Type 2 Diabetes – Symptoms, Risk Factors, Diagnosis, Treatment, and Prevention

Type 2 diabetes remains one major global health challenge. It is pretty common, with over 29 million people in the U.S. battling the ailment.

This disorder happens when your body's cells can't properly absorb sugar (glucose) from the regular foods you eat. If left undiagnosed and untreated, type 2 diabetes can result in severe complications, including stroke, heart and blood vessel diseases, kidney diseases, skin conditions, eye damage, and more. However, the condition can be effectively managed through lifestyle changes, taking insulin and other medications regularly, and visiting your healthcare provider for regular checkups.

So what is type 2 diabetes? What are the symptoms and risk factors? How can we prevent it? Read on and stay updated on all you need to know about this potentially life-threatening condition.

What is Type 2 Diabetes?

Type 2 diabetes is a chronic condition in which the pancreas doesn't make enough insulin, and the available insulin doesn't work optimally to regulate blood sugar levels. This malfunction results in a build-up of glucose levels in the blood.

The pancreas produces the insulin hormone to help your body use up glucose for energy. But with Type 2 diabetes, your pancreas produces less insulin over time, and the cells develop insulin resistance. As a result, excessive sugar builds up in your bloodstream. And unfortunately, these high blood sugar levels are often not noticed on time, leading to serious health challenges.

One disturbing fact about type 2 diabetes, which used to be known as adult-onset diabetes, is that it is now also prevalent among children. This prevalence is strongly linked to the increasing number of obese children globally.

While type 2 diabetes currently has no cure, losing weight, eating healthy foods, and exercising have proven effective in managing the disease.

Symptoms of Type 2 Diabetes

In type 2 diabetes, your body's inability to bring glucose into your cells using insulin means your body must rely on alternative energy sources in your muscles, tissues, and organs. This results in many symptoms that may begin slowly but could get more complicated if not controlled. Some of the early type 2 diabetes signs and symptoms to look out for include,

• Increased hunger
• Increased thirst
• Frequent urination
• Fatigue
• Headaches
• Unintentional weight loss
• Vision problems (blurry vision)
• Frequent infections
• Slow healing of wounds
• Tingling or numbness in the hands or feet
• Darkened areas of the skin, especially in the neck and armpits

Increased hunger

When type 2 diabetes mellitus is uncontrolled, blood glucose levels remain abnormally high (hyperglycemia) and cannot enter the cells due to either low insulin or insulin resistance. The ultimate result of this chain of reactions is that your body can't convert the food you eat into energy.

The resulting lack of energy increases your hunger levels (polyphagia).

Eating doesn't reduce or eliminate hunger in people with uncontrolled diabetes. It will, in fact, add to the already high blood sugar levels.

The best way to lower blood sugar levels at home is by exercising. Regular exercises can naturally trigger insulin production and reduce polyphagia.

If your polyphagia persists with frequent exercise, consulting your doctor is the safest measure to manage the situation effectively.

Increased thirst

With type 2 diabetes, your kidneys are forced to work extra hard to filter and absorb the excess glucose in the bloodstream.

Over time, your kidneys can't keep up with the stress, and the excess glucose is excreted into your urine and fluids from your tissues, leaving you dehydrated and thirsty.

Frequent Urination

The kidneys' primary function is to purify your blood of toxins. Unfortunately, your kidneys can't possibly handle too much sugar that builds up in your bloodstream when you have type 2 diabetes. Hence, they flush some out of the blood into the urine, resulting in more urine production and frequent, urgent need to urinate. This condition is called polyuria.

Fatigue

Type 2 diabetes typically results in your body's inability to use glucose for energy. As such, the food you eat won't give you the power you need to carry out your normal daily activities, leaving you unusually and unexplainably tired, no matter how much or how often you eat.

Unintentional weight loss

Another common symptom of type 2 diabetes is rapid, inexplicable weight loss — although it's more widespread in type 1 diabetes.

If you have type 2 diabetes, your body can't use insulin effectively and can not transport glucose to your cells. It, instead, accumulates in your blood.

When glucose doesn't get to your cells, your body is starved of energy and must find a way to compensate. Thus, you burn fat to manufacture energy, leading to rapid muscle and weight loss without even trying.

Vision Problems (blurry vision)

Type 2 diabetes is also linked to vision problems. High blood glucose levels drag fluid from your tissues, including your eye lenses, giving you a blurry focus.

If left unmanaged, type 2 diabetes can form new blood vessels in the back of your eyes (retina). These new vessels can cause a major defect to the established vessels.

While most people don't notice these early vision changes, they could eventually lead to vision loss if left undetected.

Frequent infections, slow-healing wounds, and nerve damage

High glucose levels in the bloodstream can cause poor blood circulation, undermining your body's natural healing process. Because of this impairment, diabetic people may have sores that won't heal. These sores can be found anywhere in the body, but it's more common on the feet.

Women with type 2 diabetes may also have bladder and vaginal yeast infections more often.

The nerve damage caused by too much glucose in the blood can also cause a tingling sensation and numbness in the hands and feet.

Causes of Type 2 Diabetes

There are two biological causes of type 2 diabetes:

• When the pancreas doesn't produce enough insulin required to regulate blood sugar levels,
• As a result of genetic factors, cells in the muscle, fat, and liver develop insulin resistance. When these cells fail to interact with insulin, they don't accept enough glucose, leading to blood sugar spikes.

Type 2 diabetes also has other causes associated with poor lifestyle choices, lack of exercise, unhealthy nutrition, and obesity.

Type 2 Diabetes Risk Factors

Certain factors increase your chances of developing type 2 diabetes. The more you tick the following boxes, the more likely you are to get type 2 diabetes:

Age

You are more likely to get type 2 diabetes if you are 45 years old and above.

