Type 2 Diabetes: Causes, Symptoms And Treatment
Type 2 diabetes is a serious, chronic health condition that affects millions of people around the world. It occurs when the body is unable to use insulin, a hormone produced by the pancreas, effectively. If left uncontrolled, diabetes leads to poor blood circulation and contributes to swelling in limbs, nerve damage, vision issues, kidney problems and even cardiovascular disease.
Fortunately, type 2 diabetes can be managed with lifestyle changes, medications, and regular monitoring of blood sugar levels. In this article, we will discuss the causes, symptoms, and treatment of type 2 diabetes. We will also explore ways to prevent or delay the onset of type 2 diabetes.
Understanding the risk factors and warning signs of type 2 diabetes is essential, as the condition may not cause symptoms until years after it develops. Thankfully, lifestyle changes and other therapeutic interventions can minimize the risks associated with type 2 diabetes.
What Is Type 2 Diabetes?
Type 2 diabetes (diabetes mellitus) is a chronic condition affecting how your body metabolizes glucose. It occurs when your body doesn’t produce enough insulin—a hormone created by the pancreas that allows glucose to enter your cells, which is then used for energy—or becomes resistant to it. As a result, glucose builds up in the blood instead of being used by cells. This can lead to serious health problems like heart disease, nerve damage and kidney disease.
Type 2 diabetes can have a significant impact on everyday life, as it requires constant management to maintain glucose levels within a healthy range. The condition requires a significant commitment to lifestyle changes, including diet, exercise, medications and monitoring.
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Causes of Type 2 Diabetes
The pancreas is responsible for producing insulin, a hormone that helps the body regulate glucose. When your pancreatic cells don’t secrete enough insulin, or your body’s tissues don’t respond to the insulin produced, type 2 diabetes may occur. This results in elevated blood glucose levels, also known as hyperglycemia.
Several factors can increase your risk of developing type 2 diabetes, including having obesity, family history and age. It’s generally more common among people over 45, though it’s becoming increasingly prevalent in younger individuals, according to the Centers for Disease Control and Prevention (CDC).
Those who have a parent with type 2 diabetes have an increased risk of developing the condition themselves. Having a sedentary lifestyle with little or no physical activity also increases your risk. Studies suggest that sleep deprivation and chronic stress may also possibly increase the risk of type 2 diabetes.
Symptoms of Type 2 Diabetes
The signs and symptoms of type 2 diabetes can be difficult to spot in the early stages, as they may not be very noticeable.
Common symptoms include:
- Increased thirst
- Increased hunger
- Fatigue
- Numbness or tingling in the feet and hands
- Blurry vision
- Unexplained weight loss
- Sores that heal slowly or don’t heal at all
- Increased urination
- Recurrent yeast infections
“High glucose levels can damage nerves, causing numbness, tingling or pain in the hands or feet,” says Dr. Rhinehart. This sensation, called peripheral diabetic neuropathy, can make walking and daily activities difficult.
Ocular changes, such as blurry vision and floaters, can also occur due to damage to blood vessels in the retina (tissue located in the back of the eye).
If you notice any of the above symptoms, talk with your provider about diagnostic tests that may help determine whether you have type 2 diabetes. Diagnosis is based on a combination of factors, such as the results from blood tests and your medical history. An A1C (also known as glycosylated hemoglobin) test is often used to diagnose diabetes, as it measures your average blood glucose level over the past three months. A1C levels of 6.5% or higher indicate diabetes.
Factors that may Increase the Risk of Type 2 Diabetes
Factors that may increase the risk of type 2 diabetes include:
- Weight: Being overweight or obese is a main risk.
- Fat distribution: Storing fat mainly in the abdomen — rather than the hips and thighs — indicates a greater risk. The risk of type 2 diabetes is higher in men with a waist circumference above 40 inches (101.6 centimeters) and in women with a waist measurement above 35 inches (88.9 centimeters).
- Inactivity: The less active a person is, the greater the risk. Physical activity helps control weight, uses up glucose as energy and makes cells more sensitive to insulin.
- Family history: An individual’s risk of type 2 diabetes increases if a parent or sibling has type 2 diabetes.
- Race and ethnicity: Although it’s unclear why, people of certain races and ethnicities — including Black, Hispanic, Native American and Asian people, and Pacific Islanders — are more likely to develop type 2 diabetes than white people are.
- Blood lipid levels: An increased risk is associated with low levels of high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — and high levels of triglycerides.
- Age: The risk of type 2 diabetes increases with age, especially after age 35.
- Prediabetes: Prediabetes is a condition in which the blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type 2 diabetes.
- Pregnancy-related risks. The risk of developing type 2 diabetes is higher in people who had gestational diabetes when they were pregnant and in those who gave birth to a baby weighing more than 9 pounds (4 kilograms).
