Type 2 diabetes, also called adult-onset diabetes and noninsulin-dependent diabetes, is a chronic condition caused by high levels of glucose (sugar) in the blood. 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.
According to the American Diabetes Association (ADA), nearly 26 million people in the U.S. have diabetes; most of these people have type 2 diabetes, and as many as 7 million people are living undiagnosed (ADA, 2011). Almost 80 million more have “prediabetes”—the precursor to type 2 diabetes.
Symptoms of Type 2 Diabetes
Some people may have type 2 diabetes for years without noticing any symptoms. Early signs and symptoms of this condition may include:
- the frequent need to urinate
- feeling very hungry or thirsty
- feeling very tired
- frequent infections of the urinary tract or skin
- blurry vision
- erectile dysfunction
- tingling, pain, or numbness in hands or feet
People experiencing these symptoms should seek care promptly from a health professional and ask to be tested for diabetes.
Causes of Type 2 Diabetes
Type 2 diabetes is caused by a problem with the way the body produces and uses insulin. Insulin helps the body move sugar from your blood into your muscles and cells for energy and storage.
In some people, the body stops producing enough insulin to move the glucose out of the blood and into the body’s cells. In others, the muscles and tissues begin to resist or ignore the insulin, keeping it from delivering the glucose to the parts of the body that need it. People become type 2 diabetics over time. As the body slowly loses the ability to use the glucose floating around in the blood, the sugar can build up, which causes hyperglycemia. Hyperglycemia happens occasionally in nearly all diabetics; it occurs when insulin isn’t clearing enough glucose from the blood after someone eats too much, exercises too little, or is experiencing stress or illness.
Being overweight increases the chances of being diagnosed with type 2 diabetes. A poor diet and a lack of exercise can also raise someone’s risk of becoming diabetic. Some people who are underweight, or even a healthy weight (mainly the elderly) can also be diagnosed with type 2 diabetes.
Risk Factors for Type 2 Diabetes
A type 2 diabetes diagnosis can occur in virtually anyone. Risk factors for type 2 diabetes include:
- being overweight (BMI of 25 or greater), particularly around the midsection
- exercising less than three times per week
- having had gestational diabetes or given birth to a baby nine pounds or larger
- 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 a diagnosis of polycystic ovary syndrome, metabolic syndrome, or acanthosis nigricans
- non-Caucasian ethnicity
How Does Type 2 Diabetes Differ from Type 1 Diabetes?
Type 2 diabetes is most commonly diagnosed in adults. Under the age of 20, about one in 400 children have type 2 diabetes (although this number is rising); more than one in four adults aged 65 or over have the condition (ADA, 2011). Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, can occur at any age but is most commonly diagnosed in children and young adults.
People with type 1 diabetes produce little or no insulin to move glucose out of the blood and into cells. Individuals with type 2 diabetes may produce insulin but have tissue, muscles, and organs that don’t accept it. In both forms of diabetes, glucose can build up in the blood unless cells receive and accept the insulin or less sugar enters the bloodstream.
The exact cause of Type 1 diabetes is unknown, but there is a strong hereditary link and it may be an autoimmune disorder. There is no cure for type 1 diabetes, and virtually all diagnosed individuals use insulin every day to help their body process the glucose in their blood.
Some people with type 2 diabetes may avoid the need for medication with a healthy diet and lifestyle, and some can even eliminate their need for medication by losing weight and exercising. Type 1 and type 2 diabetics need to carefully track their blood glucose levels to avoid hypo- or hyperglycemia. The symptoms and tests for each type of diabetes can be similar.
Tests for Type 2 Diabetes
If you have any of the common symptoms of diabetes or if you are at a high risk due to age, ethnicity, heredity, or health status, you may be tested yearly or every three years for diabetes. The most common tests for diagnosing Type 2 diabetes include the hemoglobin A1C test, fasting blood glucose tests, oral glucose tolerance tests, and urine tests. Many physicians will need to test glucose and urine at more than one visit to make a diagnosis of type 2 diabetes.
Blood Sugar Levels and Type 2 Diabetes
In addition to their importance in diagnosing diabetes, blood sugar levels are crucial to staying healthy for diabetics and for others. Diet and physical activity can directly affect blood sugar levels. Blood glucose changes naturally throughout the day, but it is usually higher after meals and lower after sleeping or fasting.
