When your body can’t make enough insulin or can’t use insulin, it is called type 2 diabetes. Insulin helps the cells in the body absorb glucose, or sugar, for energy. Without insulin, glucose builds up in the blood resulting in high blood sugar.
Type 2 diabetes is a chronic disease that has no known cure. It is the most common type of diabetes.
The exact cause of type 2 diabetes is unknown. It seems to run in families. But, it often takes other factors to bring on the disease such as obesity, physical inactivity, or taking certain medicines.
Risk factors for type 2 diabetes include:
- Age, people age 45 or older are at higher risk for diabetes
- Family history of diabetes
- Being overweight
- Not exercising regularly
- Race and ethnicity (African-Americans, Hispanic Americans, Asian Americans, and American Indians are more prone to develop type 2 diabetes than white Americans)
- History of gestational diabetes (pregnancy induced diabetes)
- Giving birth to a baby who weighed more than 9 pounds
- A low HDL (high-density lipoprotein, or the "good cholesterol")
- A high triglyceride level
- Being a smoker
Symptoms of type 2 diabetes may include:
- Frequent bladder and skin infections that don't heal easily
- Unusual thirst
- Frequent passing urine
- Weight loss despite an increase in appetite
- Blurred vision
- Nausea and vomiting
- Extreme weakness and fatigue
- Irritability and mood changes
- Dry, itchy skin
- Tingling or loss of feeling in the hands or feet
Some people who have type 2 diabetes don’t have symptoms. Symptoms may be mild and almost unnoticeable. Half of all Americans who have diabetes do not know it.
The symptoms of type 2 diabetes may look like other conditions or health problems. Always see your healthcare provider for a diagnosis.
There are several ways to diagnose diabetes. It is best to repeat the tests on a second day to confirm the diagnosis.
A1C. The hemoglobinA1C test measures your average blood glucose for the past 2 to 3 months. Diabetes is diagnosed if your A1C is 6.5% or greater.
Fasting plasma glucose (FPG). This test checks your blood glucose levels after 8 hours of fasting. You usually get this test before your first meal of the day. This is called your fasting blood glucose level. Diabetes is diagnosed if your fasting blood glucose is greater than or equal to 126 mg/dl.
Oral glucose tolerance test (OGTT). For this test, your glucose level is measured before and then after 2 hours after you drink a sugary drink. This test tells your doctor how well your body processes glucose. Diabetes is diagnosed if after 2 hours, your blood glucose is 200 mg/dl or higher.
Random glucose test. This blood test is done at any time of the day. Diabetes is diagnosed if your blood glucose is 200 mg/dl or higher with symptoms of hyperglycemia or hyperglycemic crisis.
Your healthcare provider will figure out the best treatment based on:
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medications, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
The goal of treatment is to keep blood sugar levels as close to normal as possible without letting them get too low. To do this, you will need to control your blood sugar (glucose). You will also need to check it regularly. Regular physical activity, meal planning, and routine healthcare are also important.
You may be able to control type 2 diabetes with weight loss, exercise, and healthy eating habits. But, in some cases, you will also need either oral or injected medicines or insulin. You will also need to check your feet regularly.
Treatment also includes:
- Lifestyle changes such as getting at least 150 minutes a week of exercise or physical activity. Don’t let more than 2 days go by without being active. Losing just 5% to 7% of your body weight can also help. When sitting for long periods of time, get up for short sessions of light activity every 30 minutes.
- Taking oral medicines, other medicines, or insulin replacement therapy, as directed by your healthcare provider. There are various types of medicines to treat type 2 diabetes. Oral medicine of several different types are available. Each type works in a different way to lower blood sugar. One medicine may be combined with another one to improve blood sugar control. When oral medicines are no longer effective, insulin may be required.
- Regularly checking your hemoglobin A1C levels. Experts recommend testing at least twice a year if the blood sugar level is in the target range and stable, and more often if the blood sugar level is unstable.
Untreated or poorly controlled diabetes can cause problems with:
- Blood flow
This can lead to:
- Heart failure
- Kidney failure
For these reasons, it is important to follow a strict treatment plan.
- When your body can’t make enough insulin or is unable to use insulin, it is called type 2 diabetes.
- Insulin helps the cells in the body absorb glucose for energy. Without insulin, glucose is left in the blood resulting in “high blood sugar.”
- Type 2 diabetes is a chronic disease that has no known cure. It is the most common type of diabetes.
- The exact cause of type 2 diabetes is unknown. However, it runs in families.
- The goal of treatment is to keep blood sugar levels as close to normal as possible without making them too low. Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
October 10, 2017
American Diabetes Association, Standards of Care 2016, Pathogenesis of type 2 diabetes, Up To Date, Risk factors for type 2 diabetes, Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association.
Hurd, Robert, MD,Sather, Rita, RN,Turley, Ray, BSN, MSN