Type 2 Diabetes

Type 2 diabetes is a health problem where the body has trouble using sugar (glucose) for energy. This means there's too much sugar floating around in the blood. Over time, high blood sugar can harm the blood vessels, nerves, and the body's defenses.

The main issues in type 2 diabetes are these: the pancreas, a gland that makes insulin, doesn't produce enough of this important hormone. Insulin helps move sugar from the blood into the body's cells. Also, the body's cells don't respond properly to the insulin that is made, and they don't take in enough sugar.

In the past, type 2 diabetes was often called "adult-onset" diabetes, but it can happen at any age. While both type 1 and type 2 diabetes can start in childhood, type 2 is more common in older adults. However, with the increase in childhood obesity, type 2 diabetes is now being seen more often in younger people.

Unfortunately, there's no cure for type 2 diabetes. However, making healthy lifestyle choices can help manage the condition. These include losing weight, eating nutritious foods, and getting regular exercise. If these lifestyle changes aren't enough to control blood sugar, doctors might suggest diabetes medication or insulin. Insulin therapy involves taking insulin to help the body use sugar.

Type 2 diabetes often sneaks up on people. You might have it for a while without realizing it. The symptoms, when they do appear, can be subtle and develop gradually. These symptoms include:

• Feeling very thirsty often. This is a common early sign.
• Needing to urinate more frequently. Your body might be trying to get rid of excess sugar in your blood.
• Feeling unusually hungry. This can happen even if you're eating a lot.
• Losing weight without trying. The body is burning fat and muscle instead of using sugar for energy.
• Feeling tired and sluggish. This is a common symptom that can be mistaken for other things.
• Having blurry vision. High blood sugar can affect how your eyes focus.
• Cuts and sores taking longer to heal. High blood sugar can affect blood circulation and healing.
• Getting infections more easily. This is another sign that blood sugar isn't under control.
• Numbness or tingling in your hands or feet. This can be a sign of nerve damage.
• Darkened skin patches, especially in the armpits and neck. This is a less common symptom but can be a sign of insulin resistance.

If you notice any of these symptoms, it's important to see your doctor. Early diagnosis and treatment can help prevent serious health problems.

If you think you might have type 2 diabetes, see your doctor. Type 2 diabetes is a condition where your body doesn't use insulin properly, leading to high blood sugar levels. Early detection is key, so if you notice any signs or symptoms, it's important to talk to your doctor. They can run tests to confirm a diagnosis and create a personalized treatment plan. Don't delay – getting proper medical care is crucial for managing type 2 diabetes and preventing potential health problems.

Type 2 diabetes happens when your body has trouble using a hormone called insulin. Insulin's job is to help sugar (glucose) from your blood get into your body's cells, where it's used for energy. This process has two main parts that go wrong in type 2 diabetes:

1. Insulin Resistance: Your body's cells, especially in your muscles, fat, and liver, become less responsive to insulin. This means the cells don't take in enough sugar from the blood, causing sugar levels to rise. Think of it like a door that's stuck – the insulin (the key) can't open the door to let the sugar in.

2. Pancreas Problems: Your pancreas, a gland located behind your stomach, makes insulin. In type 2 diabetes, the pancreas can't make enough insulin to keep up with the rising blood sugar levels. This is like a factory that's producing too few keys to open all the doors.

Why these problems happen isn't fully understood, but being overweight and not getting enough exercise are major factors.

Here's how insulin and sugar work normally:

• Sugar enters the bloodstream: When you eat, sugar (glucose) goes into your blood.
• Pancreas releases insulin: This rise in blood sugar triggers the pancreas to release insulin.
• Insulin helps sugar enter cells: Insulin acts like a key, opening the doors in your cells to allow sugar to move inside.
• Blood sugar levels drop: As sugar moves into the cells, blood sugar levels go down.
• Pancreas releases less insulin: When blood sugar levels fall, the pancreas releases less insulin.

Your body also uses glucose (sugar) for energy, and it comes from two places:

• Food: You get glucose from the food you eat.
• Liver: Your liver stores and makes glucose. If your blood sugar gets too low, your liver releases stored glucose to keep your body's sugar levels balanced.

