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What You Need to Know About Type 2 Diabetes

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By Patrick Sullivan

 

More than 29 million Americans have either type 1 or type 2 diabetes as of 2014, says the Centers for Disease Control and Prevention (CDC). That’s nearly five times the number of people who had diabetes in 1980. Additionally more than one in three Americans have prediabetes—higher than normal blood sugar--which puts them at risk for developing type 2 diabetes within five years.

 

Diabetes is a serious condition that can potentially lead to heart trouble, kidney damage, blindness, loss of extremities or limbs and other disabling conditions. But with exercise, a healthy diet and the right medication you can control your diabetes. Here’s what you need to know.

Type 1 or Type 2?

2 / 9 Type 1 or Type 2?

Sugar, or glucose, is what cells use for energy. It’s absorbed into the bloodstream as the digestive system breaks down nutrients in the food we eat. The pancreas makes a hormone called insulin, which carries your blood sugar to muscle, fat and liver cells. People develop diabetes when there’s not enough insulin to carry glucose  from the blood to the cells or when the cells become resistant to insulin.

 

In those with type 1 diabetes, the immune system destroys the insulin producing cells in the pancreas, so either enough insulin isn’t produced or it’s not produced at all. Type 2 diabetes occurs when the pancreas doesn’t make enough insulin, generally developing during middle age.

Type 2 Diabetes Progression

3 / 9 Type 2 Diabetes Progression

About 95% of diabetics have type 2 diabetes. Type 2 diabetes starts with insulin resistance, or when your muscle, fat and liver cells can’t use insulin to bring in glucose as efficiently as they once could. Sugar starts to build up in the bloodstream as the pancreas tries to keep up by making more insulin.

 

As long as the pancreas can meet the demand for more insulin, you’ll have normal blood sugar levels. If it can’t keep up, glucose builds in the bloodstream, a condition called hyperglycemia. That’s prediabetes and if it goes unchecked it can eventually become type 2 diabetes. 

Risk Factors

4 / 9 Risk Factors

Risk factors for type 2 diabetes include:

 

  • Age: You’re at greater risk for type 2 diabetes after age 45.
  • Race: In the US, Caucasians have the lowest risk for diabetes. Native Americans have the highest.
  • Weight and BMI: You’re at risk if your body mass index (BMI) is 25 or more, unless you’re Asian American (23) or of Pacific Island descent (26) .
  • You have a family history of diabetes
  • You have high blood pressure
  • You have high cholesterol
  • You have low physical activity
Symptoms

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Diabetes goes undiagnosed in more than a quarter of people who have it because symptoms can be mild and easy to miss. Common symptoms include frequent urination, abnormal hunger or thirst, extreme fatigue, blurry vision, cuts and bruises that are slow to heal and tingling, pain or numbness in the hands or feet.

Diagnosis and Testing

6 / 9 Diagnosis and Testing

Diabetes is diagnosed with a blood test. The commonly used tests are the A1C test, the fasting plasma glucose test and the oral glucose tolerance test. Once you’ve been diagnosed with diabetes, it’s important to monitor your blood sugar with a handheld meter. Typical targets are an A1C reading of below 7%, a pre-meal blood sugar level of between 80 and 130 milligrams per decileter (mg/dl) or post-meal at less than 180 mg/dl. 

Complications

7 / 9 Complications

Heart disease is a common complication among people with diabetes. The CDC found that 71% of adults with diabetes also had high blood pressure and 65% had high cholesterol. People with diabetes die from cardiovascular problems more often, and they’re hospitalized for heart attack and stroke more often, in part because high blood sugar levels damage blood vessels.

 

Diabetes damages small blood vessels, especially in the eyes and kidneys, which can lead to blindness and kidney failure. Nerve damage is another complication that can lead to loss of sensation and severe wounds in the feet. In extreme cases, amputation may be necessary. 

Medication

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Type 2 diabetes is thought to be irreversible, but it can be managed. Most type 2 diabetes treatment programs start with a drug called metformin, which improves the body’s ability to use insulin.

 

If the blood sugar is still high after a few months, drugs like sulfonylureas, which increase your body’s insulin production, insulin injections or thiazolidinediones, which increase insulin sensitivity, may be added to your treatment regimen.

Prevention and Management Tips

9 / 9 Prevention and Management Tips

Keeping weight down is one of the most important things people can do for their diabetes. A healthy diet high in fiber, exercising, tracking consumption of carbohydrates and consuming sugar and alcohol in moderation may help control blood sugar levels.

 

Exercise not only helps maintain a healthy weight, but it can help control your blood glucose, too. When you’re active, your cells can use insulin more effectively. Your muscles also pull glucose out of the blood to use for energy during physical activity. The CDC recommends getting at least 150 minutes of moderate exercise per week. 

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How Type 2 Diabetes Affects Your Organs
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