Type 2 Diabetes
Definition
Type 2 diabetes is a lifelong disease that happens when the cells of the body can't use insulin the right way or when the pancreas can't make enough insulin. Insulin lets blood sugar—also called glucose—enter the body’s cells to be used for energy. When insulin is not able to do its job, the cells can't get the sugar they need, and too much sugar builds up in the blood. Over time, this extra sugar in the blood can damage your eyes, heart, blood vessels, nerves, and kidneys.
More and more adults and children are getting type 2 diabetes. This is largely because of bad eating habits and a lack of physical activity. It is important to know if you or your children are at risk for type 2 diabetes and to know what you can do to help prevent the disease.
Causes
You can get type 2 diabetes if:
- Your body does not respond as it should to insulin. This makes it hard for your cells to get sugar from the blood for energy. This is called insulin resistance.
- Your pancreas does not make enough insulin.
Your weight, how active you are, and your family history all affect the way your body responds to insulin. If you are overweight, get little or no exercise, or have family members with diabetes, you have a greater chance of getting type 2 diabetes.
Symptoms
Some people don't have symptoms, especially when diabetes is diagnosed early. This is because the blood sugar level may rise so slowly that a person may not know that anything is wrong. Other people may have symptoms, such as:
- Feeling thirsty.
- Having to urinate more than usual.
- Feeling more hungry than usual.
- Losing weight without trying to.
- Feeling very tired.
- Feeling cranky.
Other signs of type 2 diabetes may include:
- Infections and cuts and bruises that heal slowly.
- Blurred vision.
- Tingling or numbness in your hands or feet.
- Trouble with skin, gum, or bladder infections.
- Vaginal yeast infections.
Some people have already developed more serious health problems by the time they are diagnosed with type 2 diabetes. Over time, diabetes can lead to problems with the eyes, kidneys, heart, blood vessels, and nerves. Signs of these problems may include:
- Numbness, tingling, burning pain, or swelling in your feet or hands (diabetic neuropathy).
- Blurred or distorted vision or seeing flashes of light; seeing large, floating red or black spots; or seeing large areas that look like floating hair, cotton fibers, or spiderwebs (diabetic retinopathy).
- Chest pain or shortness of breath. This may be a sign of heart or blood vessel problems.
Sometimes a person finds out that he or she has type 2 diabetes during a regular medical checkup. Or people may find out that they have the disease during an appointment for another health problem such as high blood pressure, an infection, or a wound that heals slowly.
Diagnosis
If your doctor thinks that you have type 2 diabetes, he or she will ask you questions about your medical history, do a physical exam, and order a blood glucose test. A blood glucose test is a blood test that measures the amount of sugar in your blood. The test is usually done first thing in the morning, before you eat or drink anything.
Testing
If your doctor thinks that you may have diabetes, he or she will order a couple of blood glucose tests. Blood glucose tests are blood tests that measure how much sugar is in your blood. Usually, they are done first thing in the morning, before you eat or drink anything.
To make a diagnosis of type 2 diabetes, your doctor will use your blood test results and the American Diabetes Association's criteria. He or she also will ask you questions about your medical history and do a physical exam.
If your blood sugar level is above normal but below the level for diabetes, you have prediabetes and are at risk for developing type 2 diabetes. For more information on prediabetes, see the topic Prediabetes.
Other tests
A home blood sugar test or a urine test for sugar are not the best ways to learn whether you have diabetes. However, after you are diagnosed, you may use home blood sugar tests to check your own blood sugar levels.
Along with your home blood sugar tests, your health professional will give you a hemoglobin A1c (glycohemoglobin) test after you start treatment for diabetes. This test finds your average blood sugar level over the previous 2 to 3 months. The A1c test adds to the information from your home blood sugar tests to help you keep track of your blood sugar control.
After you are diagnosed with type 2 diabetes or prediabetes, you may have a thorough exam of your cardiovascular system to check for any heart problems.
Early detection
You can use the American Diabetes Association's risk test for diabetes to see whether you are at risk for developing type 2 diabetes.
