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What Is Type 2 Diabetes?


Patients with Type 2 diabetes have excess sugar in their blood, which can cause a number of complications, including nerve and kidney damage. The disease is usually treated with medication, but some come with serious side effects.

Type 2 diabetes is a disease in which your body loses its ability to produce and use insulin, a hormone made by the pancreas. After your body breaks down sugar and starch from food, insulin delivers the glucose to cells that absorb it and use it for energy. Insulin also helps to eliminate extra glucose from your blood.

Type 2 Diabetes

With Type 2 diabetes, your body can’t produce enough insulin to maintain normal glucose levels and your cells fail to react properly to the insulin that is made – known as insulin resistance.

There are several types of diabetes, including Type 1, Type 2 and gestational. Type 2 is the most common, and of the 29.1 million Americans with diabetes, about 95 percent have this type. You may be among them. An additional 86 million adults in the United States have prediabetes, a condition where your blood sugar is high but not elevated enough for a diabetes diagnosis.

Diabetes cases increase each year, and every 17 seconds someone is diagnosed with the disease. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 3 adults may be diagnosed with diabetes by 2050.

The medical community used to call Type 2 diabetes “adult-onset” diabetes because it typically occurs in adults. Although the largest age group affected by diabetes remains 60 and older, more and more younger adults are being diagnosed. Some 3.7 percent of 20- to 44-year-olds have Type 2 diabetes.

The good news is that Type 2 diabetes is preventable. And several treatment options can help you manage your blood sugar, including lifestyle changes and medication. If diabetes is not well managed, it can cause serious health problems.

Are You at Risk for Diabetes?

Some people are more at risk to develop diabetes than others. Some of the risk factors for diabetes are:

Risk Factors for Diabetes
High blood sugar Smoking
Older than 45 Poor eating habits
Family history of diabetes High blood pressure
Inactivity Low HDL cholesterol and high triglycerides
Being overweight Moms who had a baby weighing more than 9 pounds or who had gestational diabetes

In addition to these risk factors, people of certain races are more predisposed to get diabetes, such as: Hispanic/Latino Americans, Asian-Americans, Pacific Islanders, Native Americans, natives of Alaska and Non-Hispanic Blacks.

How to Lower Your Risk for Type 2 Diabetes

The most effective ways to lower your risk of Type 2 diabetes are by making smarter food choices and increasing your physical activity. Experts recommend at least 30 minutes of activity each day. Of course, it is not always easy to make these changes overnight.

The American Diabetes Association recommends making these changes over time so you can adopt them as a lifestyle.

Here are some tips for making small, sustainable changes:
Set goals.
Keep your goals realistic. For example, if you have never exercised before, start slow.
Set a time frame for your goals. For instance, you may give yourself a month to lose some weight.
Keep your goal specific. Don’t just say, “I will exercise more.” Give yourself specific exercises, set a schedule and stick to it.
Reward yourself for reaching a goal. It’s important to look back at your progress and keep yourself motivated. You can buy some new clothes or take a trip to the movies.

Diagnosing Type 2 Diabetes

Because the symptoms of Type 2 diabetes seem mild or might not appear at all, many people don’t know they have it. The American Diabetes Association estimates that 7 million people may be living with undiagnosed Type 2 diabetes.

Some of the symptoms of Type 2 diabetes include:
Frequent urination Unusual thirst
Extreme hunger Numbness or tingling in the hands or feet
Extreme fatigue and irritability Blurred vision
Frequent infections Cuts or bruises that are slow to heal

If you suspect that you may have diabetes or have a family history of the disease, speak to your doctor about your concerns. A simple blood test is all that’s needed. The preferred test is called a fasting blood glucose test. The doctor will instruct you not to eat anything the night before the test, and it is most reliable when done in the morning. There are also other tests that can be performed.

A doctor can make a diagnosis of Type 2 diabetes based on any of the following results:
A blood glucose level of 126 milligrams per deciliter (mg/dL) or higher after an 8-hour fast.>
A blood glucose level of 200 mg/dL or higher 2 hours after drinking 75 grams of sugar water.
A blood glucose level of 200 mg/dL or higher at any time of day, along with symptoms of diabetes.

What is Prediabetes?

If your blood sugar levels are high, but not high enough for a diabetes diagnosis, this is called prediabetes. Prediabetes is also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).