- Polycystic ovary syndrome. Having polycystic ovary syndrome — a condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
Type 2 Diabetes Complications
Type 2 diabetes affects many major organs, including the heart, blood vessels, nerves, eyes and kidneys. Also, factors that increase the risk of diabetes are risk factors for other serious diseases. Managing diabetes and controlling blood sugar can lower the risk for these complications and other medical conditions, including:
Heart and blood vessel disease
Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels, a condition called atherosclerosis.
Nerve damage in limbs
This condition is called neuropathy. High blood sugar over time can damage or destroy nerves. That may result in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
Other nerve damage
Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. Nerve damage also may cause erectile dysfunction.
Kidney disease
Diabetes may lead to chronic kidney disease or end-stage kidney disease that can’t be reversed. That may require dialysis or a kidney transplant.
Eye damage
Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
Skin conditions
Diabetes may raise the risk of some skin problems, including bacterial and fungal infections.
Slow healing
Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
Hearing impairment
Hearing problems are more common in people with diabetes.
Sleep apnea
Obstructive sleep apnea is common in people living with type 2 diabetes. Obesity may be the main contributing factor to both conditions.
Dementia
Type 2 diabetes seems to increase the risk of Alzheimer’s disease and other disorders that cause dementia. Poor control of blood sugar is linked to a more rapid decline in memory and other thinking skills.
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How to Prevent Type 2 Diabetes
Healthy lifestyle choices can help prevent type 2 diabetes. If you’ve received a diagnosis of prediabetes, lifestyle changes may slow or stop the progression to diabetes. A healthy lifestyle includes:
- Eating healthy foods: Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains.
- Getting active: Aim for 150 or more minutes a week of moderate to vigorous aerobic activity, such as a brisk walk, bicycling, running or swimming.
- Losing weight: If you are overweight, losing a modest amount of weight and keeping it off may delay the progression from prediabetes to type 2 diabetes. If you have prediabetes, losing 7% to 10% of your body weight may reduce the risk of diabetes.
- Avoiding long stretches of inactivity: Sitting still for long periods of time can increase the risk of type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.
For people with prediabetes, metformin (Fortamet, Glumetza, others), a diabetes medication, may be prescribed to reduce the risk of type 2 diabetes. This is usually prescribed for older adults who are obese and unable to lower blood sugar levels with lifestyle changes.
What are the difference between Type 1 and Type 2 Diabetes?
Unlike type 2 diabetes, type 1 diabetes affects the immune system and is much less common than type 2. Those with type 1 diabetes don’t produce enough insulin due to their immune system attacking the cells in their pancreas. These cells, which usually produce insulin, are destroyed and can no longer make the hormone.
Treatment for type 1 diabetes always includes insulin, while type 2 diabetes may or may not require insulin. Unlike type 1 diabetes, type 2 diabetes can sometimes be prevented with lifestyle changes, such as eating a healthy diet, exercising regularly and maintaining a healthy weight.
The age of diagnosis and the progression of type 2 diabetes also differs from type 1 diabetes. Type 2 diabetes typically occurs later in life, while type 1 diabetes is commonly diagnosed in adolescence. There’s no cure for either condition, but both can be managed and treated with the help of a knowledgeable diabetes care team. However, those with type 2 diabetes may be able to reverse the condition and prevent medication or insulin use with proper lifestyle modifications.
Treatments for Type 2 Diabetes
Proper treatment of type 2 diabetes can significantly improve a person’s quality of life by resolving the symptoms that occur when glucose levels are not within the target range and helping to prevent or manage the condition’s complications. Treatment for type 2 diabetes may include a combination of the following:
Medications
Insulin or other medications may be needed to help control blood sugar levels. These medications work by helping your body produce more insulin, decreasing the amount of glucose produced by the liver and increasing the sensitivity of your cells to insulin. Experts also note that there are newer medications designed to promote weight loss through appetite suppression, leading to better glucose control.
Lifestyle modifications
Changing your diet, exercise and lifestyle habits can help manage and prevent type 2 diabetes. Nutritious foods, regular exercise and avoiding smoking can all help control your blood sugar levels and reduce the risk of long-term complications.
Regular monitoring
Monitoring blood glucose levels is integral to your care plan. Monitoring may include having your A1C level checked every three to six months and frequent monitoring with a home glucose meter.
Self-management skills
Learning to manage your diabetes takes patience and dedication. Understanding the condition, monitoring your blood glucose levels, managing stress and making healthy lifestyle choices are all key components of diabetes self-management.
The key to effectively managing type 2 diabetes is finding a treatment plan that works for you. “Proper treatment can improve quality of life by alleviating pain or discomfort from diabetes complications. Proper treatment can also avoid hospitalization, certain disabilities (blindness, amputations) or life-threatening conditions, especially in severe cases of diabetes.
Regular eye exams, foot exams and wellness checks can help you stay on top of your health. It’s important to attend all scheduled appointments and follow your doctor’s guidance. Working with a dietitian may also help you learn the ins and outs of managing your blood sugar levels.
