What Is Type 2 Diabetes?

Type 2 diabetes is a serious health problem across the globe. At this severe condition, the insulin made from the pancreas cannot work correctly, or your pancreas fails to produce sufficient insulin that your body needs.

A majority of the people living with diabetes have type 2 diabetes. Type 2 diabetes is a lifelong chronic disease that affects the way your body processes blood sugar.

There is no particular age for diabetes development, you may have the condition at any age, but it mostly occurs in middle-aged and older people.

Diabetes estimates for 2019 and projections to 2030 and 2045

As per global statistics, a total of 463 million people was estimated living with diabetes in 2019, which represents 9.3% of the worldwide adult population (20–79 years). 

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With time, this number is expected to increase to 578 million (10.2%) in 2030 and 700 million (10.9%) in 2045, respectively. The age-dependent increase in diabetes prevalence leads to a prevalence of 19.9% (111.2 million) in people aged 65–79 years.

Impact of living with type 2 diabetes

To live with diabetes is hard and challenging. Diabetes confers potential effects on the lives and well-being of individuals, families, and societies worldwide.

Several factors are involved in the diabetic condition, which makes your life stressful from multiple corners and perspectives. But you cannot keep your life on hold. You must learn how you adapt your lifestyle while seeking medical intervention.

Remember that, diabetes is not a condition of physical impairment only; it also imposes much impact on your emotional and mental health.

Causes of Type 2 Diabetes

You need a hormone called insulin, which is made by your pancreas. Insulin is a hormone that allows glucose from food to enter your cells to be stored or used for energy.

Consequently, insulin keeps and maintains your blood sugar levels within a normal range. Type 2 diabetes develops when your body resists the effects of insulin (insulin resistance) or when your pancreas does not make enough insulin.

If you have type 2 diabetes, your body cells don’t respond to insulin effectively. In response, the insulin-producing beta cells in your pancreas make more insulin to meet your body’s needs.

However, they eventually fail to keep up with the increased demand, causing your blood glucose levels to rise.

Risk Factors

There are many factors evidenced by the growing body of health researches which impose you to have the enhanced risk of developing type 2 diabetes, such as:

• Being obese or overweight. Having excess body weight is a leading risk factor for type 2 diabetes.
• Fat distribution. Where the extra weight accumulates may be more important than how much body fat you have. Belly fat, for instance, puts you at a higher risk of developing type 2 diabetes than fat stored elsewhere. You’re more at risk if you’re a man with a waist size above 40 inches or a woman with a waist circumference above 35 inches.
• Inactivity. The less physically active you are, the higher your risk of type 2 diabetes.
• Family history. Your possibility of developing type 2 diabetes increased if your parents or sibling has the condition.
• Age. With age, you are prone to Your risk of developing type 2 diabetes increases as you age, more so if you’re 45 years or older. However, the condition is occurring increasingly frequently in children and young adults.
• Personal history of gestational diabetes. If you experience gestational diabetes during pregnancy; you have a higher risk of developing type 2 diabetes in the future. Giving birth a baby weighing 9 pounds (4 kilograms) or more also increases your risk.
• Race. People from these races are more likely to get type 2 diabetes: Black, Hispanic, American Indian, Alaska Native, Asian American, and Pacific Islander.
• Polycystic ovarian syndrome. Women who have this hormonal disorder have a heightened risk of developing type 2 diabetes.
• Acanthosis nigricans. The aforementioned is a skin condition characterized by dark, velvety patches in body folds, such as the armpits and the posterior and lateral folds of the neck. It is usually an indicator of insulin resistance.
• Medical history. If you have experienced certain medical conditions in the past, such as heart disease and stroke, your risk of developing type 2 diabetes is higher than those without the history of mentioned medical conditions. The same goes for if you have high blood pressure.

Type 2 Diabetes Symptoms

Symptoms of type 2 diabetes often develop slowly. As a result, you may only find out you have the disease once you start experiencing diabetes-related complications. Regardless, watch out for:

• Increased thirst
• Frequent urination
• Increased hunger
• Fatigue
• Unexplained weight loss
• Blurred vision
• Sores that heal slowly
• Recurring infections
• Tingling sensation or numbness in the feet or hands
• Dark skin patches, usually in the armpits and neck

How to Diagnose Type 2 Diabetes

To recognize early signs of type 2 diabetes allows you to have a diagnosis and treatment sooner. Your doctor will use the below listed one or more blood tests to diagnose Type 2 diabetes:

A1C Test

This blood test indicates your average blood sugar level over the past 2 to 3 months. A reading below 5.7% is typical, levels between 5.7% and 6.4% indicate you have Prediabetes, while 6.5% or higher readings mean you have diabetes. The A1C test is also known as glycated hemoglobin, HbA1c, or hemoglobin A1c test.

Some conditions, such as anemia, can lead to a false diagnosis of diabetes when using the A1C test. In which case, your doctor will use a different test. You don’t have to fast before the test.

Fasting blood sugar test

With this test, your doctor measures your blood glucose level after an overnight fast. A reading of less than 100mg/dL is normal, 100 to 125 mg/dL indicates you have Prediabetes, while 126 mg/dL or higher suggests diabetes.

Random blood sugar test

If you are showing signs and symptoms of diabetes, your doctor may use this test to diagnose diabetes regardless of when you last ate. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.

Oral glucose tolerance test (OGTT)

Health professionals often use this test to diagnose gestational diabetes, but they sometimes use it to diagnose type 2 diabetes. For this, you’ll first need to fast overnight before drinking a sugary liquid. Then your blood sugar level will be checked every hour after that for the next two hours.

