What All we Know About Type 2 Diabetes
Type 2 diabetes mellitus was once known as adult-onset diabetes or noninsulin-dependent diabetes (NIDDM). It is a chronic condition that affects the way our body metabolizes sugar (glucose) that we take in our food. Just like type 1 diabetes, insulin, a hormone that regulates the movement of sugar into your cells, is the key factor in T2DM too. In type 2 diabetes, the body usually becomes insulin resistant; but sometimes the pancreas does not produce enough insulin to maintain a normal glucose level.
Commonly occurring in adults, type 2 diabetes is usually found in individuals who have had childhood obesity. Although the disorder cannot be cured, it can be managed with proper medical counseling, nutrition therapy, exercises and modification of lifestyle. If these are not enough to manage the blood sugar level, one may need diabetes medications or insulin therapy, as well.
What Increases the Risk for Type 2 Diabetes
There are certain factors that increase the risk of developing Type 2 Diabetes mellitus.
Some of them are:
- Being overweight or obese
- Sedentary lifestyle (physical activity helps to control body weight, and make cells more sensitive to insulin)
- Blood pressure of 140/90 millimeters of mercury (mm Hg) or more
- Family history of type 2 diabetes
- Ethnicity or heritage backgrounds, including Asians, black people, Hispanics, and First Nations populations
- Having low levels of high-density lipoprotein (HDL), or high levels of triglycerides in blood
Special risk factors for women include:
- A history of gestational diabetes during a past pregnancy
- Giving birth to a baby weighing more than 9 pounds (4 kilograms)
- A history of polycystic ovary syndrome
What are Warning Signals About Type 2 Diabetes
Type 2 diabetes can be show certain signs and symptoms that often develop slowly.
Not all individuals have same signs and symptoms, all or any of them, but you must watch out for the following:
Increased thirst and frequent urination:
Due to increase in blood sugar level, fluids may be absorbed from the tissues, leaving you thirsty. As a result, you may drink fluids and urinate more than usual. In individuals with type 2 diabetes, the kidneys work harder by flushing out excess blood sugar into the urine. Due to more urine production and the urge to urinate more frequently, there is an increased risk of urinary tract infections (UTIs). People with type 2 diabetes are more likely to get a UTI than those without the disease, and this risk is higher in women than in men.
the signals of hunger and satiety are sent by our brain and accordingly we feel hungry in response to those signals. In type 2 diabetes, individuals are insulin resistant. Poor utilization of insulin in the body in such individuals causes the cells, muscles and organs run out of energy leading to intense hunger. Insulin doesn’t function properly in muscle, fat, and other tissues but the pancreas continue to secrete insulin. Due to lack of coordination, insulin level is elevated in the body. This insulin level sends signals to the brain that your body is hungry.
When the body loses its efficiency to metabolize glucose due to poor insulin secretion, alternative fuels stored in muscle and fat are broken down causing weight loss. Large amount of glucose is released in the urine. Because of uncontrolled diabetes, one may lose more calories and water, resulting in sudden weight loss.
Type 2 diabetes is more about insulin resistance. Whatever you eat stays in blood and does not reach the cells. Irrespective of what you eat and how much you eat, the poor carbohydrate metabolism tends to make you run out of energy, while you have high blood sugar level. Due to deficiency of sugar in the cells, you may become tired and irritable.
The eye muscles hold the lens of the eye and allow the eye to focus by changing the shape of the lens as and when required. In uncontrolled type 2 diabetes, high blood sugar in the body causes fluid to be pulled from the lenses of your eyes. Also the flexibility of the eye muscles is reduced. The lens’s ability to bend is altered. Although the lens is not damaged, the muscles of the eye find it difficult to focus. The result is blurred vision. Unlike your body, the eye muscles cannot easily adapt to sudden changes in blood sugar levels (low to high or vice versa) which leads to vision problems.
