Type 2 diabetes is characterized by the body’s inability to use insulin effectively. Insulin is a hormone that helps regulate metabolism properly. The condition is the most common type of diabetes, affecting about 95% of the more than 38 million Americans with any form of the disease.
“The landmark study called the Diabetes Prevention Program showed that Type 2 diabetes can be prevented or delayed among those at risk,” says Dr. Nanette Steinle, an adjunct associate professor at the University of Maryland Baltimore and an endocrinologist with VA Capitol Health Care Network. These findings have been replicated in many studies worldwide.”
Screening patients more routinely is helpful for those with prediabetes, a condition that, left untreated, can lead to Type 2 diabetes within five years, according to the Centers for Disease Control and Prevention. The good news is that Steinle has seen more people being screened for Type 2 diabetes due to the growing awareness among the general population and health care professionals, and effective strategies to prevent and delay Type 2 diabetes.
[READ: Early Signs of Diabetes]
Symptoms
Common signs and symptoms of Type 2 diabetes include:
— Increased thirst
— Frequent urination
— Increased hunger
— Unintended weight loss
— Fatigue
— Blurred vision
— Slow-healing sores
— Frequent infections
— Areas of darkened skin, typically around the armpits and neck
Men may also suffer from erectile dysfunction, caused by nerve and artery damage triggered by high blood pressure.
Higher blood sugar levels can promote yeast growth and infections, and many men and women suffer from urinary tract infections. Women may also experience vaginal yeast infections. Yeast and bacteria feed on glucose, which can contribute to infections of the female urinary tract.
Some women may also have breath that smells fruity or sweet. This is caused by a high level of ketones in the blood. Ketones are chemicals produced in your liver when your body has insufficient insulin to turn glucose into energy.
Causes and Risk Factors of Type 2 Diabetes
Type 2 diabetes occurs when your body becomes resistant to insulin or when the pancreas fails to produce enough insulin. Insulin is a hormone that’s produced by a gland behind and below the stomach. Insulin lowers the amount of glucose in your bloodstream. Precisely why a body becomes resistant to insulin or why its pancreas doesn’t produce sufficient insulin is unknown, though genetics seem to be a contributing factor.
There is a fairly long list of risk factors for developing Type 2 diabetes, which include:
— Genetics
— Physical inactivity
— Poor diet quality
— The presence of metabolic syndrome (high blood pressure, lipids, blood sugar and abdominal/waist circumference)
— Being American Indian, Alaskan native, non-Hispanic Black or of Hispanic origin
— Being overweight
Type 2 diabetes typically develops after age 45, however, it can occur in younger people, especially if they carry too much weight and have a sedentary lifestyle. Being overweight or obese increases insulin resistance, thereby increasing your risk for Type 2 diabetes.
Steinle adds there are additional risk factors for developing Type 2 diabetes, which “include poor sleep quality, smoking and possibly having elevated uric acid, but many of these risk factors are modifiable.”
Still, there’s no fool-proof way to predict who will develop Type 2 diabetes. People who eat healthfully and exercise regularly throughout their lives can still develop the condition.
[READ: Questions to Ask Your Doctor About Diabetes]
Diagnosis
Health care professionals can use a glycated hemoglobin or an A1C test to diagnose Type 1 and Type 2 diabetes and prediabetes. An A1C test, also known as a hemoglobin A1C (HbA1c) test, measures the average level of blood sugar over a certain amount of time.
The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. An A1C level of 6.5% or higher on two separate tests indicates you have diabetes. A random blood sugar test, a fasting blood sugar test and an oral glucose tolerance test can also be used to screen for diabetes.
Complications
Type 2 diabetes can cause a raft of serious complications, including:
Heart and blood vessel disease
People with diabetes who have above target blood sugar levels over longer periods of time are at a higher risk for developing heart disease or a stroke compared to people without diabetes. This is because there is a higher incidence of blood vessel and nerve damage with higher blood sugar levels. The higher risk is because people with Type 2 diabetes already have a higher risk of conditions that increase the risk of heart disease, such as high blood pressure, high cholesterol and triglyceride levels, obesity, physical inactivity, blood sugar levels out of target range or smoking.
What you can do: People with diabetes can prevent or delay the onset of cardiovascular disease by managing the risk factors for heart disease through healthy lifestyle behaviors like healthy food choices, being active and refraining from smoking.
Nerve damage, or neuropathy
Anyone can develop nerve damage but people with diabetes who have regular blood sugar above target range (>180 mg/dL), have a long history of diabetes, are overweight or obese, are above age 40 or have high cholesterol or high blood pressure are at a higher risk for nerve damage.
What you can do: Make sure to protect your feet by wearing comfortable shoes and checking your feet for any sores or lack of feeling/sensation every day. Additionally, managing your blood sugar to keep your readings in target range (130mg/dL-180 mg/dL) is recommended to prevent nerve damage. Healthy eating, engaging in physical activity and use of diabetes medications, if needed, are ways to help manage blood sugar. Frequent monitoring of blood sugar is recommended.
Kidney damage
People with diabetes are at higher risk for developing kidney disease if there are consistent blood sugar levels above target because this may cause damage to the blood vessels in the kidneys. People with diabetes are also at higher risk for developing high blood pressure, and high blood pressure raises the risk of kidney disease.
What you can do: Keep your blood sugar, cholesterol and blood pressure in target range and follow healthy lifestyle behaviors such as engaging in physical activity, filling half your plate with non- starchy vegetables, eating fruit within your carbohydrate allotment and taking your medication as prescribed.
