Early-Onset Type 2 Diabetes: What You Should Know

An estimated 37 million Americans¹ have diabetes, and 90–95% are diagnosed with type 2 diabetes. The number of people with type 2 diabetes is expected to grow in the coming years.

More people are being diagnosed with early-onset type 2 diabetes, a type of diabetes diagnosed in younger people. The condition has unique risk factors and possible complications.

Find out about the condition, the signs to watch out for, who may be more at risk, health implications, and treatment options. You will also find advice about when to make an appointment with your doctor.

What is early-onset type 2 diabetes?

Early-onset type 2 diabetes is a form of diabetes that occurs in younger people. Some organizations define early-onset as type 2 diabetes diagnosed in people below the age of 40. 

Early-onset type 2 diabetes is often broken down into two distinct categories:

1. Child and adolescent

2. Young adult

Child and adolescent early-onset type 2 diabetes is usually diagnosed in children younger than 18 years. The young adult category includes people diagnosed between 18 and 25.

Early signs and symptoms

Knowing the signs and symptoms to look out for can help you get an accurate diagnosis and treatment as early as possible.

Seeking treatment early can slow the condition's progression and prevent complications.

Although not everyone displays the same signs of diabetes, the following symptoms are common and suggest you may have the condition:

• Urinating frequently

• Feeling excessively thirsty

• Being frequently hungry

• Feeling very tired

• Blurry vision

• Slow-healing wounds

• Numbness or tingling in your hands or feet

Set up an appointment with your doctor if you have any of the symptoms listed above.

Bear in mind that it's also possible to have undiagnosed diabetes without developing any noticeable symptoms.

If you are concerned about type 2 diabetes or you have risk factors, have your blood glucose levels tested at regular intervals.

Risk factors

You may have an increased risk of developing early-onset type 2 diabetes if any of the following risk factors apply to you:

• Sedentary lifestyle

• Being overweight or obese

• Low socioeconomic status

• Low birth weight

• Being female

• Family history of type 2 diabetes

• Puberty

The above risk factors increase your chance of developing early-onset type 2 diabetes, but they don't guarantee you will develop the condition.

It might be helpful to ask your doctor about diagnostic tests if you have an increased risk of developing early-onset type 2 diabetes — especially if you also have some of the symptoms listed above.

Causes

Type 2 diabetes develops when your body cannot move glucose from your blood into the cells where it's used to carry out various processes within your body. The risk factors above increase the likelihood of this occurring.

Insulin is a hormone that helps glucose move from your blood into your cells. If your body can't generate enough insulin in your pancreas, or it can't use insulin efficiently, your pancreas and other organs will come under more strain. It becomes harder for your body to regulate blood sugar levels when this occurs.

A combination of risk factors, like an unhealthy diet, not doing enough physical activity, and a family history of type 2 diabetes can lead to type 2 diabetes and impaired insulin function.

How is early-onset type 2 diabetes diagnosed?

Diagnosing type 2 diabetes is more complicated in younger people. Your doctor will need to run tests to confirm your symptoms really are caused by early-onset type 2 diabetes. They will also have to confirm they're not the result of type 1 diabetes or another condition.

Type 1 diabetes is typically diagnosed in childhood and early adulthood. As a result, it can be difficult to determine whether your impaired blood sugar levels are caused by a total absence of pancreatic insulin (as seen in type 1 diabetes) or impaired insulin function (as seen in early-onset type 2 diabetes). 

Your doctor may ask you to take a glycated hemoglobin test, also known as the A1C test. The A1C test determines how many hemoglobin cells in your blood are coated with glucose molecules. This indicates how well your body can manage blood sugar levels.

A1C levels below 5.7% are considered normal, while levels between 5.7% and 6.4% indicate prediabetes. You may be diagnosed with early-onset type 2 diabetes if:

• You are younger than 40 years old

• Your A1C test comes back at 6.5% or higher on two separate occasions

Your doctor may also recommend a random blood sugar test, which can be taken at any time without fasting beforehand. If your blood sugar level is 200 mg/dl or higher, you may have diabetes, especially if you also have other signs and symptoms.

