Type 2 Diabetes
Type 2 diabetes is a chronic condition in which the body can't effectively use or produce enough insulin. It is the most common form of diabetes. Similar to Type 1, genes are believed to play a role, but diet and exercise have proven effective in management and even prevention.
Type 2 Diabetes Causes
Scientists don’t know the exact causes that trigger Type 2 diabetes, but they believe genetics, diet and exercise play an integral role in its development. Dietary changes and increased physical activity have shown to be effective tools in treating the condition.
When cells in the muscles, the liver and fat become resistant to insulin, the pancreas tries to compensate, producing more. Eventually, the overtaxed pancreas loses its ability to make insulin, leaving cells starved for energy. This can lead to prediabetes, the precursor of Type 2 diabetes, or to Type 2 diabetes itself.
Type 1 diabetes, however, may have a genetic component in some patients, and other factors such as viruses could trigger the condition. The immune system of patients with Type 1 diabetes mistakenly destroys beta cells, leaving the body with little to no insulin. Type 1 diabetes is often diagnosed in childhood.
Risk Factors of Type 2 Diabetes
Type 2 diabetes has multiple risk factors. These include a complex combination of family history, personal medical history and lifestyle.
The role that family history and genetics plays is not fully understood, but individuals who have had relatives with diabetes are statistically more likely to develop Type 2 diabetes. Families who are of Native American, African American, Alaska native, Asian American, Latino or Hispanic, and Pacific Islander American descent have been found to be at higher risk.
Overall personal health plays a part as well. Those with a medical history of cardiovascular disease, high blood pressure, high triglycerides, low HDL (good cholesterol) and prediabetes are at higher risk for Type 2 diabetes.
Those who have had polycystic ovary syndrome or gestational diabetes are also at increased risk. Depression, weight and sleep disorders are also significant factors. Infrequent exercise and smoking put people at high risk.
Type 2 Diabetes Symptoms
Because Type 2 diabetes leads to less insulin production, your body begins to rely on alternative sources of energy in muscles, organs and tissues. This kick-starts a chain reaction that can cause a variety of diabetes symptoms.
- Excessive thirst
- Constant hunger
- Lack of energy
- Frequent urination
- Blurred vision
- Weight loss
- Slow-healing sores
- Frequent infections
- Areas of darkened skin (typically in the armpits and around the neck)
Signs of Type 2 diabetes develop slowly over several years — often without being noticed. As the disease progresses, symptoms can grow more apparent and, without treatment, can lead to potentially dangerous complications. These can include vision loss and blindness (diabetic retinopathy), kidney disease (nephropathy), a feeling of numbness in your hands and feet (neuropathy), gum disease and heart attack or stroke.
Type 2 Diabetes Testing
See your doctor immediately if you suspect you have Type 2 diabetes. Your doctor may conduct a series of tests to aid in proper diagnosis. They will likely order one or more of the following diabetes tests:
- Glycated hemoglobin testing (A1C)
- Random blood sugar test
- Fasting blood sugar test (fasting plasma glucose test)
- Oral glucose tolerance test
Glycated hemoglobin testing, which is a simple blood test, is the most commonly used diabetes test. It indicates your average blood sugar level over the past two to three months. An oral glucose tolerance test is a series of blood tests that begin with a fasting blood test, followed by one or more blood tests after the patient has consumed a sugary drink, to see how well the body can process glucose.
How Do You Treat Type 2 Diabetes?
Maintaining an active lifestyle, managing weight, taking prescribed medications and diligently monitoring blood sugar levels can help people who have Type 2 diabetes treat it effectively.
- Sulfonylureas and meglitinides
- Alpha-glucosidase inhibitors
- Thiazolidinediones (TZDs)
- GLP-1 receptor agonists
- GLP-1 antagonists
- DPP-4 inhibitors
- SGLT2 inhibitors
Scientists also continue to explore new therapies. Many burgeoning treatment strategies focus on tackling nonalcoholic fatty liver disease, which has a close relationship with insulin resistance and Type 2 diabetes. New therapies targeting NAFLD and heart-risk factors are believed to help people with this type of diabetes.
Managing Type 2 Diabetes
The American Diabetes Association provides a comprehensive guide called Standards of Medical Care in Diabetes. Its recommendations focus on an array of topics, including self-management education, treatment approaches, and diagnosis of complications such as vascular issues.
It emphasizes overall health with a focus on the role immunizations, quitting smoking, nutrition and physical activity can play. There’s also a recognition of the important role psychosocial care plays in conjunction with treatment approaches, including the intensification of insulin therapy.
Researchers have found a holistic approach provided by a multidisciplinary team of health care professionals is optimal in creating an effective overall structured disease management plan for Type 2 diabetes.
The results of the United Kingdom Prospective Diabetes Study played a key role in shaping this approach. The study highlighted the importance of controlling blood sugar levels in those with Type 2 diabetes.
Type 2 Diabetes in Children, Teens and Adults
Children with Type 2 diabetes are at higher risk of developing health complications than adults. Because children spend much of their day in school or day care, it’s important to develop close communications with teachers and child care providers to help optimize diabetes management safely. It can also be helpful when diabetes management becomes a goal for the whole family.
The complexities of diabetes management require ongoing guidance throughout childhood and into adolescence. Academic, social and family stresses can impact kids’ self-esteem and ability to maintain diabetes management plans.
Adults living with diabetes or caring for family members with diabetes may also benefit from support from dietitians, medical professionals and mental health counselors as part of a comprehensive wellness and diabetes management plan.
Preventing Type 2 Diabetes
There is no definitive way to prevent Type 2 diabetes, but following a medically advised plan from your health care team can reduce your risk of developing it. Steps you may be advised to take can take include:
- Maintaining a diet low in fat and sugar
- Quitting smoking
- Following a safe exercise plan four to five days a week in which your heart rate stays elevated for at least 30 minutes
- Getting regular checkups that include blood work
Controlling high blood pressure and stress can also help prevent Type 2 diabetes. Yoga, Pilates, tai chi, meditation and mindfulness may help mitigate stress.
Type 2 Diabetes Complications
Management of Type 2 diabetes presents many challenges, and if unsuccessful can lead to a number of potentially serious complications.
- Diabetic Retinopathy: High blood sugar weakens the capillaries supplying blood to the retina, making them swell, become blocked and leak blood into the eye, causing blurry vision.
- Nephropathy: Damage to nephrons, or filtering units, in the kidney because of chronic high blood sugar. This can lead to end-stage renal disease requiring dialysis and kidney transplant.
- Peripheral Neuropathy: Feeling of numbness in your hands and feet. This is nerve damage that can affect any nerve in your body, although it commonly affects the nerves in the legs, feet, arms and hands.
- Macrovascular complications: Combined with nerve damage, damage to the blood vessels in limbs – especially the feet – can lead to tissue damage requiring amputation.
- Cardiovascular Disease: People with diabetes are at greater risk of heart disease, suffer from more severe forms of heart disease and develop heart disease at a younger age.
These complications can be avoided with effective and proactive Type 2 diabetes management. This includes following all your health team’s instructions carefully and working closely with your doctor to monitor your health.
Talk to Your Doctor
Managing Type 2 diabetes can be complicated and requires teamwork. Given the serious implications of the disease, early intervention is key. Speak to your doctor and develop safe prevention plans, discuss screenings and maintain constant communication if treatment is necessary.
It may also be helpful to bring your family into the loop and educate them about the warning signs of abnormal blood glucose levels. This information will ensure they can help in case of an emergency.
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