In type 2 diabetes, this system isn't working correctly. Sugar builds up in the blood instead of entering the cells. To try and compensate, the pancreas releases more and more insulin. Over time, this extra demand damages the insulin-making cells in the pancreas, making it even harder to control blood sugar. This ongoing problem leads to high blood sugar levels, which can have serious health consequences.

Several factors can make a person more likely to develop type 2 diabetes. Understanding these risks can help people take steps to lower their chances.

Body Weight and Shape:

Being overweight or obese significantly increases the risk. This isn't just about overall weight; where the body stores fat matters. Carrying extra fat around the belly (rather than the hips and thighs) is a particular warning sign. A larger waist circumference is linked to higher diabetes risk. For men, a waist larger than 40 inches (102 centimeters) and for women, a waist larger than 35 inches (89 centimeters) are cause for concern.

Lifestyle Choices:

A sedentary lifestyle—not getting enough exercise—is another important risk factor. Physical activity helps control weight, burns glucose for energy, and makes the body's cells more responsive to insulin.

Family History:

If a parent or sibling has type 2 diabetes, the risk for an individual increases. Genetics play a role in how the body processes sugar.

Race and Ethnicity:

Some racial and ethnic groups, including Black, Hispanic, Native American, Asian, and Pacific Islander people, have a higher likelihood of developing type 2 diabetes compared to white people. The reasons for these differences are not fully understood but may involve genetic factors, lifestyle influences, and environmental exposures.

Blood Cholesterol and Fats:

Having low levels of HDL ("good") cholesterol and high levels of triglycerides can increase the risk of type 2 diabetes. These blood fats play a crucial role in maintaining healthy blood sugar levels.

Age:

The risk of type 2 diabetes generally increases with age, particularly after age 35. This is partly because metabolism naturally slows down with time.

Prediabetes:

Prediabetes is a stage where blood sugar levels are higher than normal but not high enough to be classified as diabetes. If left untreated, prediabetes often progresses to type 2 diabetes. This is a key indicator that lifestyle changes can prevent or delay the onset of diabetes.

Pregnancy History:

Having gestational diabetes during pregnancy or delivering a baby weighing more than 9 pounds (4 kilograms) increases the risk of developing type 2 diabetes later in life.

Other Health Conditions:

Conditions like polycystic ovary syndrome (PCOS), characterized by irregular periods, excess hair growth, and often obesity, are linked to a higher risk of diabetes. This is likely due to hormonal imbalances that affect how the body manages blood sugar.

By understanding these factors, individuals can take proactive steps to manage their risk and maintain good health. This might involve maintaining a healthy weight, engaging in regular physical activity, and getting regular checkups.

Type 2 diabetes can harm many parts of your body, including your heart, blood vessels, nerves, eyes, and kidneys. The things that raise your risk of diabetes also raise your risk for other serious health problems. Controlling your blood sugar levels is key to preventing these problems.

Heart and Blood Vessel Health: Diabetes makes it more likely you'll have heart disease, stroke, high blood pressure, and a condition called atherosclerosis. Atherosclerosis is when your blood vessels narrow due to buildup of plaque.

Nerve Damage (Neuropathy): High blood sugar over time can damage your nerves. This nerve damage, called neuropathy, often starts in your toes and fingers and can spread. Symptoms include tingling, numbness, burning, pain, and eventually a loss of feeling. Damage to nerves can also affect your heart, leading to irregular heartbeats. Problems with your digestive system, like nausea, vomiting, diarrhea, or constipation, can also result from nerve damage. Erectile dysfunction is another possible consequence.

Kidney Disease: Diabetes can lead to chronic kidney disease, which can get so severe it requires dialysis or a kidney transplant. This is a condition where your kidneys aren't working properly.

Eye Problems: Diabetes increases your risk of serious eye problems like cataracts and glaucoma. It can also damage the blood vessels in your retina, potentially causing blindness.

Skin Problems: Diabetes may increase your risk of skin infections, like those caused by bacteria or fungi.

Slow Healing: Cuts and sores take longer to heal in people with diabetes. Left untreated, they can become serious infections, and in severe cases, may require amputation of a toe, foot, or leg.

