What
Is Type 2 Diabetes?
Type 2 diabetes strikes people of
all ages, and early symptoms are subtle. In fact, about one out of three people
with type 2 diabetes don't know they have it. This chronic condition thwarts
the body's ability to use the carbohydrates in food for energy. The result is
elevated blood sugar. Over time, this excess sugar raises the risk for heart
disease, loss of vision, nerve and organ damage, and other serious conditions.
Warning
Signs
Thirst
People with type 2 diabetes
frequently have no symptoms. When symptoms do appear, one of the first may be
an increase in thirst. This is often accompanied by additional problems,
including dry mouth, increased appetite, frequent urination -- sometimes as
often as every hour -- and unusual weight loss or gain.
Headaches
As blood sugar levels become more
abnormal, additional symptoms may include headaches, blurred vision, and
fatigue.
Infections
In many cases, type 2 diabetes is
not discovered until it takes a noticeable toll on health. One red flag is
troubling infections, such as:
- Cuts or sores that are slow to heal
- Frequent yeast infections or urinary tract infections
- Itchy skin, especially in the groin area
Sexual
Dysfunction
Sexual dysfunction is common among
people with diabetes. Diabetes can cause damage to blood vessels and nerve
endings in the genitals, leading to a loss of feeling and making orgasm
difficult. Other complications can include vaginal dryness and impotence in men.
It's estimated between 35% and 70% of men with diabetes will have at least some
degree of impotence in their lifetime. And about 1 in 3 women with diabetes
will experience some form of sexual dysfunction.
Risk
Factors You Can Control
Some health habits and medical
conditions related to your lifestyle can increase the odds of developing type 2
diabetes, including:
- Being overweight, especially at the waist
- A sedentary lifestyle
- Smoking
- A diet high in red meat, processed meat, high-fat dairy products, and sweets
- Abnormal cholesterol and blood fats, such as HDL "good" cholesterol lower than 35 mg/dL and /or a triglyceride level over 250 mg/dL
Risk Factors You Can't Control
Other risk factors are out of your
control, including:
- Race or ethnicity: Hispanics, African Americans, Native Americans, and Asians have a higher than average risk.
- Family history of diabetes: Having a parent or sibling with diabetes boosts your risk.
- Age: Being 45 and older increases your risk of type 2 diabetes.
The more risk factors you have, the
greater your odds of developing type 2 diabetes.
Risk
Factors for Women
Having gestational diabetes when
you're pregnant puts you at higher risk for developing type 2 diabetes later
on. Women who give birth to a baby weighing over 9 pounds are also at risk.
Having a history of polycystic ovary syndrome can also cause insulin resistance
that can lead to diabetes.
How
Does Insulin Work?
In a healthy person, insulin helps
turn food into energy -- in an efficient manner. The stomach breaks down carbohydrates
from food into sugars, including glucose. Glucose then enters the bloodstream,
which stimulates the pancreas to release insulin in just the right
amount. Insulin, a hormone, allows glucose to enter cells throughout the
body, where it is used as fuel. Excess glucose is stored in the liver.
Metabolism
Mishaps
In type 2 diabetes, the cells cannot
absorb glucose properly. That means glucose levels in the blood become
elevated. If you've developed a condition called insulin resistance, the body
makes excess insulin, but the muscle, liver, and fat cells do not use or
respond properly to the insulin. With long-standing uncontrolled type 2
diabetes, the pancreas will reduce the amount of insulin it produces.
Diagnosing
Type 2 Diabetes
A simple blood test can diagnose
diabetes. The A1C test gives a snapshot of your average blood glucose level
over the past 2-3 months. An A1C level of 6.5% or higher may indicate diabetes.
With a fasting plasma glucose test, a result above 126 is considered diabetes.
Your doctor may order an oral glucose challenge test with a two-hour blood
test. In people with classic symptoms of diabetes, a random blood glucose level
of greater than 200 can help diagnosis diabetes.
Managing
Diabetes: Diet
Fortunately, controlling blood sugar
levels by changing diet and losing excess weight can also cut your risk of
complications. People with type 2 diabetes should carefully monitor
carbohydrate consumption and keep the amounts of carbs in your meals fairly
consistent, as well as total fat and protein intake, and reduce calories. Ask
your doctor for a referral to a registered dietitian to help you with healthy
choices and an eating plan that will work for you.
