|What Is Type 2 Diabetes?
Terminology: Type 2 diabetes used to be called adult-onset diabetes and noninsulin-dependent diabetes mellitus.
It is the main type of diabetes which typically starts later in life and develops due to a combination of lifestyle and genetic factors. It is characterized by high levels of sugar (glucose) in the bloodstream typically caused by insulin insensitivity. Insulin is a naturally produced hormone in the body and wherever it travels it opens up cells so that they accept glucose from the blood. The cells take the glucose and immediately use it as energy or store it as fat for later use. If the cells become insensitive to insulin, they don't accept the glucose and this leads to diabetes symptoms developing overtime. Type 2 diabetes is closely associated with obesity, a family history of the disease, physical inactivity and race/ethnicity. African Americans, American Hispanics, Native Americans, Asian Americans and Pacific Islanders have particularly high risk factors.
What Is The Difference Between Types 1 And 2 Diabetes?
Type 1 diabetes typically starts in childhood or the early teens and is caused by the pancreas' inability to make insulin. This complete breakdown in pancreas function causes severe diabetes symptoms to develop usually quite suddenly. So by the time a diabetes diagnosis is given, the patient may already be quite ill. All type 1 diabetics need multiple insulin shots daily to manage their condition. Type 2 diabetes is much more common, and accounts for about 90 percent of all cases of diabetes. It develops much more slowly, over a number of years and the patient is usually unaware of the disease developing. It is not initially caused the by failure of the pancreas to produce insulin but rather the body's inability to respond to the insulin produced. When signs of the disease eventually occur they are not usually as severe as those experienced by type 1 diabetics. Only about 40 percent of type 2 diabetics require insulin shots, the rest manage their condition with diet/exercise and/or oral medications.
What Causes It?
When you have type 2 diabetes, sugar from the blood cannot enter the cells of your body. This is because the cells are not responding correctly to the insulin being created by the pancreas (location of pancreas). As a result, the sugar builds up in the blood. This is called hyperglycemia. Type 2 diabetes is commonly diagnosed in obese people as increased body fat makes it more difficult for the body to respond to insulin in the correct way. However, as thin people can also develop the disease (this is more common in the elderly), it appears that other factors, like genes, low activity levels and poor diet also play a role. Read more about the causes of diabetes.
What Are The Risk Factors?
You have a higher chance of developing type 2 diabetes if you:
• Are aged over 45.
• Developed gestational diabetes during a pregnancy.
• Are overweight, particularly around the waist.
• Have a family history of the disease.
• Gave birth to baby weighing more than 9 pounds.
• Have a HDL cholesterol (the good stuff) count under 35 mg/dL.
• Have high triglycerides levels of 250 mg/dL or more.
• Suffer high blood pressure (hypertension) -140/90 mmHg or more.
• Don't exercise much (less than 3 times a week).
• Been diagnosed with metabolic syndrome.
• Have impaired glucose tolerance.
• Have been diagnosed with polycystic ovary syndrome (PCOS diagnosis).
• If you belong to certain ethnic groups: African Americans, Asian Americans, Hispanic Americans and Native Americans. See diabetes facts for some statistics.
What Are The Symptoms?
Often people with the disease display no sign of it for many years. If you experience 2 or more of the following symptoms of diabetes, ask your doctor to perform a blood sugar test:
• Increased thirst.
• Frequent urination (more than you used to).
• Increased hunger.
• Blurred vision.
• Recurrent yeast infections.
• Slow healing of gum and skin infections.
• Pain or numbness in the hands or feet - technically called diabetes neuropathy, although this problem usually only starts about 5 years after the onset of the disease. If you start sooner it is likely you had the disease longer than you realize.
How Is It Diagnosed?
Both types of diabetes are diagnosed in the same way. Your doctor will order several blood glucose tests. These tests are described in detail in our article, diabetes diagnosis. The tests will measure the levels of glucose in your blood. If the results are consistently high (over 200 mg/dL), a diagnosis will be made.
As the signs of type 2 diabetes can be hidden for some time, doctors now recommend screening for:
• All adults over the age of 45 every 3 years.
• All overweight adults every 2 years.
• All overweight children who have other risk factors for diabetes, starting at age 10 and every 2 years thereafter. Although type 2 diabetes typically affects adults, there has been a dramatic increase in childhood incidences because of childhood obesity. Kids diagnosed with type 2 are generally aged between 10 and 19 years old, obese, have a strong family history for the condition and have insulin resistance. You may also be interested in our article, are there any home tests for diabetes?
