What is Type 2 Diabetes?
Type 2 diabetes, once called non-insulin-dependent diabetes, is the most common form of diabetes, affecting 90% to 95% of the 26 million Americans with diabetes. Unlike people with type 1 diabetes, the bodies of people with type 2 diabetes make insulin. But either their pancreas does not make enough insulin or the body cannot use the insulin well enough. This is called insulin resistance. When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells. Although some people can overcome the symptoms by losing weight and following a healthy diet and exercise plan, most people with type 2 diabetes will have it for life
Insulin is a hormone that comes from the pancreas, a gland situated behind and below the stomach.
- The pancreas secretes insulin into the bloodstream.
- The insulin circulates, enabling sugar to enter your cells.
- Insulin lowers the amount of sugar in your bloodstream.
- As your blood sugar level drops, so does the secretion of insulin from your pancreas.
The role of glucose
Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues.
- Glucose comes from two major sources: food and your liver.
- Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
- Your liver stores and makes glucose.
- When your insulin levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.
In type 2 diabetes, this process works improperly. Instead of moving into your cells, sugar builds up in your bloodstream.
Type 2 diabetes diagnosis can occur in virtually anyone. But there are certain risk factors that make a person more likely to develop Type 2 diabetes. They include:
- being overweight (BMI of 25 or greater), particularly around the midsection
- exercising less than three times per week
- having a family history of type 2 diabetes
- blood pressure of 140/90 mmHg or higher
- HDL cholesterol below 35 mg/dL
- high blood triglyceride levels
- being over the age of 45
- having had gestational diabetes or given birth to a baby nine pounds or larger
- non-Caucasian ethnicity
- having a diagnosis of polycystic ovary syndrome or metabolic syndrome
Even though genes and aging play a role in the development of Type 2 diabetes, excess weight is probably the number one risk factor.
It is estimated that an obese person is 90 times as likely to develop type 2 diabetes as someone who is not, according to a review of medical literature published in 2003 by University of Kentucky and other researchers.
Belly fat, in particular, hampers your blood sugar-regulating hormones and can have the most detrimental effect on your blood sugar levels and the development of Type 2 diabetes. Insulin normally triggers the liver to take up extra blood glucose and store the energy for future use. But when the liver is submerged in fat tissue, insulin can’t get the liver to respond.
Type 2 diabetes symptoms may develop slowly. In fact, you can have type 2 diabetes for years and not know it. There are several symptoms that, when appearing together, are a sign of the disease.
Increased thirst and urination is perhaps the most common. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual.
This can also cause blurred vision, as fluid is even pulled from the lenses of your eye.
Increased hunger occurs when your body doesn’t produce enough insulin to move sugar into your cells, causing muscles and organs to be depleted of energy. This triggers a hunger response.
Your body also can’t metabolize glucose properly. It uses alternative fuels stored in muscle and fat, causing weight loss. Also, excess glucose is flushed out in urine, resulting in caloric loss.
When cells are deprived of sugar, you will most likely become tired and irritable. Slow-healing sores and infections, and patches of dark, velvety skin have also been reported. Any combination of these symptoms should prompt you to visit a doctor for tests.
Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range. Some diabetics will require insulin treatment to manage blood sugar levels, but diet and exercise have become the most important and effective means to controlling Type 2 diabetes.
In general, type 2 diabetics should limit their intake of fats and sugars, and aim for a steady amount of carbohydrates with each meal. A healthy diabetes diet will also include plenty of high-fiber grains, beans and lentils, vegetables, lean protein, fresh fruits, and low-fat dairy. Aim to fill at least half of your plate at each meal with vegetables; the other half should be split between a lean protein (like chicken or fish) and a healthy starch or grain (like brown rice or beans.)
But even if you take the utmost care with your diet, your blood sugar levels can change unpredictably. With the help of your doctor, you must learn over time how your blood sugar reacts to things like food, physical activity, medication, alcohol, stress and normal hormone fluctuations (especially in women.)
Physical activity and aerobic exercise should become part of your daily routine if you are living with Type 2 diabetes. Choose activities you enjoy, such as walking, swimming or biking. Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven’t been active for a while, start slowly and build up gradually.
Careful management of type 2 diabetes can reduce your risk of serious — even life-threatening — complications. Diabetes sufferers often develop problems with their feet. Make sure you wash your feet daily in lukewarm water. Dry them gently, especially between the toes, and moisturize. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your doctor if you have a sore or other foot problem that isn’t healing.
Adopting a healthier lifestyle in general is the best defense against developing Type 2 diabetes, and managing it once you have it. Weight loss, physical activity, and a clean healthy diet have even been shown to reverse Type 2 diabetes.
WebMD has published an informative video about taking care of yourself if you have Type 2 diabetes, which can be found here: