Condition 101 About Type 2 Diabetes

What is the definition of Type 2 Diabetes?

Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

What are the alternative names for Type 2 Diabetes?

Noninsulin-dependent diabetes; Diabetes - type II; Adult-onset diabetes; Diabetic - type 2 diabetes; Oral hypoglycemic - type 2 diabetes; High blood sugar - type 2 diabetes

What are the causes for Type 2 Diabetes?

Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy.

When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy.

When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes.

Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.

Type 2 diabetes can also develop in people who are not overweight or obese. This is more common in older adults.

Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease.

What are the symptoms for Type 2 Diabetes?

People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years.

Early symptoms of diabetes caused by a high blood sugar level may include:

  • Bladder, kidney, skin, or other infections that are more frequent or heal slowly
  • Fatigue
  • Hunger
  • Increased thirst
  • Increased urination
  • Blurred vision

After many years, diabetes can lead to serious health problems, and as a result, many other symptoms.

What are the current treatments for Type 2 Diabetes?

At first, the goal of treatment is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems that can result from having diabetes.

The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods.

Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes care and education specialist and a dietitian.

LEARN THESE SKILLS

Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include:

  • How to test and record your blood glucose
  • What, when, and how much to eat
  • How to safely increase your activity and control your weight
  • How to take medicines, if needed
  • How to recognize and treat low and high blood sugar
  • How to handle sick days
  • Where to buy diabetes supplies and how to store them

It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well with the disease. Stay up-to-date on new research and treatments. Make sure you are getting information from trustworthy sources, such as your provider and diabetes educator.

MANAGING YOUR BLOOD SUGAR

Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your provider and diabetes educator about how often to check.

To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle, called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar.

Your provider or diabetes educator will help set up a testing schedule for you. Your provider will help you set a target range for your blood sugar numbers. Keep these factors in mind:

  • Most people with type 2 diabetes only need to check their blood sugar once or twice a day.
  • If your blood sugar level is under control, you may only need to check it a few times a week.
  • You may test yourself when you wake up, before meals, and at bedtime.
  • You may need to test more often when you are sick or under stress.
  • You may need to test more often if you are having more frequent low blood sugar symptoms.

Keep a record of your blood sugar for yourself and your provider. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. Always bring your blood glucose meter to medical appointments so the data can be downloaded and discussed.

Your provider may recommend that you use a continuous glucose monitor (CGM) to measure blood sugar if:

  • You are using insulin injections many times a day
  • You have had an episode of severe low blood sugar
  • Your blood sugar level varies a lot

The CGM has a sensor that is inserted just under the skin to measure glucose in your tissue fluid every 5 minutes.

HEALTHY EATING AND WEIGHT CONTROL

Work closely with your health care providers to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like.

Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes.

Obese people whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery.

REGULAR PHYSICAL ACTIVITY

Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it:

  • Lowers your blood sugar level without medicine
  • Burns extra calories and fat to help manage your weight
  • Improves blood flow and blood pressure
  • Increases your energy level
  • Improves your ability to handle stress

Talk to your provider before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise, including adjusting doses of insulin if needed.

Diabetes

MEDICINES TO TREAT DIABETES

If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your provider may prescribe medicine. Since these drugs help lower your blood sugar level in different ways, your provider may have you take more than one drug.

Some of the most common types of medicines are listed below. They are taken by mouth or injection.

  • Alpha-glucosidase inhibitors
  • Biguanides
  • Bile acid sequestrants
  • DPP-4 inhibitors
  • Injectable medicines (GLP-1 analogs)
  • Meglitinides
  • SGLT2 inhibitors
  • Sulfonylureas
  • Thiazolidinediones

You may need to take insulin if your blood sugar cannot be controlled with some of the above medicines. Most commonly, insulin is injected under the skin using a syringe, insulin pen, or pump. Another form of insulin is the inhaled type. Insulin cannot be taken by mouth because the acid in the stomach destroys the insulin.

PREVENTING COMPLICATIONS

Your provider may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including:

  • Eye disease
  • Kidney disease
  • Heart disease and stroke

FOOT CARE

People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make your feet less able to feel pressure, pain, heat, or cold. You may not notice a foot injury until you have severe damage to the skin and tissue below, or you get a severe infection.

Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected.