How Is It Treated?
Diabetes treatment: There is no cure for diabetes. Instead treatment focuses on managing the condition. The goal is to keep the patient's blood sugar levels as normal as possible. This is achieved in 3 ways:
3. Diabetic Medications (oral pills and/or injections)
Most newly diagnosed type 2 diabetics will be able to control their blood sugar levels by taking regular exercise and controlling what they eat. They will need to regularly self-perform blood glucose testing with a handheld device called a blood glucose monitor. If lifestyle changes alone do not control sugar levels, then oral medications will be prescribed next. It is only if these meds fail, that insulin injections will be recommended. Approximately 40 percent of type 2 diabetics require insulin injections - but injections are only usually necessary if the disease has progressed after a number of years. Typically patients self-administer their insulin either using a syringe and vial, or more recently many are using insulin pens which make the administration much easier.
Managing Your Blood Sugar
It may take several months to learn how to monitor and regulate your blood sugar levels, but your diabetes healthcare team will work closely with you during the process. Most people with type 2 only need to check their blood sugar once or twice a day, and if they manage to bring it under control, testing may be reduced to a few times a week. Testing is normally performed first thing in the morning, before meals and/or at bedtime. What is a normal blood sugar count?
Diet and Weight Loss
A dietician will recommend a special diabetes diet for you incorporating balanced meals containing carbs, protein and small amounts of fat. Typically most diabetics follow a Low GI Diet, which helps to maintain regular blood sugar levels. If you need to lose weight, your doctors will also recommend calorie counting/restriction. Very overweight patients whose diabetes is not managed well by diet and medicines may need to consider weight loss surgery (such as gastric bypass surgery or laparoscopic gastric banding).
Exercise will help you manage your weight and promote better blood flow and blood pressure. It also helps to increase your energy and manage stress. But importantly it will also reduce your need for insulin or diabetic drugs. Typically patients are recommended 30 minutes of aerobic activity at least 5 days a week. Before starting any new exercise program, discuss your personal needs with your doctor.
Diabetes medications are also called anti-diabetic drugs, oral hypoglycemics and oral hypoglycemic agents (OHAs). They all mean the same thing, so don't get confused! The following diabetic medications are taken orally and help to reduce blood sugar levels in different ways (note: they are not insulin, which can only be taken as an injection). Your doctor may recommend one or more of the following:
Sulfonylureas: Brandnames Orinase, Tolinase, Dymelor, Diabinase and Glucamide.
Metformin (Biguanides): Brandnames Glucophage, Benoformin, Diabex, Dextin, Fornidd, Metforal and Orabet.
Alpha-Glucosidase Inhibitors: Brandnames Precose (acarbose) and Glyset (miglitol).
Thiazolidinediones: Brandnames Rezulin or Prelay (troglitazone); Avandia (rosiglitazone) and Actos (pioglitazone).
Meglitinides: Brandnames Prandin (repaglinide) and Starlix (nateglinide).
DDP-4 Inhibitors: Brandnames Januvia and Glavus.
Injectable Drugs: These medications must be injected: exenatide, pramlintide (Symlin), mitiglinide, sitagliptin, and saxagliptin.
If you have type 1 diabetes insulin is the only thing that will keep you alive. If you have type 2, it is only usually needed if the disease progressively gets worse. There are quite a few different types of insulin and your doctor will prescribe the best one for you, if needed.
In order to avoid complications associated with diabetes, it is important that you stay in close contact with your doctor who will recommend regular diabetes tests. These tests will include eye checks, blood tests, checking your feet and much more.
What Complications Are Associated With It?
After a few years diabetes can play havoc with many parts of the body - the risk is higher if your blood glucose levels are not well managed. Diabetes complications include:
• Increased stroke risk factors. Read about the symptoms of stroke.
• Increased heart attack risks factors. Read about heart attack symptoms.
• Damage to your eyesight.
• Foot infections which can lead to gangrene and amputations (images).
• Nerve damage causing pain and loss of feeling.
• High blood sugar can cause kidney damage.
See also: What to do in case of diabetic coma. Helping someone in need.
Can It Be Prevented?
Diabetes Prevention: You can help reduce your chance of developing the condition by:
• Maintaining a healthy weight and taking regular exercise.
• Avoid gaining fat around the waist (known as visceral fat).
• Eat plenty of fiber (it helps to slow the rate of sugar into the bloodstream).