1C by about 0.66% in type 2 diabetes. Its 2026 standards advise most adults to get 150 minutes or more of moderate activity a week, plus strength training. Ask your team what is safe for you.
Cinnamon
A Cochrane review found no clear effect on A1C. A later review found lower fasting blood sugar, but the studies differed a lot. The ADA does not recommend cinnamon for blood sugar. Cassia cinnamon contains coumarin, which in large amounts might worsen liver disease.
Berberine
A 2021 review of 46 studies suggested it may lower blood sugar, but most studies were done in China and some were poor quality. It can cause stomach upset and may interact with medicines. It should not be used during pregnancy or breastfeeding, or given to infants.
Apple cider vinegar
A 2025 review pooled only 7 small trials and reported lower fasting blood sugar. Larger, better trials are needed before anyone can say it helps.
Vitamin D
In the D2d trial of 2,423 adults with prediabetes, vitamin D did not significantly lower the risk of getting type 2 diabetes. The ADA does not advise routine vitamin D for people with diabetes who are not low in it. Too much can be harmful.
Use with caution
Chromium
A 2022 review of 16 small studies suggested it may help blood sugar, but the ADA does not recommend it. A few reports link large doses to kidney, liver, muscle and skin problems. Long-term effects are not well studied.
Magnesium
People who eat more magnesium tend to have lower diabetes risk, but a 2022 review said research on supplements is not enough to guide care. The ADA does not recommend them for blood sugar. Large doses cause diarrhea and cramps, and very large doses can be deadly.
Bitter melon
Human studies are few and low quality. Memorial Sloan Kettering warns it may add to the effect of insulin and other diabetes medicines. Case reports include stomach ulcers and severe kidney injury.
Fenugreek
Some studies suggest it may lower blood sugar, but many were not high quality. NCCIH says large doses may cause a harmful drop in blood sugar. It may raise bleeding risk with warfarin and can cause serious allergic reactions.
Aloe vera (by mouth)
Only a small amount of research suggests it may lower blood sugar, and the ADA does not recommend it. Aloe leaf extracts taken by mouth have been linked to cases of acute hepatitis, and aloe latex can cause cramps and diarrhea.
Be careful: the FDA warns against products that claim to be a "natural diabetes cure" or to "replace your diabetes medicine." They are sold illegally. Some "blood sugar support" products sold as supplements contained hidden prescription diabetes drugs. FDA tests found glyburide and metformin in Dr. Ergin's SugarMD Advanced Glucose Support (Nov 3, 2023) and in Fouzee SugarLin Herbal Formula (Dec 6, 2024). Hidden drugs like these can cause dangerously low blood sugar. The FDA also warns that unapproved versions of GLP-1 drugs such as semaglutide and tirzepatide are not reviewed for safety or quality. Some carry fake pharmacy labels, some are sold "for research use," and counterfeit Ozempic pens have been found in the U.S. drug supply (most recently Dec 5, 2025). Get these medicines only with a prescription from a state-licensed pharmacy. Herbs that lower blood sugar, such as bitter melon or fenugreek, may add to insulin or other diabetes medicines and cause lows. Tell your care team about every supplement you take, and never stop or cut a prescribed medicine to try one.
Where to get care and support
Centers recognized for expertise in this condition, and communities of people living with it.
Where people find expert care
Joslin Diabetes CenterBoston, Massachusetts, USA
Listed by the NIH's diabetes institute (NIDDK) as one of its funded Diabetes Research Centers. Its adult clinic, now on the Beth Israel Deaconess Medical Center East Campus, cares for adults with type 1 or type 2 diabetes and has programs for older adults and a Latinx diabetes clinic.
Vanderbilt Eskind Diabetes Clinic, Vanderbilt University Medical CenterNashville, Tennessee, USA
Vanderbilt's Diabetes Research and Training Center is an NIDDK-funded Diabetes Center. The Eskind clinic treats type 1, type 2 and other forms of diabetes, with diabetes education classes and dietitians.
UAB Medicine, University of Alabama at BirminghamBirmingham, Alabama, USA
An NIDDK-funded Diabetes Research Center. UAB says more than 200 researchers work in its Comprehensive Diabetes Center, and its diabetes clinics treat both type 1 and type 2 diabetes.
Yale New Haven Health and Yale School of MedicineNew Haven, Connecticut, USA
Yale is an NIDDK-funded Diabetes Research Center. Yale New Haven's diabetes center offers diabetes care and education, is recognized by the American Diabetes Association for diabetes education, and its research includes a type 2 (adult-onset) diabetes program.
