What Is Type 2 Diabetes?

Diabetes, also called diabetes mellitus, is a group of metabolic disorders marked by elevated blood sugar levels that extend for long periods of time. Type 2 diabetes results from insufficient quantities of insulin or from insulin’s inability to properly regulate blood sugar levels. Insulin is a hormone produced by the pancreas that stores converted food energy, sugar or glucose, inside cells, where it can be used to drive the day-to-day functions that are essential to life. Holding sugar in the bloodstream rather than in the cells is detrimental to good health.

Type 2 diabetes is the most common form of the disease. Until recently, it was also known as adult-onset diabetes, because it tends to come on later in life, though a growing number of young people are being diagnosed with this condition today. Type 2 diabetes is controllable with diet, exercise, and other behavioral modifications. In some cases, oral medicines or insulin injections are required.

What Are the Symptoms of Type 2 Diabetes?

Type 2 diabetes has several medical indicators. These often appear gradually, developing unnoticed before you become aware of them:

• Extreme thirstiness
• Exaggerated hunger
• Frequent urination
• Regular infections
• Physical weakness and fatigue
• Blurred or unfocused vision
• Sores and cuts that heal slowly
• Darkened skin on the neck and upper body
• Unplanned-for weight loss.

If you experience these symptoms, see your physician immediately.

What Causes Type 2 Diabetes? What Are the Risk Factors?

Insulin is a hormone produced by a pancreatic region called the islets of Langerhans. When released into the bloodstream, it circulates with glucose to the cells of the body, where it stimulates the absorption of chemical energy by the cell nuclei. The process breaks down in persons with type 2 diabetes. Either the body fails to produce enough insulin to transfer glucose from the bloodstream to the cells or the cells themselves begin to resist the stimulus effect of the insulin molecules. When this happens, glucose remains unabsorbed in the bloodstream, creating a variety of potential health problems. 

Scientists have identified several risk factors for type 2 diabetes:

• Weight and where it accumulates: The primary risk factor in the development of type 2 diabetes is weight. There is a strong correlation between obesity and metabolic disease. A related factor is the bodily location of the excess weight. Abdominal fat storage is more indicative of potential type 2 diabetes than thigh or hip storage. 
• Age: Type 1 diabetes can occur at any point in life but the most common period of onset is middle age, at 45 or more years old. 
• Inactivity: Being inactive increases your risk of type 2 diabetes. In fact, one reason why middle-aged adults are more likely to develop diabetes is the fact that older persons tend to be less physically active. 
• Race: For reasons that are unclear, African, Hispanic, Asian, and Native Americans have a greater chance of developing type 2 diabetes than European (but non-Hispanic) Americans. 
• Family history: A parent, brother, or sister with type 2 diabetes means that you’re at greater risk of manifesting the disease. 
• Darkened skin on the neck and upper body: Dark or discolored skin on the neck or in the armpits are indicators of insulin resistance. 
• Prediabetes: Prediabetes comes before diabetes. It’s a medical condition in which blood sugar levels are higher than healthy but still not high enough to be considered diabetic. According to one study, about five to ten percent of prediabetics move to diabetic status every year.
• Gestational diabetes: Gestational diabetes is a form of diabetes that occurs during pregnancy. Though this form of the disease tends to be temporary, if you experience it while pregnant, you will be at a higher risk for developing diabetes in the future.
• Polycystic ovarian syndrome: Women with polycystic ovarian syndrome have a higher risk of developing type 2 diabetes later in life than other women.

How Is Type 2 Diabetes Diagnosed?

Your physician can perform one or more tests to confirm a suspected diagnosis of type 2 diabetes:

• Glycated hemoglobin (A1C) test: An A1C test determines your average blood sugar levels over the most recent two- to three-month period. It does this by measuring the percentage of hemoglobin in red blood cells to which glucose molecules are attached. A percentage of 6.5 percent or greater indicates elevated blood sugar levels, and supports a diabetes diagnosis. 
• Random blood sugar test: A second test focuses on glucose levels in randomly drawn blood samples. The units of measure are milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Readings equal to or higher than 200 mg/dL or 11.1 mmol/L are indicative of diabetes, especially in conjunction with other known symptoms.
• Fasting blood sugar test: A third test utilizes blood samples following an overnight fast. A healthy reading is below 100 mg/dL or 5.6 mmol/L. A prediabetic condition falls between 100 and 125 mg/dL (5.6 to 6.9 mmol/L). If your glucose level is above the high end of these ranges in at least two tests, then you are, by medical definition, diabetic. 

If you’re pregnant, your physician might opt for an oral glucose tolerance test instead. After fasting overnight and drinking a sugary liquid in the morning, a series of readings are taken. A healthy reading during pregnancy is 140 mg/dL or 7.8 mmol/L. A prediabetic range runs from 140 to 199 mg/dL (7.8 to 11.0 mmol/L). If your glucose level is above 200 mg/dL (11.1 mmol/L), you meet the medical definition of diabetic during pregnancy.

