Diabetes is a chronic medical condition in which sugar, or glucose, levels build up in your bloodstream. The hormone insulin helps move the sugar from your blood into your cells, which are where the sugar is used for energy.
In type 2 diabetes, your body’s cells aren’t able to respond to insulin as well as they should. In later stages of the disease your body may also not produce enough insulin.
Uncontrolled type 2 diabetes can lead to chronically high blood sugar levels, causing several symptoms and potentially leading to serious complications.
In type 2 diabetes your body isn’t able to effectively use insulin to bring glucose into your cells. This causes your body to rely on alternative energy sources in your tissues, muscles, and organs.
This is a chain reaction that can cause a variety of symptoms. Type 2 diabetes can develop slowly. The symptoms may be mild and easy to dismiss at first.
The early symptoms may include:
- constant hunger
- a lack of energy
- weight loss
- excessive thirst
- frequent urination
- dry mouth
- itchy skin
- blurry vision
As the disease progresses, the symptoms become more severe and potentially dangerous.
If your blood sugar levels have been high for a long time, the symptoms can include:
- yeast infections
- slow-healing cuts or sores
- dark patches on your skin
- foot pain
- feelings of numbness in your extremities, or neuropathy
If you have two or more of these symptoms, you should see your doctor. Without treatment, diabetes can become life-threatening.
Diabetes has a powerful effect on your heart. Women with diabetes are twice as likely to have another heart attack after the first one. They’re at quadruple the risk of heart failure when compared to women without diabetes. Diabetes can also lead to complications during pregnancy.
Diet is an important tool to keep your heart healthy and blood sugar levels within a safe and healthy range. It doesn’t have to be complicated or unpleasant. The diet recommended for people with type 2 diabetes is the same diet just about everyone should follow. It boils down to a few key actions:
- Eat meals and snacks on schedule.
- Choose a variety of foods that are high in nutrition and low in empty calories.
- Be careful not to overeat.
- Read food labels closely.
Foods to choose
Healthy carbohydrates can provide you with fiber. The options include:
- legumes, such as beans
- whole grains
Foods with heart-healthy omega-3 fatty acids include:
You can get healthy monounsaturated and polyunsaturated fats from a number of foods, including:
- olive oil
- canola oil
- peanut oil
Although these options for fat are good for you, they’re high in calories. Moderation is key. When choosing dairy products, choose low-fat options.
Foods to avoid
There are certain foods that you should limit or avoid entirely. These include:
- foods heavy in saturated fats
- foods heavy in trans fats
- processed meats
- organ meats, such as beef or liver
- stick margarine
- baked goods
- processed snacks
- sugary drinks
- high-fat dairy products
- salty foods
- fried foods
Talk to your doctor about your personal nutrition and calorie goals. Together, you can come up with a diet plan that tastes great and suits your lifestyle needs.
Tips for Snacking at Work
My brother, who has type 2 diabetes, keeps packets of raw almonds at his desk to munch on when avoiding sweets at the office.
– Aimee Villamayor, Healthline staff
You can effectively manage type 2 diabetes. Your doctor will tell you how often you should check your blood glucose levels. The goal is to stay within a specific range.
Follow these tips to manage type 2 diabetes:
- Include foods rich in fiber and healthy carbohydrates in your diet. Eating fruits, vegetables, and whole grains will help keep your blood glucose levels steady.
- Eat at regular intervals
- Only eat until you’re full.
- Control your weight and keep your heart healthy. That means keeping refined carbohydrates, sweets, and animal fats to a minimum.
- Get about half an hour of aerobic activity daily to help keep your heart healthy. Exercise helps to control blood glucose, too.
Your doctor will explain how to recognize the early symptoms of blood sugar that’s too high or too low and what to do in each situation. Your doctor will also help you learn which foods are healthy and which foods aren’t.
Not everyone with type 2 diabetes needs to use insulin. If you do, it’s because your pancreas isn’t making enough insulin on its own. It’s crucial that you take insulin as directed. There are other prescription medications that may help as well.
Insulin is a naturally occurring hormone. Your pancreas produces it and releases it when you eat. Insulin helps transport sugar from your bloodstream to cells throughout your body, where it’s used for energy.
If you have type 2 diabetes, your body becomes resistant to insulin. Your body is no longer using the hormone efficiently. This forces your pancreas to work harder to make more insulin. Over time, this can damage cells in your pancreas. Eventually, your pancreas may not be able to produce any insulin.
If you don’t produce enough insulin or if your body doesn’t use it efficiently, glucose builds up in your bloodstream. This leaves your body’s cells starved for energy.
Doctors don’t know exactly what triggers this series of events.