Early-onset type 2 diabetes sometimes goes under the radar, as many doctors begin routine screening when people reach 45 years of age. Doctors may also recommend routine screening if:

• You have a significant family history of type 2 diabetes

• You have been diagnosed with prediabetes

• You are overweight or obese

Importance of early diagnosis

Visiting your doctor for annual checkups is important for your overall health. Voicing your concerns about early-onset type 2 diabetes can help you receive a diagnosis and start a treatment plan as soon as possible.

Diagnosing type 2 diabetes early is especially important for people younger than 40. This is because people with early-onset type 2 diabetes tend to have worse health outcomes than those who develop the condition later in life.

People diagnosed with early-onset type 2 diabetes tend to have a higher risk of cardiovascular disease, including microvascular complications, even if they have good blood sugar control.

Nephropathy, the deterioration of kidney function, is another common concern for people with early-onset type 2 diabetes.

End-stage kidney failure typically starts developing around ten years after an early-onset type 2 diabetes diagnosis. End-stage kidney failure is a life-threatening condition. Various studies report that people with early-onset type 2 diabetes have an increased risk of developing end-stage kidney failure compared to those with type 1 diabetes.

Detecting early-onset type 2 diabetes allows you and your doctor to devise a treatment plan that can help control your blood sugar levels and prevent damage to your vascular system, kidneys, and other organs.

Is early-onset type 2 diabetes reversible?

Early-onset type 2 diabetes cannot be reversed. You will have this condition for the rest of your life.

In some cases, it's possible to reduce or eliminate your need for oral or injectable diabetes medications or supplemental insulin. This might be the case if you developed early-onset type 2 diabetes mainly because of lifestyle factors. However, this may not be possible for everyone.

It is more accurate to say type 2 diabetes can go into remission. This occurs when you no longer need medical interventions, like prescription drugs or supplemental insulin, to manage your blood sugars.

Diabetes remission is a good goal to aim for. However, it may still be helpful to regularly monitor your blood sugar levels, even if you can manage them with lifestyle changes alone.

Remember, there is no shame in needing to take medications to properly manage your condition. If your doctor prescribes diabetes medication to take alongside making lifestyle changes, follow their advice carefully.

Managing early-onset type 2 diabetes

Type 2 diabetes can be a tricky condition to manage. It involves many complex processes and can impact nearly every part of your body. It may take some time for you and your doctor to find the best treatment plan to manage your condition.

Fortunately, there are now more treatment options available than ever. Several treatment combinations can be incredibly effective in managing your early-onset type 2 diabetes.

Some common management techniques include:

Lifestyle changes

Eating a balanced, nutritious diet and doing enough physical activity are vital for your overall health, but these things are especially important if you have early-onset type 2 diabetes.

Eating a proper diet can help keep your blood sugar levels in check and provide the nutrients necessary to keep other parts of your body healthy and operating well. Exercising can also lower blood sugar levels during the activity and for hours afterward.

Lifestyle changes may also include weight loss or maintenance and reducing stress.

Oral medications

Oral medications can help manage type 2 diabetes. Here are some examples of how different oral diabetes medications work:

• Stimulating increased insulin production in the pancreas

• Controlling how much glucose your liver produces and releases

• Improving insulin efficiency

• Prompting your kidneys to filter more glucose from your blood

Your doctor may recommend an oral medication early on in your treatment plan.

They can be even more effective when paired with lifestyle changes, like increasing physical activity and consuming a healthy diet.

Many of these medications can produce unpleasant side effects. Speak to your doctor if you notice any negative changes that may be caused by your medications. They may prescribe you a different medication if the one you are taking is unsuitable.

Non-insulin injectable medications

Non-insulin injectable medications are another form of type 2 diabetes medication. These are often self-administered once or twice a day.

Many work by slowing your digestion to keep blood sugars more consistent throughout the day. Some also provide similar effects to oral medications, like reducing the amount of glucose released by the liver.

Many non-insulin injectable medications can be combined with oral medications, but others cannot. For this reason, ensure your doctor and pharmacist are aware of any other medications you are currently taking, as some combinations can produce adverse effects.

Supplemental insulin

Supplemental insulin is often reserved for people who have had type 2 diabetes for longer and who have not responded well to other treatment options. It can help when there isn't enough insulin or your body's insulin doesn't work sufficiently.

