What You Need To Know About Type 2 Diabetes

Type 2 diabetes is a very common condition. Roughly one in every 10 Americans live with this condition. An estimated 37 million people in the US live with the disorder. In comparison, only 1.6 million people in the US are currently managing type 1 diabetes.¹

Despite type 2 being more common than type 1 diabetes, both conditions are serious and should be managed carefully. Since 2000, a 70% increase in the diabetes death rate has been reported. It is one of the top ten causes of death around the world.²

If you live with type 2 diabetes, don’t be hard on yourself if your diagnosis was made late. This condition often builds up slowly and you may have only minimal, non-specific symptoms. They remain in the dark until diabetes-associated illnesses such as blurred vision or dry, itchy skin emerge.

When blood sugar levels are consistently high for months or even years, it can cause symptoms like:

• Increased thirst

• Frequent urination

• Fatigue

• Unclear vision

• A lack of enthusiasm

• Numbness in the feet or hands

• Tingling in the feet or hands

• Wounds that won’t heal

• Frequent infections

• Unexplained weight loss

• Nausea

• Dizziness

In severe cases, people with type 2 diabetes may experience a diabetic coma. This happens when a person loses consciousness due to high blood sugar levels.

Symptoms of type 2 diabetes in children and teens

In young people, obesity is the most important risk factor for developing type 2 diabetes. Previously, type 2 diabetes was considered an adult condition. However, with one-third of the young US population overweight, children as young as ten are starting to show signs of diabetes.¹

In rare cases, children may receive a diabetes diagnosis because of an abnormality in a single gene. This is called monogenic diabetes and differs from both type 1 and type 2 diabetes. It includes conditions like maturity-onset diabetes of the young (MODY) and Donohue syndrome.²

To determine if a child has type 2 diabetes, the following symptoms will usually be observed:

• Weakness

• Nausea

• Vomiting

• Irritability

• Mood changes

• Severe thirst

• Blurred vision

• High glucose levels in urine when tested

• Frequent bladder infections

• Skin infections and wounds that take time to heal

• Unexplained weight loss despite increased appetite

• Tingling or numbness in the hands or feet

• Poor growth

When a child displays these symptoms, it’s important to get them to a doctor quickly. Professional help can manage type 2 diabetes before lasting damage is caused.

Type 2 diabetes diagnosis

If you notice symptoms of type 2 diabetes, get an expert’s opinion. It may not be diabetes, but it’s important to know either way so that you can begin proper treatment as soon as possible.

To diagnose this condition, health professionals will often use the fasting plasma glucose test or the A1C test. Other times, a random glucose test may confirm if diabetes is present.

Fasting glucose test

This test is otherwise known as the fasting blood glucose test, or the fasting blood sugar test. It measures how much blood sugar is in your blood at a given time. The fasting test is a simple and inexpensive way to determine if insulin is doing its job properly.

If your health professional recommends this test, you’ll be expected to fast (eating/drinking nothing but a little water) for around 8–12 hours.

By steering clear of food and drink for some time, the body is pushed to produce a hormone called glucagon. Made in the pancreas, glucagon triggers the liver to release glucose into the bloodstream.

If diabetes is present, the body will have a hard time producing the insulin needed to get the glucose to the relevant cells. The cells may also resist insulin, causing them to miss out on the available glucose.

When this happens, glucose will accumulate in the blood, causing high levels of blood sugar. This high level will be detected by the fasting glucose test.

However, if diabetes is absent, your body will carry on as always. Insulin will be produced to prevent hyperglycemia from taking place.

The A1C test

The A1C test looks at how well your body manages blood sugar levels. It is also known as the hemoglobin A1C test, HBA1C, glycated hemoglobin, or the glycohemoglobin test.

Hemoglobin is an important part of red blood cells. This protein is responsible for distributing oxygen throughout the body.

Usually, glucose piggybacks on hemoglobin to reach cells and deliver the energy they need. But when blood glucose levels are too high, a higher amount of glucose will attach to hemoglobin. This is where the A1C test comes in.

By using the hemoglobin A1C test, experts can determine the number of hemoglobin proteins coated with glucose. This test can measure average blood glucose levels for the past two to three months.

Test results are usually given as a percentage. A normal result (no diabetes) is below 5.7%. Adults with diabetes should aim for an A1C of below 7%. The higher the percentage, the higher the blood glucose level.

A1C is also used to determine prediabetes and can help with treatment decisions in people living with type 2 diabetes.

However, the A1C test has been known to wrongly assess diabetes in people living with anemia.

What’s more, if you are of African, Mediterranean, or Southeast Asian descent, be aware that people from these ethnicities have reported incorrect readings that measure glucose levels as too low or high. It may be wise to take a different test for a more accurate diagnosis.

Random plasma glucose test

If you don’t have much time but are curious about your diabetes status, a random plasma glucose test is a trusted option.

This test measures the level of blood glucose at any point in time. Without requiring fasting or other restrictions, a random test uses a blood sample to determine glucose levels.

This test needs only a prick of blood to be placed on a test strip. A glucose reading will then be carried out to assess blood sugar levels.

