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Type 2 diabetes – A quick guide

Introduction

Type 2 diabetes is a chronic condition that affects how your body processes blood sugar (glucose). In type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn’t produce enough insulin to maintain normal glucose levels.

 

Over time, high blood sugar can damage nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. But there’s good news — type 2 diabetes can be managed through lifestyle changes and medication. This guide provides a quick overview of the causes, risk factors, symptoms, diagnosis, treatment, and prevention of type 2 diabetes.

 

What Causes Type 2 Diabetes?

Type 2 diabetes is mainly caused by two interrelated issues: insulin resistance and dysfunctional insulin production. Genetics, excess weight, inactivity, and aging are thought to contribute to these issues.

 

Insulin resistance occurs when your cells stop responding properly to insulin, causing a buildup of glucose in your bloodstream. Your pancreas initially tries to overcome this by producing more insulin. Over time, it can’t keep up, leading to decreased insulin production.

 

Risk Factors

Several factors increase your risk of developing type 2 diabetes, including:

 

– Family history. Having a parent or sibling with type 2 diabetes raises your risk.

– Weight. Being overweight or obese increases insulin resistance.

– Inactivity. Not getting enough physical activity can make cells more resistant to insulin.  

– Age. Your risk goes up as you get older, especially after age 45. 

– Race. Type 2 diabetes is more common among people of certain racial and ethnic backgrounds, such as African Americans, Hispanics/Latinos, American Indians, and Asian Americans.

 

Prediabetes 

Before developing full-blown type 2 diabetes, many people have prediabetes. This means your blood sugar level is higher than normal but not high enough for a diabetes diagnosis. Prediabetes raises your risk for type 2 diabetes, heart disease, and stroke. Making healthy lifestyle changes can help prevent prediabetes from turning into diabetes.

 

Symptoms

Symptoms of type 2 diabetes often develop slowly over time. Common signs and symptoms include:

 

– Increased thirst and frequent urination: As excess sugar builds up in your bloodstream, fluid is pulled from the tissues. This may leave you thirsty. Your kidneys respond by flushing out the extra sugar via urine, which increases your need to urinate.

– Increased hunger: Lack of insulin also prevents your cells from absorbing blood sugar for energy. This triggers hunger as your cells become deprived of energy.

– Weight loss: Despite increased hunger, you may lose weight if you’re losing calories via frequent urination.

– Fatigue: You feel tired and weak because your cells aren’t getting the energy they need.

– Blurry vision: Changing fluid levels may cause the lenses in your eyes to swell, temporarily changing your vision.

– Slow wound healing: High blood sugar hinders circulation and can cause nerve damage, making wound healing sluggish.

– Recurring infections: High glucose provides breeding grounds for bacteria and fungi.

 

Diagnosis

If you’re experiencing potential diabetes symptoms, your doctor will check the following:

 

– Fasting blood sugar level: After an 8-hour fast, your blood is checked for glucose. 126 mg/dL or higher on two separate tests indicates diabetes. 100-125 mg/dL is considered prediabetes.

– Oral glucose tolerance test: This measures your blood sugar before and 2 hours after drinking a sweet drink. Results confirming diabetes are the same as for fasting blood sugar tests.

– Hemoglobin A1C: This blood test measures your average blood sugar level over the past 2-3 months. Diabetes is diagnosed at 6.5% or higher.

 

Early diagnosis allows prompt treatment to prevent complications. Adults should be screened for type 2 diabetes regularly starting at age 45, or earlier/more often if you have risk factors.

 

Treatment 

Although not curable, type 2 diabetes is highly manageable through lifestyle modifications, oral medications, insulin therapy, or a combination of these. Work closely with your doctor to determine the right treatment plan for you based on your symptoms and health profile.

 

Lifestyle changes form the foundation of type 2 diabetes treatment. Your doctor will likely recommend:

 

– Watching your diet: Pay attention to portion sizes and choose foods that positively impact blood sugar levels. Work with a dietitian to develop a meal plan that works for you.

– Exercising regularly: Aim for 30 minutes per day to promote weight loss and improve insulin sensitivity. Check with your doctor before starting an exercise program. Walking is generally safe for most people.

– Losing extra weight: Carrying extra body fat worsens insulin resistance. Losing 5-10% of your weight can significantly lower blood sugar levels.

– Quitting smoking: Smoking increases diabetes complications such as heart disease. It’s crucial to kick the habit.

– Limiting alcohol: Drinking alcohol can cause blood sugar to drop or spike unpredictably. Avoid excessive drinking and drink in moderation if at all.

 

When lifestyle changes aren’t enough, type 2 diabetes requires medication to control blood sugar levels. Often, more than one medication is necessary. Common options include:

 

– Metformin: This is often recommended as the first oral drug for type 2 diabetes. It decreases glucose production by the liver and enhances how your cells process insulin.

– Sulfonylureas: These stimulate the pancreas to release more insulin. Examples are glipizide, glyburide, and glimepiride.

– Thiazolidinediones: Like metformin, these make cells more sensitive to insulin. Side effects may include weight gain and fluid retention though.  

– DPP-4 inhibitors: These help insulin and incretin hormones work better to lower glucose levels. Examples include linagliptin and sitagliptin.

– SGLT2 inhibitors: This new class of medications blocks the reabsorption of glucose in the kidneys, causing excess glucose to be eliminated in urine.

– Insulin therapy: People who don’t achieve glycemic targets with other medications use insulin therapy alone or combined with oral drugs.

 

Prevention

Making healthy lifestyle choices is the best way to ward off type 2 diabetes if you’re at risk. Key prevention tips include:

 

– Reaching and maintaining a healthy body weight. Losing even 10-15 pounds can reduce your diabetes risk.

– Exercising regularly. Brisk walking for 30 minutes daily has been shown to prevent diabetes in people with prediabetes. Any activity is better than none though.

– Choosing whole grains, vegetables, fruits, beans, lentils, nuts and healthy fats like olive oil over highly refined carbohydrates and sugary foods.  

– Avoiding sweetened beverages like sodas and juices. Water, unsweetened tea and coffee are healthiest.

– Getting adequate sleep. Poor sleep is linked to impaired glucose metabolism and weight gain.

– Managing stress through yoga, meditation, or other relaxation techniques. Stress contributes to elevated blood sugar levels.

 

Type 2 diabetes is incredibly common, affecting over 30 million Americans alone. But by understanding the condition and making the right lifestyle choices, it can be managed — and even prevented in those most at risk. Work closely with your healthcare provider to find an individualized treatment approach to minimize symptoms, complications, and medication needs if you receive a diagnosis. Consistent self-care and routine medical follow-ups are key to successfully controlling type 2 diabetes and enjoying an active, healthy life

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