Eye damage
When blood sugar levels remain above target range, this can cause damage to blood vessels, including the blood vessels in your eyes. Diabetes related retinopathy occurs when the blood vessels in your retina are damaged.
What can you do: Prevention of eye damage from diabetes follows the same recommendations for managing diabetes overall. Choosing healthy food selections, being physically active, taking medications as prescribed by your health care provider and monitoring your blood sugar levels. Make sure to visit an ophthalmologist annually for a diabetes eye exam.
Slow healing of cuts and blisters
An increase in risk for poor healing of cuts and wounds can be caused by one or several factors for people with diabetes. Blood sugar that remains out of target range affects the performance of white blood cells in helping to fight bacteria. Poor circulation causes blood to move slower to deliver nutrients to repair wounds, and neuropathy that can delay in treating a wound due to lack of sensation.
What can you do: Participate in daily foot care; monitor and care for any wounds; and manage blood sugar with a goal to keep it target range.
Hearing impairment
Above or below target blood sugar readings can cause damage to the nerves associated with hearing, causing hearing loss.
What can you do: Try to keep your blood sugar in target range to lessen your risk for developing hearing loss. As with the recommendation for your eyes to be checked annually, it is also recommended that you have your hearing checked annually by an audiologist.
Alzheimer’s disease and dementia
People with Type 2 diabetes are twice as likely to develop cognitive impairment, such as Alzheimer’s.
What can you do: As of today, there are no solid tips for preventing dementia and Alzheimer’s in people with diabetes. Although, healthy lifestyle behaviors associated with diabetes management are recommended.
[READ Meal Plans for People With Diabetes]
Treatments and Medications
Type 2 diabetes management and treatment can involve an array of approaches, including:
— Healthy eating
— Regular exercise
— Possibly insulin therapy or diabetes medication
— Monitoring blood sugar levels
For some people, diabetes medications may be prescribed to help manage blood sugar along with participating in healthy eating and physical activity. Your health care provider will individualize the best diabetes medications, if necessary, that can help manage your diabetes. You may be prescribed one medication or a combination of medications, which all have the goal of managing blood sugar levels.
Type 2 diabetes medications
Oral medications are taken by people with Type 2 diabetes that still produce some insulin. There are currently nine different classifications of oral meds for use to improve blood sugar levels. Some of these medications, such as metformin, focus on lowering glucose absorption or production in the liver, lowering absorption or delaying digestions through the intestines, or increasing production of insulin from the pancreas.
Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) and dual GLP-1/GIP receptor agonists are injectable medications (like Ozempic) to help manage blood sugar by enhancing insulin secretion from the pancreas and delaying gastric emptying. Some medications, such as Wegovy, in this classification have been approved as a weight loss strategy.
Insulin can only be taken through injection by using an insulin pump or use of an inhaled insulin. Insulin is the first line of treatment for people with Type 1 diabetes and often used as a treatment for Type 2 diabetes. There are several types of insulin (long acting, intermediate acting, short acting and rapid acting) that all work to directly lower blood sugar.
Other medications: Other medications may include those to help manage other conditions like high blood pressure, high cholesterol or high triglycerides.
Living With Type 2 Diabetes
Lifestyle changes are key in diabetes management and can be supported through apps and other emerging technologies. Let’s face it, our lives are busy so digital devices like insulin pumps, continuous glucose monitors and tracking apps can be helpful with managing blood glucose.
Making informed decisions is a key to managing diabetes. Monitoring blood sugar levels both before and two hours after a meal can give you insight into how your readings are reacting to the food you consume. Likewise, checking before and after exercise can also give you information about the effects of physical activity on your blood sugar levels.
The American Diabetes Association’s Diabetes Plate offers a visual of how to portion your foods at mealtimes: One half of your plate should be filled with non-starchy vegetables, one quarter of the plate filled with lean protein and the last quarter of the plate filled with quality carbohydrates.
People with Type 2 diabetes can also distribute their carbohydrate intake throughout the day by eating small meals and snacks. It’s not an on and off again type of diet, it’s a lifestyle change for every day. U.S. News asked a group of experts to evaluate the best diets to prevent and manage diabetes, and the Mediterranean diet and DASH diet top the list.
As for physical activity, any movement helps. Wendy Gregor, a registered dietitian and certified diabetes care and education specialist with Cecilia Health in Michigan, recommends that people with the diabetes take a short walk after meals to help their bodies move sugar from the blood into muscle cells.
Steinle has found that many people with Type 2 diabetes believe their condition and the associated complications and comorbidities are inevitable because their grandparents, parents, siblings and other relatives have diabetes and suffered vision loss or kidney problems or other problems like amputations. But many complications can be prevented.
In fact, there are more discoveries on best approaches for diabetes management.
“In the past 10 years newer approaches to addressing the metabolic problems involved with Type 2 diabetes, for example incretin hormones, have improved health outcomes for persons with Type 2 diabetes, as well as those at risk. I expect we will continue to see more of these types of pharmacologic aids becoming available,” says Steinle.
The good news is that there is a lot a person diagnosed with or at risk for diabetes (pre-diabetes) can do. Steinle conveys to her patients that Type 2 is preventable, even among those who carry at- risk genes. A healthy lifestyle is a powerful way to remain healthy.
More from U.S. News
What Foods Are Good for Diabetes?
Best Diabetic Desserts Everyone Will Enjoy
Questions to Ask an Endocrinologist
A Guide to Type 2 Diabetes: Symptoms, Causes and Treatments originally appeared on usnews.com
Update 09/17/24: This story was previously published at an earlier date and has been updated with new information.