Complications

The body can’t cope with the high blood glucose levels associated with type 2 diabetes. When there is excess blood sugar, this can cause major damage to blood vessels.

Because these vessels supply blood, oxygen, energy, and more through the body, problems with blood vessel function can have dangerous results.

Blood vessel damage can prevent blood from reaching necessary parts of the body. This will likely lead to nerve damage, creating numbness in certain areas.

With type 2 diabetes causing nerve and blood-vessel damage, it’s only a matter of time before different parts of the body begin to feel the ripple effects.

Complications caused by this condition include:

Hyperosmolar hyperglycaemic syndrome (HHS)

This condition is a serious complication of type 2 diabetes. When the body experiences a high glucose build-up, the kidney will attempt to get excess glucose out of the body.

Through the kidney, extra glucose is removed via urine, causing frequent visits to the bathroom. The body then needs to replace all the water it is losing.

If water isn’t consumed, or if sugary drinks and foods remain a part of the diet, this can cause a spike in blood sugar levels and severe dehydration. This leads to a loss of alertness and even unconsciousness.

Hyperosmolar hyperglycaemic states are common in people who are unaware of their diabetic condition. It is also seen in cases where diabetes is not properly managed.

This syndrome may be the result of:

• An infection

• Illnesses like a stroke or heart attack

• Medication that interrupts insulin’s effects on the body

• Conditions that cause dehydration

• Failing to take the right medication to manage diabetes

Older people and those who have been through a recent stressful situation such as surgery or a stroke are at a higher risk of HHS.

Eyes

High blood glucose levels can damage the delicate nerves in your retina. This may result in a condition known as retinopathy.

Retinopathy can lead to vision loss, and in worst-case scenarios, blindness.

This condition is, however, manageable, provided it is diagnosed and controlled by a professional.

Foot problems

Type 2 diabetes can pose a real challenge to the feet. Damage can happen in different ways. Nerve damage can affect whether sensations are felt correctly on the feet. Also, high blood sugar levels make it difficult for foot wounds to heal. Both of these issues can result in foot ulcers and infections.

Kidney disease

A common complication of diabetes is hypertension. This increased pressure is a direct cause of kidney disease, also known as nephropathy.

Diabetes makes it extra hard for the kidneys to do their job of clearing fluid and waste from the body. High blood sugar levels also damage the vessels that filter blood to produce urine.

Cardiovascular diseases

Diabetes can cause serious problems for large blood vessels, as it can cause plaque to build up. High glucose levels lead to blockages, preventing the free flow of blood around the body.

These blockages can cause a heart attack or stroke.

Sexual challenges

Diabetes has far-reaching effects. The damage caused to nerves and blood vessels can affect blood flow to the genitals. This can lead to difficulty with arousal, and in men may even cause erectile dysfunction or impotence.

People with diabetes are also at a higher risk of urinary tract infections because of high blood sugar, especially women. The female urethra (that conducts urine from the bladder) is shorter, so there is less distance for bacteria to travel to the bladder.

Your body does a fine job of putting the food you eat to good use. Via your metabolism, glucose in food finds its way into the cells, making sure organs have enough sugar for energy. To keep this process running seamlessly, your pancreas produces the insulin needed to get glucose into the cells.

Insulin is made every time you enjoy breakfast, a light lunch, or a dessert. This is because when you eat any food, your body's sugar levels go up, which triggers the release of insulin into your bloodstream. Insulin then allows glucose to go into the cells to keep them energized. This reduces the amount of blood glucose in circulation.

With type 2 diabetes, the pancreas produces insulin either as normal or in reduced amounts. However, insulin resistance occurs, when the cells are no longer able to respond normally to the hormone.

This development may be the result of biological, environmental, or lifestyle factors.

Risk factors for type 2 diabetes

Obesity

One of the main risk factors is obesity. Unlike other risk factors like age or ethnicity, obesity accounted for the largest increase in type 2 diabetes diagnoses.¹

Being obese means you are 100 times more likely to develop diabetes over 14 years compared to people in a healthy weight range.

Lifestyle

Working behind an office desk, attending video meetings all day from home, and doing other sedentary tasks are usual suspects that can increase the risk of type 2 diabetes.

Our lifestyles tend to keep us seated or inactive for long periods. Inactivity means exercise doesn’t always factor into daily life. This raises the chances of developing type 2 diabetes.

Smoking

This habit promotes diabetes. A 2014 surgeon general’s report revealed that active smokers are at an increased risk of 30%–40% of developing type 2 diabetes.²

Diet

What goes into your mouth can have serious effects on your body. A diet high in red meat, sugar, and fried foods can lead to insulin resistance and type 2 diabetes.³

When usual food choices are low in fiber, high in fat, and dense in sugar, this can increase the odds of diabetes.

Medication

Sometimes, even drugs have a role to play in developing diabetes. Several medicines stand out for increasing blood glucose levels. These include:

• Corticosteroids

• Diuretics

• Beta-blockers

• Antipsychotics

• Statins

These drugs alter how the body metabolizes sugar. Blood glucose levels may return to normal when these drugs are stopped.