Cuts and sores that heal slowly or frequent infections:
Type 2 diabetes affects your ability to heal and resist infections. The disease affects circulation of blood and impedes normal healing of wounds. Sometimes, minor cuts or bruises take too long to heal and become serious injuries, leading to amputation of limbs. Women with diabetes (type 1 or 2) are more vulnerable to feminine health issues, such as bacterial infections, yeast infections, and vaginal thrush, especially in case of poorly controlled diabetes.
Areas of darkened skin:
Some people with type 2 diabetes have dark, patchy skin or creases in their bodies, usually in the armpits and neck. This condition is called acanthosis nigricans, and may be a sign of insulin resistance. It is more commonly reported in individuals who have diabetes and are trying to find ways how to manage their weight.
How can you Manage Diabetes?
You can manage type 2 diabetes by:
- Nutrition therapy (Healthy eating)
- Physical activity (Regular exercise)
- Diabetes medication or insulin therapy
- Self monitoring of Blood glucose
These are the basic steps to keep your blood sugar level under control to certain extent, and can delay or prevent complications associated with diabetes.
Although there is no specific diabetes diet, yet you must center your diet on high-fiber, low-fat foods if you have diabetes:
- Whole grains
You’ll also need to eat fewer animal products, refined carbohydrates and sweets.
Foods with low glycemic index foods also may be helpful in achieving more stable blood sugar level. These are mostly rich in fiber content. Beware of foods with high glycemic index like white bread, potatoes, and short-grain rice. Foods with a high glycemic index raise your blood sugar quickly. According to ADA (American Diabetes Association) guidelines 2018, higher intakes of nuts, berries, yogurt, coffee, and tea are associated with reduced diabetes risk. On the other hand, red meats and sugar-sweetened beverages are associated with an increased risk of type 2 diabetes.
With the help of a registered dietitian you can get your specific meal plan drafted that fits your health goals and lifestyle. You can learn how to monitor your carbohydrate intake to manage diabetes.
Like everyone else, people with type 2 diabetes need exercise and an exercising program under the supervision of a diabetologist. You can choose aerobic activities like, such as yoga, walking, or swimming as a part of daily routine. 150 minutes of moderate-intensity physical activity per week, such as brisk walking is suggested. In addition to that, an exercise regimen with resistance training such as weightlifting can also be helpful. Breaking up prolonged sedentary time, associated with moderately lower postprandial glucose levels.
Physical activity lowers blood sugar. Check your blood sugar level before any activity.
Diabetes Medications and Insulin Therapy:
Some people with type 2 diabetes can attain their target blood sugar levels with regulated diet and exercise alone, but many also need diabetes medications, or even insulin therapy. Your doctor may recommend which combination of drugs can help you control your blood sugar in the right way.
Examples of possible treatments for type 2 diabetes include:
- Metformin (Glucophage, Glumetza, others)
- DPP-4 inhibitors
- GLP-1 receptor agonists
- SGLT2 inhibitors
Some people who have type 2 diabetes need insulin therapy as well. Depending on your requirement, your doctor will prescribe a mixture of insulin types to be, used throughout the day and night. Often, people with type 2 diabetes start insulin use with one long-acting shot at night. The doctor’s advice is extremely important for diabetes medication.
Monitoring Your blood sugar:
You may need to check and record your blood sugar level at shorter intervals, if you are following any treatment plan, or taking any diabetes medication or if you’re on insulin, multiple times a day. Consult your doctor as to how often you need to check your blood sugar. Careful monitoring is very essential to maintain you r target blood sugar level.
Medication During Pregnancy:
Women with type 2 diabetes may require to change their treatment during pregnancy. Many of them are advised to switch to insulin therapy during pregnancy. Cholesterol-lowering medications and some blood pressure controlling drugs are not recoomended during pregnancy.Sgns of diabetic retinopathy may worsen during pregnancy. You must visit your ophthalmologist during the first trimester of your pregnancy and at one year postpartum.
Type 2 diabetes affects men and women with various signs and symptoms. They may need to follow different treatment therapies or diet plan specific to their lifestyle and other conditions. Advice of your healthcare expert is the most important treatment for this incurable metabolic disorder.