If you are age 45 or older, the American Diabetes Association recommends that you be tested for diabetes every 3 years. The United States Preventive Services Task Force (USPSTF) recommends testing for diabetes in people who have either high cholesterol or high blood pressure. Talk with your doctor about your risk factors and how often you need to be tested.
Risk factors
There are some things that you cannot change that increase your chances of getting type 2 diabetes:
Risk factors that you cannot control include:
- Family history. If you have a parent, brother, or sister who has type 2 diabetes, you have a greater chance of developing the disease.
- Age. The risk for getting prediabetes and type 2 diabetes increases with age. And the number of children being diagnosed with type 2 diabetes is increasing. Usually, children who get type 2 diabetes have a family history of the disease, are overweight, and are physically inactive.
- Race and ethnicity. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at higher risk than whites for type 2 diabetes.
- History of gestational diabetes or having a baby weighing more than 9 lb (4 kg). Women who have had gestational diabetes or who have had a large baby are at higher risk for developing type 2 diabetes later in life.
- Low birth weight. People who weighed less than 5.5 lb (2.5 kg) at birth are more likely to develop type 2 diabetes later in life.
Risk factors under your control. There are some things you can do to reduce your chances of getting diabetes or reduce your chances of developing complications from diabetes:
- Lose weight. Your risk for type 2 diabetes increases as your weight (or body mass index, BMI) increases. Your risk also increases if most of your body fat is in your belly area. Reaching and staying at a healthy body weight can reduce your risk.
- Get more exercise. The less you exercise, the greater your risk of developing type 2 diabetes. People who do moderate exercise for at least 30 minutes on most or all days of the week have a lower risk of developing type 2 diabetes.
- Eat foods that are good for you. Eating a lot of sugary foods, red meat, soft drinks, and fast food can increase your risk of developing type 2 diabetes. Eating whole grains, nuts, and vegetables can decrease your risk.
- Quit smoking. This change may reduce your chance of having complications from diabetes.
- Get treatment if you have prediabetes. If your fasting blood sugar levels are in the range from 100 mg/dL to 125 mg/dL, you are at increased risk for developing type 2 diabetes.
- Get treatment if you have high blood pressure (hypertension). People who have blood pressure levels above 140/90 millimeters of mercury (mm Hg) are at greater risk for type 2 diabetes than people who have blood pressure below 140/90. The United States Preventive Services Task Force (USPSTF) recommends diabetes testing for people who have blood pressure higher than 135/80.
- Get treatment if you have high cholesterol. People who have high-density lipoprotein (HDL) cholesterol levels of 35 milligrams per deciliter (mg/dL) or less, or triglyceride levels of 250 mg/dL or more are at higher risk of developing complications from type 2 diabetes.
Other conditions that put you at risk for type 2 diabetes—and that are also linked to obesity and a lack of physical activity—include:
- Polycystic ovary syndrome (PCOS), a hormone imbalance that interferes with normal ovulation.
- Metabolic syndrome, a group of abnormal physical findings related to the body's metabolism.
If you are concerned about diabetes, you can take a test to determine your risk of getting the disease. If you are at risk, you can discuss with your doctor how to make healthy changes in your life. If you want, your doctor can refer you to health professionals who are trained to help you make your own easy-to-follow plan for eating and exercising. No matter how and when you start, it is important to remember that even small changes can lower your chances of developing diabetes.
Treatment
The key to treating type 2 diabetes is controlling blood sugar levels. All of the following help to lower blood sugar:
- Eating healthy foods
- Losing weight, if you are overweight
- Getting regular exercise
- In some cases, taking medicines
Treatment for diabetes also includes checking blood sugar levels to make sure that the disease is under control. It is important to watch for signs of high and low blood sugar. Both can cause problems and need to be treated.
People with diabetes need regular checkups to make sure that the treatment is working and that they do not get more serious health problems.
Prevention
If you are at risk for type 2 diabetes or if you have prediabetes, you may prevent diabetes by getting regular exercise and paying attention to what and how much you eat. If you are overweight, losing a little weight (10 to 20 pounds) can go a long way toward preventing or delaying the disease.
This infomation was taken from the University of Michigan Health System's Health Library.