  • IGT is diagnosed if blood glucose is 140-199 mg/dL two hours after drinking sugar water.
  • IFG occurs when blood glucose is 100 – 125 mg/dL after an overnight fast.

Without intervention, prediabetes can turn into diabetes within 10 years. At this stage, diet and exercise can cut or eliminate your risk of diabetes, or delay the disease. In fact, studies revealed that people with prediabetes who lost just 5 to 7 percent of their body weight lowered their chances of getting diabetes by 60 percent.

Health Problems Related to Diabetes

Because their cells are resistant to insulin, people with Type 2 diabetes have extra sugar in their blood. If high blood sugar is not managed, it can have devastating health consequences.

Over time, this extra sugar can cause health problems such as:
Eye problem like blindness and glaucoma
Foot complications
Skin problems
High blood pressure
Gum disease
Gastroparesis (when food takes too long to leave the stomach)
Nerve damage (neuropathy)
Kidney disease (nephropathy)
Peripheral arterial disease (PAD) (pain and tingling in the legs)
Heart problems (stroke, congestive heart failure)

Lack of insulin production can also lead to a condition called diabetic ketoacidosis. This occurs when the body cannot use glucose for fuel and burns fat instead. The byproducts of breaking down fat for fuel are called ketones. When ketones build up in the body, they become toxic. This condition is rare in people with Type 2 diabetes, though, and usually affects people with Type 1 diabetes whose bodies do not produce insulin at all.

Treating Type 2 Diabetes

There are a number of different treatment plans if you are diagnosed with diabetes. A common treatment for diabetes involves controlling your blood sugar through medication. There are a number of prescription medications available that are effective. However, some are known to harmful side effects. You may be able to treat your Type 2 diabetes with lifestyle changes instead of medication.

Diabetes Medications and Their Side Effects

There are several types of drugs that can help control your blood sugar.

Canagliflozin, sold under the brand name Invokana, is among a new class of diabetes medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors are unique because they reduce excess glucose in the body through urination. Urinary tract infections and diabetic ketoacidosis are some of the side effects of SGLT2 inhibitors. The FDA in December 2015 ordered manufacturers of SGLT2 inhibitors to add warnings regarding the risk of ketoacidosis and urinary tract infections to the drugs’ labels. Patients who developed ketoacidosis or UTIs after taking the drugs filed lawsuits claiming the drugs’ manufacturers failed to warn of the risks of the drugs.

Other drugs focus on producing more insulin to help absorb glucose.

For example, medications called incretin mimetics and dipeptidyl peptidase IV inhibitors (DPP-4s) work by stimulating the pancreas to produce insulin in response to a meal. Drugs like Januvia, Janumet and Tradjenta belong to the DPP-4 class. Byetta, Bydureon and Victoza are incretin mimetics and are also called glocagonlike-peptide-1 (GLP-1) receptor antagonists. Unfortunately, these two classes of drugs are linked to pancreatitis, pancreatic cancer and thyroid problems.

Another class of drugs called thiazolidinediones (TZDs) includes Actos and Avandia. These drugs will lower your blood sugar, but Actos carries a risk of bladder cancer, and Avandia can cause heart problems.

When any of these drugs are taken together, the risk of complications increases. Ask your doctor about safer alternatives. You need to read about any medications prescribed to make sure you understand the risks of complications.

Diet and Exercise

Since Type 2 diabetes is affected by lifestyle, it is possible doctors will recommend treatment based on a more regulated diet and a stepped-up exercise plan instead of medications. In fact, a groundbreaking study published in Diabetologia showed that exercise and diet produced dramatic results.

In this study, researchers monitored a group of people with diabetes. They were put on a low glycemic load, plant-based, low-calorie diet with no exercise, and many of the features of diabetes reversed in just one week. By eight weeks, the insulin-producing cells in the pancreas began to work again, cholesterol and fat deposits dropped, and there was no evidence of diabetes in the participants at the end of the study.

What is A1C?

Testing your blood sugar levels at home shows you how high your blood sugar is at that moment. An A1C, or glycated hemoglobin, test is an average measurement of your blood sugar levels over a two- or three-month period. This test is very useful for determining if your current treatment plan is working.

You may have to test your A1C every three months, but these levels should be tested at least twice a year. If your doctor is trying a new medication or treatment plan, there may be more frequent tests. This test does not replace self-testing.