Newcastle University and University of Glasgow (DiRECT trial teams)Newcastle upon Tyne, England, and Glasgow, Scotland, UK
These research teams led DiRECT, a trial in 49 family-doctor practices. At 12 months, 46% of people on its weight-management program were in remission, compared with 4% on usual care. They are research teams, not clinics.
These are centers recognized for expertise in this condition, not a ranking, and Cure Checker does not endorse or rate any facility. Outcomes depend on the individual. Ask your doctor which center fits your situation.
Support groups & communities
Type 2 diabetes means making choices about food, medicine and checks every day, and it helps to talk with people who live it too. Most of these are free.
Beyond Type 2 Community
Online community
People with type 2 diabetes · English and Spanish
A private online community from Beyond Type 1, with a space just for type 2. Members ask questions, share successes and vent. It works on the web, iPhone and Android.
Women with any type of diabetes or at risk · U.S. · virtual and in person
Free, peer-led meetups where women share stories and tips on eating, staying active, coping with stress and taking medicines. Some sessions are in Spanish. Free membership is needed to sign up.
Volunteer-led groups across the UK that usually meet once a month. Members offer understanding and support, and many groups also run social events and awareness activities.
Diabetes Canada's free online community with trained moderators, for people who are newly diagnosed, have lived with diabetes for years, or care for someone who has it.
Adults with diabetes · Australia · online and face to face
A free site from the NDSS, which Diabetes Australia runs, to find peer support groups near you or online, including groups for type 2 diabetes and for older adults.
Before you join: support groups share experiences, not medical advice. Check any change to your diet, medicines or insulin with your own care team first. Be wary of anyone selling a "cure", supplements, or cheap or compounded diabetes and weight-loss drugs online. Protect your privacy, because many forums are public, and never share passwords or financial details. Cure Checker isn't affiliated with these groups.
How other countries treat type 2 diabetes
The basics are the same almost everywhere: healthy habits, metformin, SGLT2 and GLP-1 medicines, and insulin. The differences are in newer medicines. Japan uses imeglimin and China uses dorzagliatin, neither sold in the U.S. A weekly insulin reached Europe, Canada, Japan and China two years before the U.S., and the UK approved the orforglipron pill for diabetes first.
Who has approved what
Treatment
U.S.
EU
UK
Canada
Japan
China
Australia
Switz.
TirzepatideMounjaro, weekly GIP + GLP-1 shot
2022
2022
2022
2022
2022
2024
—
2022
Oral semaglutideRybelsus, daily GLP-1 pill
2019
2020
—
2020
2020
—
—
2020
Insulin icodecAwiqli, once-weekly insulin
2026
2024
—
2024
2024
2024
2024
2024
OrforglipronFoundayo, daily GLP-1 pill
2026, weight only
Review
2026
Review
Review, weight
—
—
—
ImegliminTwymeeg, daily pill
—
—
—
—
2021
—
—
—
DorzagliatinHuaTangNing, daily pill
—
—
—
—
—
2022
—
—
2022 approved (year)Review conditional, under review, or limited fundingRejected refused or withdrawn— not approved, or no approval on record
Available abroad, not in the U.S.
Imeglimin (Twymeeg)
Japan
Approved June 23, 2021 · Sumitomo Pharma
The first of a new type of diabetes pill. In a Japanese trial of 213 adults, it lowered A1C by 0.87 points more than placebo over 24 weeks, with side effects similar to placebo. It has no FDA approval.
The first approved glucokinase activator, a pill that helps the body sense blood sugar and release insulin. In people not yet on medicine, A1C fell 1.07 points versus 0.50 on placebo after 24 weeks. It is approved alone or with metformin.
The UK was the first country in Europe to authorise this GLP-1 pill, for weight management and to improve blood sugar in type 2 diabetes. In the U.S., the same pill is approved only for weight management, not diabetes.
Insulin is first used successfully in a patient, in Toronto.
U.S. approves metformin (Glucophage), long the usual first diabetes pill.
The UK Prospective Diabetes Study shows tighter blood-sugar control cuts small-blood-vessel complications, such as eye damage, by 25%.
U.S. approves canagliflozin, the first SGLT2 inhibitor in the country.
EMPA-REG OUTCOME shows a diabetes pill, empagliflozin, lowers deaths from heart disease.
U.S. approves weekly semaglutide. The DiRECT trial shows remission is possible after major weight loss.
U.S. approves semaglutide as a daily pill (Rybelsus).