Like other medications, it can take a while to figure out the right type, dose, and frequency of insulin for your individual needs.

Your doctor may also refer you for an evaluation with an endocrinologist (a hormone specialist) to help you establish your optimal insulin regimen.

Preventing early-onset type 2 diabetes

Type 2 diabetes is becoming more common in the US, but you can take several steps to help prevent the condition — even if it's in your family. In fact, an estimated 90%² of type 2 diabetes cases are preventable with lifestyle changes.

If you already have type 2 diabetes, adopting a healthier lifestyle can significantly improve your health outcomes.

It's never too late to make healthier choices that can benefit you in the short and long term. Some of the best lifestyle changes you can make to prevent early-onset type 2 diabetes, or improve your current health if you already have it, include:

Consuming a balanced diet

Eating a healthy, balanced diet is one of the most important lifestyle changes you can make to prevent type 2 diabetes.

Diets high in sugar and bad fats without sufficient nutrients can increase your risk of developing type 2 diabetes. Doing so can also make it much harder to manage an existing type 2 diabetes diagnosis.

A balanced diet typically includes eating plenty of fruits, vegetables, whole grains, and a moderate amount of low-fat dairy and protein. You should only consume limited sugary foods and drinks, baked goods, and red meat.

An early-onset type 2 diabetes diagnosis doesn't mean you can no longer eat your favorite foods, but you will need to be more mindful of what you eat and consume unhealthy foods in moderation. It can also mean adding new foods to your diet that you may not eat enough of.

Your doctor may refer you to a dietitian if they believe dietary changes can help you manage your diabetes, and you could benefit from professional nutritional guidance.

Keeping active

It is generally recommended to get at least 150 minutes of moderate physical activity per week, but 300 minutes of exercise per week is recommended for weight loss and greater health benefits.

You don't need to go for long runs or join an expensive gym to keep physically active. An active lifestyle may include dancing, gardening, playing with your kids outside, or playing team sports with your friends and family.

The best way to maintain a fitness routine is to find an activity that you enjoy, so don't be afraid to get out and try something new!

Minimizing stress levels

Receiving an early-onset type 2 diabetes diagnosis can be stressful. Excessive stress can actually worsen type 2 diabetes symptoms and affect blood sugar control.

Stress can't cause type 2 diabetes, but you may be more likely to develop type 2 diabetes if you have chronic stress. For example, people with high-stress levels may be more likely to reach for alcohol. Alcohol can worsen diabetes symptoms when consumed irresponsibly.

Stress can also impair your ability to manage your own blood glucose levels, which can make diabetes harder to manage and cause damage to your body.

You can take steps to manage your stress in the following ways:

• Engaging in creative, relaxing hobbies like drawing or painting

• Doing regular physical activity

• Reducing your tasks and obligations where possible

• Getting sufficient sleep

• Talking to a counselor or loved one

• Engaging in deep breathing and mindfulness practices

Small steps in the right direction can add up over time and lead to significant improvements in your health. Don't be afraid to start with small goals, like taking a walk around the block after dinner or doing deep breathing exercises a few times a day.

Ask your doctor which lifestyle changes they recommend for preventing or managing early-onset type 2 diabetes.

When to see a doctor

See your doctor if you find yourself feeling generally unwell for an extended period of time. This is common in people with undiagnosed diabetes.

Make an appointment right away if you notice you have developed any type 2 diabetes symptoms, such as increased thirst, extreme tiredness, or blurry vision.

Diabetes treatment tends to work best when the condition is caught early, so the sooner you can talk to your doctor about your concerns, the better.

Regardless of your age, if your doctor believes you may have type 2 diabetes, they will conduct a physical exam and order tests to rule out other possibilities and reach a diagnosis.

The lowdown

Learning that you have early-onset type 2 diabetes may feel overwhelming. However, you can still live a long and healthy life.

With the right lifestyle changes and treatments, you can manage your diabetes and minimize its progression.

If you suspect you or a loved one may have early-onset type 2 diabetes, or you are worried about developing type 2 diabetes later in life, it's always sensible to speak to your doctor about steps to take to reduce your risk and improve your health.

Working closely with your healthcare team is the best way to ensure you stay as healthy as possible, even with an early-onset type 2 diabetes diagnosis.