A healthy fasting blood glucose range is 70–100 mg/dL. Your doctor may suspect diabetes if you have a test above 200 mg/dL or if you test higher than 126 mg/dL for fasting glucose levels on two occasions. Blood sugar can be checked quickly at home with a simple device.
Individuals with type 2 diabetes need to track their blood sugar levels to know how well they are managing their condition. If blood sugar levels get too high (hyperglycemia) or too low (hypoglycemia), serious health problems can occur. Glucose monitoring and diet management are among the most common treatments for type 2 diabetes.
Treatments for Type 2 Diabetes
In addition to monitoring blood glucose levels, two other main treatments for type 2 diabetes include diet and exercise. Some people with this condition may also need diabetes medicine or insulin. Oral diabetes medications help people with type 2 diabetes make or use their own insulin. In people with very poorly controlled or severe diabetes, insulin therapy may be essential for maintaining health.
Type 2 Diabetes Diet
Although diabetics don’t have to follow a very specific diet, there are general guidelines that are important. Eating a healthy, balanced diet can help manage blood sugar and prevent diabetes complications. Working with a dietitian to learn about a healthy diabetes diet can make the transition easier.
Although entire books have been devoted to the subject, there are some simple tricks for a diabetic diet. Planning meals in advance and learning to pay attention to the amount of carbohydrates, fats, and nutrients in foods can help make a diabetes diet simpler. Most people with type 2 diabetes will need to manage calorie intake and their weight, as well. Sometimes, weight loss can help reverse diabetes symptoms and blood glucose problems.
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 (NIH, 2011). 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) (ADA, 2012).
Exercise for Type 2 Diabetics
Most people with type 2 diabetes can benefit from regular physical activity. Exercise can help control blood sugar levels and even help reverse insulin resistance.
Individuals with type 2 diabetes should incorporate physical activity into their daily routine on a regular basis. If they were previously inactive, they can slowly build their way up to regular exercise by starting with a short walk every evening or some gentle stretching. Diabetics should aim for about 30 minutes of moderate physical activity at least five days each week.
Coupled with a healthy diet, exercise can be one of the most effective treatments for diabetes. Weight loss and exercise can help diabetics avoid the need for oral medications and prevent some complications of the disease.
Prognosis and Outcomes for Type 2 Diabetes
Diabetes can cause serious health problems. It is most dangerous when it is poorly controlled. People who don’t manage their blood glucose levels, have other health problems, are inactive, or are undergoing a lot of stress may experience serious complications of this disease.
Problems like hyper- and hypoglycemia can cause weakness, fatigue, confusion, and—over time—nerve and organ damage. Blood sugar difficulties have a slow and cumulative effect. Over time, the damage to nerves, blood vessels, and organs can cause serious health problems. These include vision problems, foot and skin problems, recurrent infections, heart problems, kidney disease or failure, pain and numbness in limbs, amputation of the feet or legs, and comas. According to the American Diabetes Association, diabetes plays a factor in nearly a quarter of a million deaths each year (ADA, 2011).
Despite these serious potential complications, type 2 diabetes can be safely managed. Many people live long, healthy lives despite having diabetes. With proper management, most or all of these serious side effects can be avoided.
Preventing Type 2 Diabetes or Its Effects
Diabetes prevention involves a healthy lifestyle. In most cases, type 2 diabetes can be prevented by maintaining a healthy body weight, eating a balanced diet, and staying physically active. Individuals who are prediabetic or at a high risk of getting type 2 diabetes for other reasons should take extra care to exercise and maintain a healthy weight.
In order to prevent complications and the negative symptoms of type 2 diabetes, careful treatment is essential. Managing blood sugar on a daily basis, following a healthy diet, and being physically active can all help to prevent many dangerous complications.
Maintaining a healthy blood pressure and keeping stress under control is important to preventing complications. Taking care of your feet by cleaning, drying, and checking them regularly can also be important to preventing problems. Sometimes, diabetes medications and other pharmaceuticals are used to protect health and prevent complications. These drugs help manage blood sugar, blood pressure, or other health problems that can impact the body’s ability to function safely.