Japan approves imeglimin, a new type of diabetes pill.
U.S., EU, UK, Canada, Japan and Switzerland approve tirzepatide. China approves dorzagliatin.
Weekly insulin icodec is approved in the EU, Canada, Japan, China, Switzerland and Australia. The U.S. FDA sends back its first application. FLOW shows semaglutide protects the kidneys.
The SOUL and SURPASS-CVOT heart trials report results for the semaglutide pill and tirzepatide.
U.S. approves weekly insulin icodec for type 2 diabetes and orforglipron for weight management. The UK authorises orforglipron for type 2 diabetes.
What causes type 2 diabetes
Type 2 diabetes happens when the body stops responding well to insulin and the pancreas can no longer make enough insulin to keep blood sugar in a healthy range. It is not a personal failing. Researchers still don't fully know what starts it. Age, family history and genes, extra weight, low physical activity, and social factors such as income, neighborhood, the local food environment and access to health care all play roles.
Step 1 · The start
Risk builds over years
Who is at risk: people 45 or older, with a parent, brother or sister with type 2 diabetes, with extra weight, or active fewer than 3 times a week
Genes: a common TCF7L2 gene variant raises risk about 1.5-fold with one copy and 2.4-fold with two
Life circumstances: diabetes affects low-income adults and some racial and ethnic groups more in the U.S.
Younger people: more and more children, teens and young adults are developing it
Step 2 · The tipping point
Insulin stops keeping up
Insulin resistance: muscle, fat and liver cells stop responding well to insulin
Organ fat: extra fat in the liver and pancreas is thought to drive both problems, and can fall with large weight loss
The pancreas: over time it cannot make enough insulin, and blood sugar rises
Prediabetes first: an estimated 115.2 million U.S. adults have prediabetes
Step 3 · The damage
Quiet harm over time
Often hidden: about 27.6% of U.S. adults with diabetes, 11.0 million people, don't know they have it
Blood vessels: damage can lead to heart disease and stroke
Kidneys, eyes, nerves: kidney disease, vision loss and nerve damage
Feet: nerve damage and poor blood flow can cause serious foot problems
Step 4 · The result
Lifelong, but sometimes reversible
Share in remission at 1 year by kilograms lost, across everyone in the DiRECT trial (Lancet, 2018)
Works best early: people who reached remission had had diabetes for less time
Can come back: regaining weight brought back pancreas fat and diabetes in some people, so checkups continue
January 1936, two kinds of diabetes: Harold Himsworth wrote in The Lancet that diabetes could be split into "insulin-sensitive" and "insulin-insensitive" types. He proposed that some diabetes comes from the body not responding to insulin, rather than from a lack of insulin, an early form of the idea now called insulin resistance.
January 15, 2006, a gene variant: a study in Nature Genetics found that a common variant in the TCF7L2 gene raises the risk of type 2 diabetes, a finding confirmed in Icelandic, Danish and U.S. groups. The authors estimated it accounted for about 21% of type 2 diabetes risk in the groups studied.
June 9, 2011, reversible in some: in a small Newcastle study of 11 people, 8 weeks of a very-low-calorie diet brought insulin release and the liver's insulin response back to normal as liver and pancreas fat fell. The same Newcastle team later helped run the DiRECT remission trial.
Find a clinical trial
Live numbers and the newest entries from the world's main trial registries and medical databases. Most of this loads fresh each time you open the page.
Where type 2 diabetes trials are recruiting right now
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Drug trials with no U.S. site
Newest published clinical trials
PubMed · U.S. National Library of Medicine
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Newest Cochrane systematic reviews
Cochrane Database of Systematic Reviews, via PubMed
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Newest trials in the EU registry
EU Clinical Trials Information System
Newest UK & international registrations
ISRCTN registry
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FDA records for the medicines in this report
Medicine
Brand
FDA application
Original approval
From Drugs@FDA via FDA's openFDA service. Some older brands are missing from FDA's open data, and newly approved drugs can take a few weeks to appear. An approval may be for a different disease than this one.
Search every registry yourself
The WHO's ICTRP gathers trials from registries worldwide, including China, Japan, India, Iran, Australia and Brazil. Cochrane CENTRAL and OpenMD don't allow automated access, so they're linked here for you to search directly.
Financial help for people living with type 2 diabetes
These charities help people with type 2 diabetes pay for medicines, supplies and other care costs. Several funds are closed right now. Funds are limited and rules vary, so contact each one directly.
