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Type 2 diabetes is a condition where the body cannot use insulin properly. Over time the pancreas cannot make enough of it to keep up. So glucose, the sugar your body runs on, builds up in the blood instead of getting into your cells. It usually develops slowly, and symptoms often go unnoticed for years. Most people are diagnosed after age 45, but it can develop at any age. More children, teens, and young adults are being diagnosed now. It is by far the most common form of diabetes, about 9 in 10 diagnosed cases in adults. Some groups carry a heavier burden, with the highest rates among American Indian and Alaska Native, Black, and Hispanic adults.
A few things make type 2 diabetes research unusual. Trials here measure success with a standard blood test of long term blood sugar. So results are objective, not based on how someone feels. From 2008 to 2020 the FDA required proof that diabetes drugs do not raise heart risk. That is why some of the largest trials ever run have been in this disease. The field is so crowded that new medicines are now often tested head to head against approved drugs instead of placebo alone. But there is a documented gap. Black and Hispanic patients are underrepresented in the field's major heart outcome trials, compared to how heavily the disease affects them.
Want to know why this keeps happening — and what's being done about it? Check out our article on diversity and inclusion in clinical trials.
They are different diseases with different causes. Type 1 is autoimmune. The immune system attacks and destroys the cells in the pancreas that make insulin, so the body cannot make insulin at all. In type 2 the body still makes insulin but cannot use it properly, and over time makes less of it. Type 2 is far more common in adults. And neither one is the mild version. Both are serious conditions that can lead to serious complications, so no doctor ranks one as worse than the other.
Type 2 diabetes clinical trials test a wide range of approaches to help the body manage blood sugar more effectively. These trials generally fall into a few categories:
Much of today's research builds on GLP-1 and related drug classes, testing new formulations (including oral versions), combination therapies, and next-generation medications aimed at better blood sugar control alongside weight loss. Trials also continue testing newer insulin formulations and other drug classes for people who haven't responded well to standard treatment.
Some trials evaluate continuous glucose monitors, insulin delivery devices, and digital tools that help people track and manage their blood sugar day to day. These studies look at whether better monitoring leads to better outcomes and easier day-to-day management.
Because type 2 diabetes is closely tied to diet, weight, and activity level, many trials study structured lifestyle programs, dietary approaches, and exercise interventions. These studies look at how lifestyle changes affect blood sugar control and long-term complications, either on their own or alongside medication.
It depends on the study. Some trials want people who were diagnosed recently or have early type 2 diabetes. Others enroll people who already take medicines like metformin. And many studies here are not drug trials at all. Diet, nutrition, and sleep studies recruit on this page too, and some accept people who do not have diabetes yet. Because Black and Hispanic patients have long been underrepresented in type 2 diabetes research, many studies especially welcome participants from these communities. Eligibility always varies by study.
The body becomes unable to use insulin the way it should. The pancreas tries to make more to keep up, and over time it cannot, so sugar builds up in the blood. It runs in families more than type 1 does, and weight and activity level matter too. It usually builds slowly over years, which is why so many people have it before they know it.
Some studies offer compensation for time and travel, and study related care is typically provided at no cost to participants. Compensation varies by trial and is always described during the informed consent process before you agree to anything.
Curious whether clinical trials pay participants? Here's how compensation actually works.