With dedication and a comprehensive treatment plan, you can effectively manage type 2 diabetes for years to come.
How common is Type 2 diabetes?
Type 2 diabetes is the most common form of diabetes. About 1 in 10 Americans have the disease. It’s the 7th leading cause of death in the U.S.
How is Type 2 diabetes diagnosed?
The following blood tests help your healthcare provider diagnose diabetes:
- Fasting plasma glucose test: checks your blood glucose level. This test is best done in the office in the morning after an eight hour fast (nothing to eat or drink except sips of water).
- Random plasma glucose test: This lab test can be done any time without the need to fast.
- Glycolated hemoglobin testing (A1c) measures your average blood sugar levels over three months.
- Oral glucose tolerance testing checks your blood sugar levels before and after you drink a sugary beverage. The test evaluates how your body handles glucose.
How is Type 2 diabetes managed?
There’s no cure for Type 2 diabetes. But you can manage the condition by maintaining a healthy lifestyle and taking medication if needed. Work with your healthcare provider to manage your:
- Blood sugar: A blood glucose meter or continuous glucose monitoring (CGM) can help you meet your blood sugar target. Your healthcare provider may also recommend regular A1c tests, oral medications (pills), insulin therapy or injectable non-insulin diabetes medications.
- Blood pressure: Lower your blood pressure by not smoking, exercising regularly and eating a healthy diet. Your healthcare provider may recommend blood pressure medication such as beta blockers or ACE inhibitors.
- Cholesterol: Follow a meal plan low in saturated fats, trans fat, salt and sugar. Your healthcare provider may recommend statins, which are a type of drug to lower cholesterol.
What should a Type 2 diabetes meal plan include?
Ask your healthcare provider or a nutritionist to recommend a meal plan that’s right for you. In general, a Type 2 diabetes meal plans should include:
- Lean proteins: Proteins low in saturated fats include chicken, eggs and seafood. Plant-based proteins include tofu, nuts and beans.
- Minimally processed carbohydrates: Refined carbs like white bread, pasta and potatoes can cause your blood sugar to increase quickly. Choose carbs that cause a more gradual blood sugar increase such as whole grains like oatmeal, brown rice and whole-grain pasta.
- No added salt: Too much sodium, or salt, can increase your blood pressure. Lower your sodium by avoiding processed foods like those that come in cans or packages. Choose salt-free spices and use healthy oils instead of salad dressing.
- No added sugars: Avoid sugary foods and drinks, such as pies, cakes and soda. Choose water or unsweetened tea to drink.
- Non-starchy vegetables: These vegetables are lower in carbohydrates, so they don’t cause blood sugar spikes. Examples include broccoli, carrots and cauliflower.
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Will I need medication or insulin for Type 2 diabetes?
Some people take medication to manage diabetes, along with diet and exercise. Your healthcare provider may recommend oral diabetes medications. These are pills or liquids that you take by mouth. For example, a medicine called metformin helps regulate the amount of glucose your liver produces.
You can also take insulin to help your body use sugar more efficiently. Insulin comes in the following forms:
- Injectable insulin is a shot you give yourself. Most people inject insulin into a fleshy part of their body such as their belly. Injectable insulin is available in a vial or an insulin pen.
- Inhaled insulin is inhaled through your mouth. It is only available in a rapid-acting form.
- Insulin pumps deliver insulin continuously, similar to how a healthy pancreas would. Pumps release insulin into your body through a tiny cannula (thin, flexible tube). Pumps connect to a computerized device that lets you manage the dose and frequency of insulin.
What is the outlook for Type 2 diabetes?
If you have Type 2 diabetes, your outlook depends on how well you manage your blood glucose level. Untreated Type 2 diabetes can lead to a range of life-threatening health conditions. Diabetes requires lifelong management.
When should I call my doctor if I have Type 2 Diabetes?
It’s important to monitor diabetes very closely if you’re sick. Even a common cold can be dangerous if it interferes with your insulin and blood sugar levels. Make a “sick day” plan with your healthcare provider so you know how often to check your blood sugar and what medications to take. Contact your provider right away if you experience:
- Confusion or memory loss.
- Fever of 100°F or higher.
- High blood sugar for more than 24 hours.
- Nausea and vomiting for more than four hours.
- Problems with balance or coordination.
- Severe pain anywhere in your body.
- Trouble moving your arms or legs.
Conclusion
Type 2 diabetes is a serious and progressive chronic health condition that affects millions of people around the world. It is caused by an imbalance in the body’s ability to produce and use insulin, which is the hormone responsible for regulating blood glucose levels. Symptoms of type 2 diabetes include increased thirst and hunger, frequent urination, fatigue, and blurred vision. Treatment for type 2 diabetes includes lifestyle changes such as eating a healthy diet and exercising regularly, as well as medications like insulin and other drugs. It is important to consult with a doctor to get a proper diagnosis and to determine the best treatment plan for each individual. With proper management, type 2 diabetes can be successfully managed and even reversed.
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