The American Diabetes Association (ADA) recommends people aged 45 and above be screened for type 2 diabetes at 3-year intervals, especially if overweight or obese.

People under 45 with multiple risk factors, such as obesity, inactive lifestyle, blood pressure above 140/90 mm Hg, or a personal history of gestational diabetes, should also be screened.

Treatment of Diabetes Type 2

There are vital interventions both from the perspectives of lifestyle medicine, and pharmacological treatments that are indispensable to fight with diabetes and live with diabetes.

Having the right treatment, adopting lifestyle changes, and strict controlling blood sugar levels significantly impact your health and quality of life.

These interventions consequently suppress the risk of complications. Your health care team can help you come up with a self-care plan designed to manage your diabetes.

The team may include your primary care physician, a member from lifestyle medicine, ophthalmologist (eye doctor), podiatrist (foot doctor), registered dietitian nutritionist, and pharmacist. The self-care plan may include:

Healthy eating

Make a diabetes meal plan, which should ideally center around fruits and vegetables, whole grains, beans, skinless chicken/turkey, lean meats, fish, non-fat or low-fat milk and cheese.

Additionally, go for foods with fewer calories, saturated fats, refined sugars, and salt. And drink water instead of sugar-sweetened beverages.

Note: A registered dietitian can help you prepare a meal plan that’s more fitted to your food preferences, health goals, and lifestyle.

Being physically active

Aim for at least 30 minutes of aerobic exercise, like walking, cycling, or swimming, on most days of the week as it lowers your blood sugar.

Choose activities you enjoy so that you can easily incorporate them into your daily routine. Check with your health care team before starting an exercise program.

Losing weight

Losing weight helps lower your blood sugar levels, so work with your health care team to create a weight-loss plan that is ideal for you.

Being more active and following your meal plan can help you maintain or achieve a healthy weight.

Checking your blood sugar regularly

Ask your doctor how often you need to check and record your blood sugar levels. Careful monitoring helps keep your blood sugar levels within your target range, which in turn prevents or delays diabetes-related complications.

Managing stress

Stress can make managing your diabetes difficult by wearing you down physically and mentally.

Indulging in physical activity regularly, getting more sleep, relaxation techniques, keeping a reflection journal, and talking to someone can help keep stress at bay.

Taking your medicine

You may be able to achieve your target blood sugar levels with healthy eating and being active only, or you may also need diabetes medications or insulin therapy.

The medication you take depends on your type of diabetes, other health conditions, your daily schedule, medication costs, et cetera. Type 2 diabetes medicine can be taken orally or injected.

Most people with type 2 diabetes are usually first prescribed Metformin. Other possible medications include insulin, Sulfonylureas, Meglitinides, Thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, et cetera.

Your doctor may also prescribe blood pressure and cholesterol-lowering medications to help lower your chances of having the diabetes-associated complications.

Complications of Type 2 Diabetes

Serious health complications can emerge from diabetes if your high blood glucose levels are not under proper control.

Uncontrolled blood glucose levels can lead to diseases involving your heart and blood vessels, eyes, kidneys, nerves, and teeth. You also should know the diabetic patients have a higher risk of developing infections.

Evidence shows that in almost all of the high-income countries, type 2 diabetes accounted for cardiovascular disease, blindness, kidney failure, and lower limb amputation.

You can avoid the complications through proper control of blood glucose levels, blood pressure, and cholesterol at or close to normal. These cautions can delay or prevent the development of diabetes complications.

Prevention of Type 2 Diabetes

As the development of type 2 Diabetes is multi-factorial and complex, it is evident that the most crucial factor you must know is lifestyle behaviour.

This principally includes your consumption of unhealthy foods, less physical activity, and inactive lifestyles with sedentary behaviour.

You should remember that a growing body of researches emphasizes lifestyle modification with physical exercise and/or a healthy diet, and these lifestyle changes can delay or prevent the onset of type 2 diabetes.

International Diabetes Federation (IDF) recommendations for a healthy diet for the general population

• Choosing water, coffee, or tea instead of fruit juice, soda, or other sugar-sweetened beverages.
• Eating at least three servings of vegetables every day, including green leafy vegetables.
• Eating up to three servings of fresh fruit every day.
• Choosing nuts, a piece of fresh fruit, or unsweetened yogurt for a snack.
• Limiting alcohol intake to a maximum of two standard drinks per day.
• Choosing lean cuts of white meat, poultry, or seafood instead of red or processed meat.
• Eating peanut butter instead of chocolate spread or jam.
• Choosing whole-grain bread, rice, or pasta instead of white bread, rice, or pasta.
• Using unsaturated fats (olive oil, canola oil, corn oil, or sunflower oil) instead of saturated fats (butter, ghee, animal fat, coconut oil, or palm oil.

You must know what Prediabetes is

Prediabetes is a condition where your blood sugar level is higher than normal. Still, this is not clinically high to consider you as a case of type 2 diabetes.

But if you are not aware of your lifestyle changes, irrespective of your age, you are more likely to develop type 2 diabetes. If you are with Prediabetes, you may have the long-term damage of diabetes the damages to your heart, blood vessels, and kidneys may already be starting.

But you also know the useful information that the progression from Prediabetes to type 2 diabetes is not unpreventable and inevitable.

Take Away

Type 2 diabetes can be prevented and managed by adopting appropriate lifestyle changes such as eating healthy, becoming active and losing weight. If you suspect you have diabetes, visit your doctor.