Ethnicity

For reasons that aren’t completely clear — people of certain ethnicities have a higher chance of developing type 2 diabetes.

In the US, Asians, African Americans, and Latinos have higher rates of type 2 diabetes than their white counterparts.⁴ Globally, people of African-Caribbean and South Asian (i.e., people of Indian, Pakistani, and Bangladeshi descent) are at an increased risk of type 2 diabetes.

This increased risk is linked to family history and certain social and environmental factors. For instance, South Asian people experience insulin resistance from a much younger age. This may be tied to how fat is stored around the body. Visceral fat may gather around important organs like the liver. Not only is this fat dangerous for general well-being, but it is also a specific risk factor for type 2 diabetes.

There is no one-stop treatment for type 2 diabetes. Instead, this condition may be managed by making appropriate lifestyle changes, as well as through the right medications.

Lifestyle improvements

Movement is always welcome when it comes to managing diabetes. By getting more exercise, the body can lower blood sugar levels. The Center for Diseases Control and Prevention recommends 150 minutes of moderate exercises, such as brisk walks, every week to manage chronic conditions.

Also, making changes that assist with weight loss can be beneficial to managing diabetes.

To remain in the safe zone, it is always advisable to ask an expert’s opinion when deciding on lifestyle changes.

Medication

To get diabetes under control, lifestyle changes are usually the first order of the day. However, where these changes don’t work, health experts may recommend medication to get blood sugar under control.

One name always comes up first when recommending medicine for type 2 diabetes — metformin.¹ This medication can lower glucose production in the liver. Metformin is the first-line therapy for improving the body’s sensitivity to insulin.

Insulin therapy is also recommended for particular cases of type 2 diabetes. Long-acting insulin works to keep blood sugar levels stable throughout the day, while short-acting forms may be taken during meals. It’s always best to have an expert recommend the appropriate insulin where required.²

Other medications include sulfonylureas which can help your body secrete more insulin. More options are glinides, thiazolidinediones, and DPP-4 inhibitors.

Once a type 2 diabetes diagnosis is confirmed, this condition will require lifelong management. But while no cure exists for diabetes, it can be controlled.

Diet

Your diet is just as important as other lifestyle factors when managing type 2 diabetes. You’ll recall that red meats and sugary foods are not good options when looking to improve blood sugar levels. However, there are plenty of delicious healthy alternatives.

In particular, foods in the following food groups should be staples in your diabetic-care diet:

• Vegetables: broccoli, carrots, potatoes, green peas

• Fruit: orange, melon, apples, grapes

• Grains: whole grains such as wheat, rice, cornmeal

• Protein: lean meat, fish, eggs, peanut, tofu

• Non-fat or low-fat dairy

Foods containing healthy fats, such as avocado, are also welcome in the diabetic diet. To improve sugar levels, making simple substitutions in the kitchen such as oils in place of butter and margarine can make a big difference.

To make the right eating choices, deciding on a meal plan with a health professional is a move in the right direction. This can determine how much to eat of what food each day.

It is worthwhile taking preventative steps before you develop type 2 diabetes, especially if your ethnicity or another factor places you at high risk of developing the condition.

Effective preventative measures to avoid type 2 diabetes include:

• Maintaining a healthy weight

• Getting more physical exercise

• Eating a healthy diet

As discussed, these activities are important in reducing and managing blood sugar levels. For other, more personalized approaches, consult a health professional.

Diabetes comes at a heavy cost, and not just to people’s well-being. This condition is the most expensive chronic disease in the US. $1 out of every $4 in US healthcare costs is spent on caring for people with diabetes.¹

For anyone living with diabetes, this disease can cost a whopping $4,800 per year to manage. This represents out-of-pocket expenses when prices of additional doctor visits, non-prescription drugs, and lost wages are calculated and will vary depending on the level of insurance that the person has.²

This disease also cuts into productivity. An estimated $90 billion is lost annually due to diabetic workers needing to take sick leave, or if they are unable to perform optimally at work due to their condition.¹

These are very high costs to bear. Where possible, avoiding diabetes will not only promote your welfare but the state of your finances.

If a doctor or other healthcare specialist confirms that you have type 2 diabetes, you’ll be keen to hear what the next steps are. An endocrinologist and other specialists can guide you in lifestyle changes, appropriate medication, and other relevant information necessary to manage this condition.

You should also visit a doctor if you observe symptoms of diabetes like tingling/numbness in the hands or feet, and excessive dehydration.

To make sure you’re getting the right information, the following questions can act as a trusted guide when visiting the specialist:

Questions on physical appearance

• How often should I check my feet?

• What should I look out for when examining my limbs?

• What kind of foot care should I adopt?

• Is it necessary to see a foot doctor?

Questions about physical exercise

• What physical examination should I carry out before I begin exercising?

• What are recommended exercise programs and what should be avoided?

• When are suggested times to eat while maintaining an active lifestyle?

Questions about diet

• What foods will lower my blood glucose?

• What is recommended for managing weight?

Questions about medicine

• What is recommended for managing diabetes?

• What side effects may occur with use?

• Are there safe options to manage co-occurring conditions?