Exercise
Routine exercise, such as strength
training or walking, improves the body's use of insulin and can lower blood
sugar levels in people with type 2 diabetes. Being active also helps reduce
body fat, lower blood pressure, and protect against heart disease. People with
type 2 diabetes should try to get 30 minutes of moderate exercise on most days
of the week.
Stress
Reduction
Stress can cause blood pressure to
rise. It can also increase glucose levels in your blood as part of your
"fight or flight" response. Or you may turn to food to cope with
stress. All are bad when living with diabetes. Instead of letting stress take
its toll, try practicing relaxation techniques such as deep breathing,
meditation, or visualization. Sometimes talking to a friend, family member,
counselor, or member of the clergy can help. If you're still battling stress,
reach out to your doctor.
Oral
Medication
When people with type 2 diabetes are
unable to control blood sugar sufficiently with diet and exercise, medication
may be added. There are many types of diabetes pills available, and they are
often used in combination. Some work by stimulating the pancreas to make more
insulin, and others improve the effectiveness of insulin, or block the digestion
of starches. Some medications used to treat type 2 diabetes also help inhibit
the breakdown of insulin.
Insulin
Your doctor may prescribe insulin
early on in your treatment and in combination with pills. Insulin can also used
in people with type 2 diabetes who develop "beta-cell failure." This
means the cells in the pancreas no longer produce insulin in response to high
blood sugar levels. In this case, insulin therapy -- injections or an insulin
pump -- must become part of the daily routine.
Non-Insulin
Injectables
New drugs are available for people
with type 2 diabetes. Pramlintide (Symlin), exenatide (Byetta), and liraglutide
(Victoza) are non-insulin injectable drugs. Whereas insulin pulls glucose into
the cells, these medications cause the body to release insulin to control blood
sugar levels.
Glucose
Testing
Testing your blood glucose level
will let you know how controlled your blood sugars are and if you need to take
actions to change your treatment plan. How often and when you test will be
based on how controlled your diabetes is, the type of therapy used to control
your diabetes, and whether you are experiencing symptoms of fluctuating sugars.
Talk with your doctor to find out how often you should use a glucose meter to
check your blood sugar. Some common testing times may be when waking up, before
and after meals and exercise, and at bedtime.
Continuous glucose monitor (GGM) may
be useful to those with type 1 diabetes to help lower their blood glucose.
Long-Term
Damage: Arteries
Over time, untreated type 2 diabetes
can damage many of the body's systems. About two out of three people with
diabetes die of heart disease. Having diabetes also puts you at a two to four
times higher risk for stroke. People with diabetes are likely to develop plaque
in their arteries, reducing blood flow and increasing risk of clots. This
hardening of the arteries (atherosclerosis) raises the risk of heart attack and
stroke.
Kidneys
The longer you have diabetes, the
greater the risk of developing chronic kidney disease. Diabetes is the leading
cause of kidney failure, accounting for 44% of new cases in 2008. Controlling
risk factors such as uncontrolled diabetes, high blood pressure, and high
cholesterol reduces your risk of developing this complication. Annual
screening for kidney disease and medications, which slow the development and
progression of kidney disease, are used to reduce your risk of kidney failure.
Eyes
High blood sugar can damage the tiny
blood vessels that bring oxygen and nutrients to the retina, a critical part of
the eye. This is known as diabetic retinopathy, and it can cause progressive,
irreversible vision loss. It is the leading cause of new cases of blindness in
people between the ages of 20 and 74. Pools of blood, or hemorrhages, on the
retina of an eye are visible in this image.
Nerve
Pain
Over time, uncontrolled diabetes and
elevated blood sugars create a very real risk for nerve damage. Symptoms can
include tingling, numbness, pain, and a pins and needles sensation -- often in
the fingers, hands, toes, or feet. The damage is not reversible, but treatments
can help with the pain and numbness. And controlling your diabetes can help
prevent further damage.
Feet
Diabetic nerve damage can make it
difficult to feel your feet and detect injury. At the same time,
hardening of the arteries results in poor blood flow to the feet. Foot sores
and gangrene can occur, even from small injury. In severe cases, infections can
go unchecked and result in an amputation.
Preventing
Type 2 Diabetes
One of the most astonishing things
about type 2 diabetes is that such a life-altering condition is often
preventable. To lower your risk, follow the same guidelines for warding off
heart disease:
- Eat a healthy diet.
- Exercise for 30 minutes, five days a week.
- Maintain a healthy weight.
- Talk to your doctor about being screened for prediabetes.
In people with prediabetes,
lifestyle changes and medication can help prevent the progression to type 2
diabetes.
Source: Web MD
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