Your physician will continue to monitor your blood sugar levels after you’ve been diagnosed with diabetes. He or she will focus on the A1C reading, which provides a longer-term perspective than the other two. Other tests will center on organ function, blood pressure, and cholesterol levels.

How Is Type 2 Diabetes Treated?

There is no known cure for type 2 diabetes. There are, however, steps you can take to control the disease, minimizing its impact on your life and well-being. These steps include:

• Losing weight: Because obesity is strongly tied to the onset of type 2 diabetes, weight loss is one key to combating it. Research suggests that losing an average of seven percent of your body mass should prove effective in curtailing disease symptoms, assuming the weight is kept off. If, for instance, you weighed 200 pounds, this would be a reduction of 14 pounds (to 186). 
• Taking Insulin or other diabetes medications: There are several types of diabetes medications, including a variety of insulin products. Non-insulin medications focus on increasing insulin production, lowering glucose levels, or reducing cellular resistance to insulin. Many are in pill form. Insulin is typically administered by means of injections or an insulin pump, which is a device worn outside the body that dispenses insulin through a catheter. 
• Monitoring blood sugar: Diabetics should be in the habit of checking their glucose levels several times a day. Studies have shown that persons who regularly check blood sugar levels are more likely to maintain them within healthy ranges. This can be done either by the standard fingerstick method or by means of a continuous glucose monitoring system. 
• Eating a healthy diet: There is no perfect diet for diabetics, since all foods are a source of chemical energy (glucose). However, a diet that emphasizes low-fat, high-fiber foods, including vegetables, whole grains, and fruits, has a better nutritional profile than a diet focused on animal products, starches, and refined carbohydrates. 
• Exercising regularly: Being overweight can add to the health issues faced by diabetics. Accordingly, aerobic exercise – walking, running, swimming, and cycling – is particularly important as part of a program of intentional weight loss. However, because exercise decreases glucose levels, there is an attendant risk of hypoglycemia – too-low levels of blood sugar. Glucose monitoring and awareness of hypoglycemia symptoms are critical to exercise safety for diabetic individuals.

Individuals with type 2 diabetes and a body mass index of 35 or greater often benefit from bariatric or weight-loss surgery. Blood glucose levels have shown substantial declines in persons undergoing a bariatric procedure, especially those bypassing sections of the small intestines.

What Are the Long-term Effects of Type 2 Diabetes?

Type 2 diabetes is a chronic condition that affects nearly every part of the body. It is a health risk in and of itself, but also as a contributor to other life-threatening diseases and conditions. Some of diabetes’s potential consequences are:

• Cardiovascular disease, including chest pain, heart attack, stroke, and hardening of the arteries
• Nerve damage, numbness, and loss of feeling in the extremities
• Kidney damage, including organ failure and end-stage renal disease
• Eye damage leading to cataracts, glaucoma, and blindness
• Foot damage, slow-healing cuts, and, in the worst cases, amputations
• Skin conditions, including bacterial and fungal infections
• Hearing impairment
• Skin conditions
• Sleep apnea
• Alzheimer’s disease and other forms of dementia.

Diabetes should be managed under a physician’s guidance throughout a person’s life.

Can I Prevent Type 2 Diabetes?

The best way to manage diabetes is to not develop it. This isn’t an idle concern; millions of Americans already suffer from diabetes and many, many more are prediabetic, meaning that their blood sugar levels are just below diabetic levels. Fortunately, there is evidence that Type 2 diabetes is preventable. A major study published in 2006 showed that lifestyle modifications could substantially reduce the risk of developing diabetes.

In preventing diabetes, healthy habits are fighting the good fight. Here are seven tips for stopping diabetes before it starts:

• Lose excess weight: Shedding pounds reduces your risk of diabetes.
• Follow a plant-based, low-carb diet: Avoid bad fats and processed sugars.
• Drink water: H2O goes better with health than sodas or alcohol.
• Increase physical activity: This is especially important if you’re deskbound at work or sofa-bound at home.
• Don’t sweat the small stuff: Excessive stress is bad for you.
• Get your ZZZs: Beauty sleep is healthy sleep.
• Make your medical appointments: And when you make them, keep them!

Can I Manage Type 2 Diabetes?

It is also possible to successfully manage type 2 diabetes. There are some things you can do to limit the impact of your condition that go beyond insulin dosing and other required medical treatments:

• Commit yourself to a lifelong process of diabetes management
• Schedule yearly physical and eye exams
• Pay close attention to your feet, which are especially vulnerable to diabetes-related complications
• Keep up to date with your immunization requirements
• Don’t skimp on dental care – diabetics face a higher incidence of periodontal (gum) disease than people without the disease 
• Watch your cholesterol and blood pressure
• If you smoke, stop – and don’t use other tobacco products either
• Drink alcohol responsibly and in moderation
• Keep your stress levels in check
• Wear some form of identification with information about your diabetic condition.