Diabetes organizations
Diabetes Foundation: free medication and supplies
Medicines & supplies
New Jersey residents with any type of diabetes facing financial hardship
An emergency service that gives up to 60 days of free insulin, diabetes pills or non-insulin injectables, and a two-month supply of testing and insulin supplies (such as meters, test strips, sensors and pods) to uninsured or underinsured people. Proof of New Jersey residency is required.
Insured patients treated in the U.S. · household income up to 300% of the federal poverty level
Helps with copays, coinsurance and deductibles for type 2 diabetes prescription drugs, up to $1,000 per year by pharmacy card. As of Oct 11, 2026 the page says the fund is temporarily closed to new patients because of a lack of funding.
Patient Advocate Foundation TotalAssist: type 2 diabetes funds
Closed
People with Medicare, Medicaid or TRICARE · income up to 500% of the federal poverty level (cost-of-living adjusted) · U.S.
Two funds, a main fund and a health-equity fund for certain ZIP codes, each with a $1,500 guaranteed award and a $2,000 maximum toward copays, coinsurance, deductibles, insurance premiums and other costs. Both were listed as closed on Oct 11, 2026, with a sign-up to be told when they open.
Before you apply: Cure Checker does not run, verify or endorse these organizations, and being listed is not a promise of help. Funds are limited and rules change, so confirm eligibility and details with each organization. Be careful of anyone who asks for payment up front or for your bank login to 'release' a grant.
Sources
Everything this report is based on, grouped by section. Checked Oct 11, 2026.
U.S. figures: the CDC's National Diabetes Statistics Report (updated Sep 16, 2026) counts all diabetes (40.1 million in 2023, diagnosed or not) and does not give a separate type 2 count; the 90% to 95% share comes from the CDC's type 2 page. Most drug trials cited (SURPASS, TRIUMPH, ACHIEVE, QWINT, ONWARDS, CREDENCE, FLOW, SOUL, REIMAGINE and others) were funded by the drug makers, and the TRANSCEND-T2D-1 figures are company-reported topline results. Retatrutide, survodutide, CagriSema, zenagamtide, safiglipron and maridebart cafraglutide are not approved. Orforglipron (Foundayo) is FDA-approved for weight management only (label checked in openFDA); its EU, Canada and Japan "Review" cells rest on a July 2026 review article and may be out of date. FDA dates follow Drugs@FDA where news differs (Onswik Sep 23, 2026, news Sep 24; Awiqli Mar 26, 2026, company release Mar 27). The Awiqli and Onswik labels were not in openFDA, so their "adults with type 2 diabetes" wording and the Onswik and Rybelsus heart-use details come from trade-press reports. Approvals: several cells rest on company releases or news rather than the regulator (tirzepatide in the UK and China, insulin icodec in Australia and China); "—" can mean "not verified" rather than "not approved" for tirzepatide and oral semaglutide in Australia, oral semaglutide in the UK and China, and insulin icodec in the UK. The 1922 insulin date comes from a university history article. DiRECT enrolled UK adults aged 20 to 65 diagnosed within 6 years, with medicines withdrawn by their doctors under the trial protocol; its 5-year figure comes from a non-randomized extension group, and results may not apply to everyone. Himsworth's 1936 paper is dated to the month only. PubMed dates are electronic publication dates, except three papers with none listed (SURPASS-CVOT and two JAMA papers). SURPASS-CVOT showed tirzepatide was not worse than dulaglutide, not that it was better. Observational studies show links, not cause. Natural remedies: NCCIH's supplement fact sheet dates from November 2023 and the Cochrane cinnamon review from 2012; the apple cider vinegar review pooled 7 small trials; grades are Cure Checker's own judgment. Missing-link hypothesis: the statement that no large trial has measured insulin-cell recovery after medicine-driven weight loss is our inference from searches; the tirzepatide figure comes from an abstract. Expert care centers: there is no official U.S. designation for type 2 diabetes care centers; four are listed because NIDDK names them as funded Diabetes Research Centers (NIDDK's page was last reviewed April 2025), and the DiRECT entry is a research team, not a clinic. Support groups: no Reddit community is listed because Reddit blocked every automated check today; the Beyond Type 2 community app blocked checks, so its card links to the organization's description page. Financial help: checked October 11, 2026. The HealthWell and Patient Advocate Foundation type 2 diabetes funds were closed that day. The Diabetes Foundation serves New Jersey residents only. The PAN Foundation and Accessia Health sites could not be checked, so they are not listed. Drug-company assistance programs are left out by site rule. We found no UK, Canadian or Australian charity giving grants to individuals with type 2 diabetes.