To prevent problems with your feet:

  • Stop smoking if you smoke.
  • Improve control of your blood sugar.
  • Get a foot exam by your provider at least twice a year to learn if you have nerve damage.
  • Ask your provider to check your feet for problems such as calluses, bunions or hammertoes. These need to be treated to prevent skin breakdown and ulcers.
  • Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems.
  • Treat minor infections, such as athlete's foot, right away.
  • Use moisturizing lotion on dry skin.
  • Make sure you wear the right kind of shoes. Ask your provider what type of shoe is right for you.

EMOTIONAL HEALTH

Living with diabetes can be stressful. You may feel overwhelmed by everything you need to do to manage your diabetes. But taking care of your emotional health is just as important as your physical health.

Ways to relieve stress include:

  • Listening to relaxing music
  • Meditating to take your mind off your worries
  • Deep breathing to help relieve physical tension
  • Doing yoga, taichi, or progressive relaxation

Feeling sad or down (depressed) or anxious sometimes is normal. But if you have these feelings often and they're getting in the way of managing your diabetes, talk with your health care team. They can find ways to help you feel better.

People with diabetes should make sure to keep up on their vaccination schedule.

What are the support groups for Type 2 Diabetes?

There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes.

What is the outlook (prognosis) for Type 2 Diabetes?

Diabetes is a lifelong disease and there is no cure.

Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level.

What are the possible complications for Type 2 Diabetes?

After many years, diabetes can lead to serious health problems:

  • You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.
  • Your feet and skin can develop sores and infections. If the wounds do not heal properly, your foot or leg may need to be amputated. Infections can also cause pain and itching in the skin.
  • Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet.
  • Nerves in your body can get damaged, causing pain, tingling, and numbness.
  • Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.
  • High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant.
  • High blood sugar can weaken your immune system. This may make it more likely for you to get infections, including life-threatening skin and fungal infections.

When should I contact a medical professional for Type 2 Diabetes?

Call 911 or the local emergency number right away if you have:

  • Chest pain or pressure
  • Fainting, confusion or unconsciousness
  • Seizure
  • Shortness of breath
  • Red, painful skin that is spreading quickly 

These symptoms can quickly get worse and become emergency conditions (such as seizures, hypoglycemic coma or hyperglycemic coma).

Also call your provider if you have:

  • Numbness, tingling, or pain in your feet or legs
  • Problems with your eyesight
  • Sores or infections on your feet
  • Symptoms of high blood sugar (extreme thirst, blurry vision, dry skin, weakness or fatigue, the need to urinate a lot)
  • Symptoms of low blood sugar (weakness or fatigue, trembling, sweating, irritability, trouble thinking clearly, fast heartbeat, double or blurry vision, uneasy feeling)
  • Frequent feelings of depression or anxiety
Low

How do I prevent Type 2 Diabetes?

You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.

Diabetic
15/15
Starchy
Glucose
Alpha-glucosidase
Biguanides
Sulfonylureas
Thiazolidinediones
Food
Monitoring

REFERENCES

American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S14-S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S135-S151. PMID: 31862754 pubmed.ncbi.nlm.nih.gov/31862754/.

American Diabetes Association. 8. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S89-S97. PMID: 31862751 pubmed.ncbi.nlm.nih.gov/31862751/.

Riddle MC, Ahmann AJ. Therapeutics of type 2 diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 35.

Latest Advances On Type 2 Diabetes

  • Condition: Type 2 Diabetes
  • Journal: European review for medical and pharmacological sciences
  • Treatment Used: Glucokinase Activators
  • Number of Patients: 762
  • Published —
In this study, researchers evaluated the safety and effectiveness of glucokinase activators for the treatment of type 2 diabetes.
  • Condition: Type 2 Diabetes Mellitus
  • Journal: BMJ open diabetes research & care
  • Treatment Used: Lipid-Lowering Drugs
  • Number of Patients: 288
  • Published —
The aim of this study was to investigate factors associated with lipid therapy adherence and achievement of goals in real-life setting among patients with recently diagnosed type 2 diabetes mellitus (T2DM).

Clinical Trials For Type 2 Diabetes

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Dietary Supplement
  • Participants: 40
  • Start Date: June 1, 2022
High-amylose Barley (HIAMBA) in the Regulation and Prevention of Type 2 Diabetes: a Randomized, Cross-over, Acute Dietary Intervention Study.
Clinical Trial
  • Status: Not yet recruiting
  • Phase: Phase 1
  • Intervention Type: Drug
  • Participants: 36
  • Start Date: December 1, 2021
Oral Peri-operative TIming of Metformin (or) Salsalate to Improve Non-cardiac Surgery Glucose Control - A Placebo-Controlled Internal Feasibility Trial