It may have to do with cell dysfunction in the pancreas or with cell signaling and regulation. In some people, the liver produces too much glucose. There may be a genetic predisposition to developing type 2 diabetes.
There’s also a genetic predisposition to obesity, which increases the risk of insulin resistance and diabetes. There could also be an environmental trigger.
Most likely, it’s a combination of factors that increases the risk of type 2 diabetes. Research into the causes of type 2 diabetes is ongoing.
In some cases, lifestyle changes are enough to keep type 2 diabetes under control. If not, there are several medications that may help. Some of these medications are:
- metformin, which can lower your blood sugar levels and improve how your body responds to insulin
- sulfonylureas, which help your body make more insulin
- meglitinides or glinides, which are fast-acting, short-duration medications that stimulate your pancreas to release more insulin
- thiazolidinediones, which make your body more sensitive to insulin
- dipeptidyl peptidase-4 inhibitors, which are milder medications that help reduce blood sugar levels
- glucagon-like peptide-1 receptor agonists, which slow digestion and improve blood sugar levels
- sodium-glucose cotransporter-2 inhibitors, which help prevent the kidneys from reabsorbing sugar into the blood and sending it out in your urine
Each of these medications can cause side effects. It may take some time to find the best medication or combination of medications to treat your diabetes.
If your blood pressure or cholesterol levels are a problem, you may need medications to address those needs as well.
If your body can’t make enough insulin, you may need insulin therapy. You may only need a long-acting injection you can take at night or you may need to take insulin several times per day.
Type 2 diabetes in children is a growing problem. According to the American Diabetes Association, approximately 208,000 Americans under age 20 have diabetes.
The reasons for this are complex, but risk factors include:
- being overweight, or having a body mass index above the 85th percentile
- having a birth weight of 9 pounds or more
- being born to a mother who had diabetes while she was pregnant
- having a close family member with type 2 diabetes
- having a sedentary lifestyle
- being American Indian, Alaska Native, African-American, Asian-American, Latino, or Pacific Islander
The symptoms of type 2 diabetes in children include:
- excessive thirst
- excessive hunger
- increased urination
- sores that are slow to heal
- frequent infections
- blurry vision
- areas of darkened skin
See your child’s doctor immediately if your child has symptoms of diabetes. Untreated diabetes can lead to serious and even life-threatening complications.
A random blood sugar test may reveal high blood sugar levels. A hemoglobin A1C test can provide more information about average blood sugar levels over a few months. Your child may also need a fasting blood sugar test.
If your child’s doctor diagnoses them with diabetes, your doctor will need to determine if it’s type 1 or type 2 before suggesting a specific treatment.
You can help lower your child’s risk by encouraging them to eat well and to be physically active every day.
Risk factors for type 2 diabetes
We may not understand the exact causes of type 2 diabetes, but we do know that certain factors can put you at increased risk.
Certain factors are out of your control:
- Your risk is greater if you have a brother, sister, or parent who has type 2 diabetes.
- You can develop type 2 diabetes at any age, but your risk increases as you get older. Your risk is particularly high after age 45.
- African-Americans, Latinos, Asian-Americans, and American Indians are at higher risk than Caucasians.
- Women who have a condition called polycystic ovarian syndrome are at increased risk.
You may be able to change these factors:
- Being overweight means that you have more fatty tissue, which makes your cells more resistant to insulin. Extra fat in the abdomen increases your risk more than extra fat in the hips and thighs.
- Your risk increases if you have a sedentary lifestyle. Regular exercise uses up glucose and helps your cells respond better to insulin.
- Eating a lot of junk foods or eating too much wreaks havoc on your blood glucose levels.
You’re also at increased risk if you’ve had gestational diabetes or if you have prediabetes.
You can’t always prevent type 2 diabetes. There’s nothing you can do about your genetics, ethnicity, or age.
If you have prediabetes or other diabetes risk factors and even if you don’t, a few lifestyle tweaks can help delay or even prevent the onset of type 2 diabetes. These changes in diet, exercise, and weight management work together to help keep your blood sugar levels within the ideal range all day long:
Your diet should be high in nutrient-rich carbohydrates and fiber. You also need heart-healthy omega-3 fatty acids from certain kinds of fish and monounsaturated and polyunsaturated fats. Dairy products should be low in fat. It’s not only what you eat, but also how much you eat that matters. You should be careful about portion sizes and try to eat meals at about the same time every day.
Type 2 diabetes is associated with inactivity. Getting 30 minutes of aerobic exercise every day can improve your overall health. Try to add in extra movement throughout the day, too.
You’re more likely to develop type 2 diabetes if you’re overweight. Eating a healthy, balanced diet and getting daily exercise should help you keep your weight under control. If those changes aren’t working, your doctor can make some recommendations for losing weight safely.
