Understanding Type 2 Diabetes

Insights into Causes, Treatments, and Healthier Living

Type 2 diabetes is a chronic medical condition in which the levels of sugar, or glucose, build up in your bloodstream. This happens because your body cannot react to insulin effectively or is unable to produce enough of it.

Typically, the hormone insulin helps move glucose from your blood to your cells, where it’s used for energy. But with type 2 diabetes, your body’s cells aren’t able to respond to insulin as well as they should. In later stages of the condition, your body may also not produce enough insulin.

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
fatigue
excessive thirst
frequent urination
blurry vision
pain, tingling, or numbness in your hands or feet

As the disease progresses, the symptoms become more severe and can cause some potentially dangerous complications.

Causes

Insulin is a naturally occurring hormone. Your pancreas produces it and releases it when you eat. Insulin helps transport glucose 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.

While the definitive trigger of type 2 diabetes is your body’s resistance to insulin, a combination of factors usually increases your risk of that resistance occurring.

Diagnosis

Even if you do not have prediabetes, you should see your doctor right away if you think you may be experiencing symptoms of diabetes. Your doctor can get a lot of information from blood work. Diagnostic testing may include the following:

Hemoglobin A1C test: This test measures your average blood glucose levels for the previous 2 or 3 months. You don’t need to fast for this test, and your doctor can diagnose diabetes based on the results. It’s also called a glycosylated hemoglobin test.

Fasting plasma glucose test: This test measures how much glucose is in your plasma. You may need to fast for 8 hours before taking it.

Oral glucose tolerance test: During this test, your blood is drawn three times: before drinking a dose of glucose, 1 hour after, and 2 hours after. 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.

Treatment

Type 2 diabetes can be managed and, in some cases, reversed. Most treatment plans will include checking your blood glucose levels, and your doctor will let you know how often you should do it. The goal is to stay within a specific range.

Additional lifestyle changes your doctor will likely advise to help treat your type 2 diabetes include:

eating foods rich in fiber and healthy carbohydrates — eating fruits, vegetables, and whole grains can help keep your blood glucose levels steady
eating at regular intervals
learning to listen to your body and know when you’re full
managing your weight and keeping your heart healthy, which typically means keeping refined carbohydrates, sweets, and animal fats to a minimum
getting about half an hour of physical activity daily to help keep your heart healthy — exercise can help to regulate blood glucose, too

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, and it’s crucial that you take insulin as your doctor prescribes. There are other prescription medications that may help as well.

Medications

In some cases, lifestyle changes are enough to manage type 2 diabetes. If not, there are several medications that may help, including:

Metformin: This can lower your blood glucose levels and improve how your body responds to insulin. It’s the first-line treatment for most people with type 2 diabetes.
Sulfonylureas: These are oral medications that help your body make more insulin.
Meglitinides: These are fast-acting, short-duration medications that stimulate your pancreas to release more insulin.
Thiazolidinediones: These make your body more sensitive to insulin.
Dipeptidyl peptidase 4 (DPP-4) inhibitors: These are milder medications that help reduce blood glucose levels.
Glucagon-like peptide-1 agonists: These slow digestion and improve blood glucose levels.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors: These help your kidneys remove sugar in your body through urine.

Each type of medication listed above can cause side effects. It may take some time for you and your doctor to find the best medication or combination of medications to treat your diabetes.

If your body is unable to 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.

Diet Considerations

Diet is an important tool to help maintain optimal heart health and blood glucose levels that are within a safe range.

The diet recommended for people with type 2 diabetes is the same diet that just about everyone should follow. It boils down to a few key actions:

Choose a variety of foods that are high in nutrients and low in empty calories.
Work on being mindful about portion sizes and stopping eating when you’re full.
Read food labels closely to understand the amount of sugar or carbs you could be ingesting in a serving size.

The Takeaway

Type 2 diabetes can be managed — and even reversed — with certain lifestyle changes. For more severe cases, medication is available.

If you’ve been diagnosed with type 2 diabetes, talk with your doctor about developing a treatment plan that works for your lifestyle. Because this condition is so common, there’s a plethora of resources and first-person accounts to help you on your journey towards managing — or breaking free from — type 2 diabetes.

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