Hearing Loss: People with diabetes are more likely to have hearing problems.

Sleep Apnea: Obstructive sleep apnea, a condition where breathing stops and starts during sleep, is more common in people with type 2 diabetes. Obesity is often a factor in both conditions.

Dementia: People with type 2 diabetes may be at higher risk for Alzheimer's disease and other forms of dementia. Poor blood sugar control is linked to a faster decline in memory and thinking skills.

Making healthy choices can help prevent or delay type 2 diabetes. If you have prediabetes, lifestyle changes can slow or stop the disease from developing further.

A healthy lifestyle involves several key areas:

• Eating well: Focus on foods that are lower in fat and calories, but higher in fiber. This means choosing plenty of fruits, vegetables, and whole grains over processed foods. Think about filling your plate with colorful options! Small changes add up.

• Staying active: Aim for at least 150 minutes of moderate-intensity exercise per week. Moderate activity means you can talk while you're doing it, but you're breathing a little harder than usual. Examples include brisk walking, cycling, jogging, or swimming. Even short bursts of activity throughout the day can help.

• Managing your weight: If you're overweight, losing even a small amount of weight and keeping it off can significantly reduce your risk of developing type 2 diabetes. For someone with prediabetes, losing 7% to 10% of their body weight can make a big difference in lowering the risk. This doesn't mean you need to lose a massive amount of weight quickly. Focus on gradual, sustainable changes.

• Breaking up long periods of sitting: Sitting for extended periods can increase your risk of developing type 2 diabetes. Try to get up and move around every 30 minutes or so. Take the stairs instead of the elevator, walk around during phone calls, or stand up and stretch regularly.

• Medication (sometimes): For some people with prediabetes, a medication called metformin might be recommended. This is often prescribed for older adults who are obese and haven't been able to manage their blood sugar levels effectively through lifestyle changes alone. It's important to talk with your doctor about any potential medication options.

Remember, making these changes can take time and effort, but the benefits are well worth it. If you have prediabetes, working closely with your doctor to create a personalized plan is crucial.

Diagnosing Type 2 Diabetes: Different Tests and When to Get Screened

Type 2 diabetes is often diagnosed using a blood test called the A1C test. This test measures your average blood sugar levels over the past two to three months. The results help determine if you have diabetes, prediabetes, or neither.

• Normal: A1C level below 5.7%
• Prediabetes: A1C level between 5.7% and 6.4%
• Diabetes: A1C level of 6.5% or higher on two separate tests

If the A1C test isn't possible or isn't suitable for you, your doctor might use other tests:

1. Fasting Blood Sugar Test: A blood sample is taken after an overnight fast (no food or drinks).

• Healthy: Less than 100 mg/dL (5.6 mmol/L)
• Prediabetes: 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
• Diabetes: 126 mg/dL (7 mmol/L) or higher on two separate tests

2. Oral Glucose Tolerance Test (OGTT): This test is less common except during pregnancy. You'll need to fast and then drink a sugary liquid at your doctor's office. Blood sugar levels are checked periodically for two hours.

• Healthy: Less than 140 mg/dL (7.8 mmol/L) after two hours
• Prediabetes: 140 to 199 mg/dL (7.8 to 11.0 mmol/L) after two hours
• Diabetes: 200 mg/dL (11.1 mmol/L) or higher after two hours

When Should You Get Screened?

The American Diabetes Association (ADA) recommends routine diabetes screening for everyone age 35 and older. Screening is also important for these groups:

• Younger Adults (under 35): If overweight or obese, or have other diabetes risk factors.
• Women with Gestational Diabetes: They are at higher risk for developing type 2 diabetes later.
• People with Prediabetes: They need to be monitored closely.
• Overweight or obese children: Especially if they have a family history of type 2 diabetes.

What Happens After Diagnosis?

If you're diagnosed with diabetes, your doctor will likely do further tests to differentiate between type 1 and type 2 diabetes, as the treatments often differ. Your doctor will monitor your A1C levels at least twice a year and whenever your treatment plan changes. The target A1C goal varies depending on individual factors, but for most adults, the ADA recommends an A1C level below 7%. You will also get regular checks for any diabetes-related complications or other health problems.