Whether or not you have prediabetes, you should see your doctor right away if you have the symptoms of diabetes. Your doctor can get a lot of information from blood work. Diagnostic testing may include the following:
- A hemoglobin A1C test is also called a glycosylated hemoglobin test. It measures average blood glucose levels for the previous two or three months. You don’t need to fast for this test, and your doctor can diagnose you based on the results.
- You need to fast for eight hours before having a fasting plasma glucose test. This test measures how much glucose is in your plasma.
- During an oral glucose tolerance test, your blood is drawn before and two hours after you drink a dose of glucose. The test results show how well your body deals with glucose before and after the drink.
If you have diabetes, your doctor will provide you with information about how to manage the disease, including:
- how to monitor blood glucose levels on your own
- dietary recommendations
- physical activity recommendations
- information about any medications that you need
You may need to see an endocrinologist who specializes in the treatment of diabetes. You’ll probably need to visit your doctor more often at first to make sure your treatment plan is working.
For many people, type 2 diabetes can be effectively managed. It can affect virtually all your organs and lead to serious complications, including:
- skin problems, such as bacterial or fungal infections
- nerve damage, or neuropathy, which can cause a loss of sensation or numbness and tingling in your extremities as well as digestive issues, such as vomiting, diarrhea, and constipation
- poor circulation to the feet, which makes it hard for your feet to heal when you have a cut or an infection and can also lead to gangrene and loss of the foot or leg
- hearing impairment
- retinal damage, or retinopathy, and eye damage, which can cause deteriorating vision, glaucoma, and cataracts
- cardiovascular diseases such as high blood pressure, narrowing of the arteries, angina, heart attack, and stroke
- kidney damage and kidney failure
Hypoglycemia can occur when your blood sugar is low. The symptoms can include shakiness, dizziness, and difficulty speaking. You can usually remedy this by having a “quick-fix” food or drink, such as fruit juice, a soft drink, or a hard candy.
Hyperglycemia can happen when blood sugar is high. It’s typically characterized by frequent urination and increased thirst. Exercising can help lower your blood sugar level.
Complications during and after pregnancy
If you have diabetes while you’re pregnant, you’ll need to monitor your condition carefully. Diabetes that’s poorly controlled can:
- complicate labor and delivery
- harm your baby’s developing organs
- cause your baby to gain too much weight
- increase your baby’s risk of developing diabetes during their lifetime
The U.S. Centers for Disease Control and Prevention reports the following statistics about diabetes in the United States:
- Over 29 million people have diabetes. That’s 9.3 percent of the population.
- One in four people have no idea they have diabetes.
- More than one in three adults have prediabetes, and 15 to 30 percent of them will develop type 2 diabetes within five years.
- Non-Hispanic black, Hispanic, and American Indian, including Alaska Native, adults are about twice as likely to have diabetes as non-Hispanic white adults.
The American Diabetes Association reports the following statistics:
- In 2012, diabetes cost the United States $245 billion in direct medical costs and reduced productivity.
- The average medical expenses for people with diabetes are about 2.3 times higher than they would be in the absence of diabetes.
- Diabetes is the seventh leading cause of death in the United States, either as the underlying cause of death or as a contributing cause of death.
The World Health Organization reports the following statistics:
- The 2014 global prevalence of diabetes was about 9 percent for adults.
- About 90 percent of people with diabetes have type 2 diabetes.
- Diabetes caused about 1.5 million deaths worldwide in 2012.
- About half of people with diabetes die of cardiovascular disease, including heart disease and stroke.
- Diabetes is also a leading cause of kidney failure.
Managing type 2 diabetes requires teamwork. You’ll need to work closely with your doctor, but a lot of the results depend on your actions.
Your doctor may want to perform periodic blood tests to determine your blood sugar levels. This will help determine how well you’re managing the disease. If you take medication, these tests will help gauge how well it’s working.
Because diabetes increases your risk of cardiovascular disease, your doctor will also monitor your blood pressure and blood cholesterol levels. If you have symptoms of heart disease, you may need additional tests. These tests may include an electrocardiogram or a heart stress test.
Follow these tips to help manage your diabetes:
- Maintain a diet high in nutrient-rich carbohydrates and fiber but low in unhealthy fats and simple carbohydrates.
- Exercise daily.
- Take all your medication as recommended.
- Use a home monitoring system to test your own blood sugar levels between visits to your doctor. Your doctor will tell you how often you should do that and what your target range should be.
It may also be helpful to bring your family into the loop. Educate them about the warning signs of blood sugar levels that are too high or too low so that they can help in an emergency. If everyone in your home follows a healthy diet and participates in physical activity, you’ll all benefit.