What Is It?
Type 2 diabetes is a chronic disease. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also called type 2 diabetes mellitus, adult-onset diabetes, non-insulin-dependent diabetes or just diabetes.
Type 2 diabetes affects the way the body processes and uses carbohydrates, fats and proteins. During digestion, food is broken down into its basic components. The liver processes these nutrients into one type of sugar -- glucose. Glucose is the most basic fuel for the body.
Glucose enters your body's cells with the help of insulin. Insulin is a hormone produced by the pancreas. Without insulin, glucose cannot pass through the cell wall.
Type 2 diabetes occurs when your body's cells do not react efficiently to insulin. This condition is called insulin resistance.
In people with insulin resistance, the pancreas first makes extra insulin to maintain a normal blood sugar. Over time, the body's insulin resistance gets worse. The pancreas cannot keep up with the demand for more and more insulin. As a result, blood glucose levels rise.
Type 2 diabetes runs in families. It most often affects people who are older than 40. But type 2 diabetes is now being seen in more and more young people. Obesity greatly increases the risk of diabetes.
The symptoms of diabetes are related to high blood glucose levels. They include:
Extremely high blood sugar levels can lead to a dangerous complication called hyperosmolar syndrome. This is a life-threatening form of dehydration. In some cases, hyperosmolar syndrome is the first sign that a person has type 2 diabetes. It causes confused thinking, weakness, nausea, and even seizure and coma.
People with type 2 diabetes take medications to reduce blood sugar. But these medications may cause sugar levels to drop below normal. Low blood sugar is called hypoglycemia. Symptoms of hypoglycemia include:
You can correct hypoglycemia by eating or drinking something with carbohydrates. This raises your blood sugar level.
Type 2 diabetes affects all parts of the body. It can cause serious, potentially life-threatening complications. These include:
Diabetes is diagnosed by testing the blood for sugar levels. Blood is tested in the morning after you have fasted overnight.
Typically, the body keeps blood sugar levels between 70 and 100 milligrams per deciliter (mg/dL), even after fasting. If a blood sugar level after fasting is greater than 125 mg/dL, diabetes is diagnosed.
Your doctor will examine you to look for signs of diabetes complications. These include:
Laboratory tests are also used routinely to evaluate diabetes. These include:
Diabetes is a lifelong illness.
Aging and episodic illness can cause the body's insulin resistance to increase. As a result, additional treatment typically is required over time.
You can help to prevent type 2 diabetes by:
If you already have type 2 diabetes, you can still delay or prevent complications:
In most cases, type 2 diabetes treatment begins with weight reduction through diet and exercise. A healthy diet for a person with diabetes is:
A daily multivitamin is recommended for most people with diabetes.
Type 2 diabetes can be controlled with medications -- pills or injections.
Medicines for type 2 diabetes work in many different ways. They include medications that:
About one of three people with type 2 diabetes use injectable insulin regularly. Insulin often is used in small doses before bed. This helps prevent the liver from producing and releasing glucose during sleep.
In advanced type 2 diabetes, or for people who want to tightly control glucose levels, insulin may be needed more than once per day and in higher doses.
Treatment plans that include both very long-acting insulin and very short-acting insulin are frequently the most successful for controlling blood sugar. Doses of very short-acting insulin can be adjusted to accommodate inconsistent eating patterns.
Medications used to treat type 2 diabetes can have side effects. These vary by medication. Side effects may include:
Although diabetes treatments, like all treatments, can cause side effects, the benefits generally greatly outweigh the risks.
Medicines are also available to reduce the risk or to slow the onset of complications. These include medications that:
When To Call a Professional
If you have diabetes, see your doctor regularly.
People with high blood sugar levels have a higher risk of dehydration. Contact your doctor immediately if you develop vomiting or diarrhea and are not able to drink enough fluids.
Monitor your blood sugar as advised by your health care team. Report any significant deviations in blood sugar levels.
Your treatment plan is likely to require adjustment over time. Insulin resistance increases with age. And the insulin-producing cells in the pancreas may wear out as the pancreas tries to keep up with the body's extra insulin needs.
After the first few years, the majority of people with type 2 diabetes require more than one medicine to keep their blood sugar controlled. About one out of three people with type 2 diabetes requires insulin.
The prognosis in people with type 2 diabetes varies. It depends on how well an individual modifies their risk of complications. Heart attack, stroke and kidney disease can result in premature death. Disability due to blindness, amputation, heart disease, stroke and nerve damage may occur. Some people with type 2 diabetes become dependent on dialysis treatments because of kidney failure.
There is a tremendous amount you can do to decrease your risk of complications:
American Diabetes Association
ATTN: National Call Center
1701 N. Beauregard St.
Alexandria, VA 22311
American Dietetic Association
120 South Riverside Plaza
Chicago, IL 60606-6995
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
National Institute of Diabetes and Digestive and Kidney Disorders
Office of Communications and Public Liaison
Building 31, Room 9A06
31 Center Drive, MSC 2560
Bethesda, MD 20892-2560
Weight-Control Information Network
1 Win Way
Bethesda, MD 20892-3665