Family history

Your risk of developing diabetes increases if your family members (parents or siblings) live with the condition.

Ethnicity

People of certain races or ethnicities are more likely to have type 2 diabetes, although the reason for this is unknown. African Americans, Asian Americans, Alaska Natives, Native Americans, Hispanics or Latinos, or Pacific Islanders are more likely to get type 2 diabetes than whites in the United States.

Lifestyle

Certain lifestyles that make you less active predispose you to type 2 diabetes. Physical activity helps control your body weight, uses glucose as an energy source, and makes your cells more insulin-sensitive.

Feeding

Eating highly processed foods can also increase your risk of type 2 diabetes. Processed foods contain lots of hidden sugar in the form of refined carbs.

Body weight

Being overweight is another primary risk factor for type 2 diabetes.

The amount of NEFA, glycerol, cytokines, hormones, proinflammatory substances, and other substances involved in developing insulin resistance increases in obese people. And, of course, insulin resistance, with impairment of β-cell function, leads to the progression of type 2 diabetes.

Fat distribution

Those who store more fat in their abdomen instead of hips and thighs are at increased risk of type 2 diabetes. If your waist circumference as a man is above 40 inches (or above 35 inches as a woman), chances are you may develop type 2 diabetes.

Blood lipid levels

You also have a greater chance of type 2 diabetes if you have low levels of good cholesterol and high triglycerides.

Prediabetes

Prediabetes is one of the most widespread risk factors for type 2 diabetes. If you are pre-diabetic, your blood sugar level is higher than average but not high enough to be called diabetes. When not treated, prediabetes can progress to full-blown diabetes mellitus.

Pregnancy-related risks

Having gestational diabetes during pregnancy predisposes you to Type 2 diabetes. Giving birth to a baby that weighs more than 9 pounds also places you at a higher risk

Skin coloration

Having areas of darkened skin (especially in the neck and armpits) could indicate insulin resistance, making it a major risk factor.

Polycystic ovary syndrome

Polycystic ovary syndrome is a common condition that causes irregular menstrual periods, excess hair growth, and obesity. This disorder is more prevalent in diabetic people.

Diagnosis for Type 2 Diabetes

If you are pre-diabetic or have some of the symptoms of type 2 diabetes discussed earlier, visiting your health care team for a proper diagnosis is highly recommended. Diagnosing diabetes requires blood tests typically carried out on two different days for confirmatory purposes.

Your doctor will most likely subject you to the following blood tests to diagnose you:

• The Hemoglobin A1C test measures average blood sugar levels for the past 8 to 12 weeks. The test is otherwise known as the glycosylated hemoglobin test. It's a less complicated but highly efficient test for type 2 diabetes and doesn't require fasting.
• Random plasma glucose tests also require no fasting and can be done at any time.
• Fasting plasma glucose tests is another important test to check your blood glucose level. It's best done in the morning, just after an eight-hour fast.
• The oral glucose tolerance test assesses how your body handles glucose by checking your blood sugar before and after you drink a sugary beverage.

Diet Recommendations

If you have type 2 diabetes, a healthy diet can go a long way to help you reach your target blood sugar levels and stay fit. A healthy meal plan will also help you maintain healthy body weight and ultimately reduce your chances of experiencing complications related to diabetes.

Your type 2 diabetes meal plans should include the following:

• Minimally processed carbs: Refined carbohydrates such as pasta and white bread can spike your blood sugar rapidly. To be safe, go for carbs that can only cause gradual blood sugar increase. Some good examples include brown rice and oatmeal.
• Lean proteins: The American Diabetes Association (ADA) recommends that diabetic people include lean proteins and avoid meats high in saturated fats.
• Reduced salt: Too much salt (sodium) is linked to high blood pressure. Hence, it would help to cut sodium intake as much as possible. You can start by avoiding highly processed, canned foods. If you must use spices, ensure they are salt-free. Also, avoid mayonnaise since they usually contain a high amount of sodium.
• No extra sugars: if you have type 2 diabetes, avoiding sugary foods like pies, cakes, and soda puts you on the safer side. Having water or unsweetened tea instead is healthier.
• Reduced starchy foods: Excessive starch intake could result in blood glucose spikes. You can instead go for non-starchy vegetables like broccoli, carrots, and cauliflower which are lower in carbohydrates and rarely contribute to blood sugar spikes.

Type 2 Diabetes Complications

If left unmanaged, type2 diabetes will eventually affect many vital organs, including the heart, blood vessels, kidneys, nerves, and eyes, leading to the following complications:

Chronic kidney disease

Over time, with unmanaged diabetes, the kidneys get exhausted since they must constantly remove excess glucose from the blood. If undiagnosed and treated on time, the condition may progress to end-stage kidney diseases (or kidney failure), requiring dialysis or kidney transplant.

Blood vessel and Heart disease

Untreated diabetes is linked to narrowed blood vessels (atherosclerosis), high blood pressure, heart disease, stroke, etc.

Slow healing

In diabetes complications, your cuts and blisters can rapidly progress to severe infections that don't heal and may require toe, foot, or leg amputation.

Nerve damage in limbs (neuropathy)

High blood sugar can impair your nerves over time, resulting in numbness, tingling, and burning sensation that usually start at the tips of your fingers or toes and slowly spread upward.

Multiple nerve damage

Your heart and digestive nerves can also be damaged, leading to multiple symptoms like irregular heartbeats, nausea, diarrhea, vomiting, or constipation. Nerve damage can also cause erectile dysfunction in men.

Eye damage

Complicated diabetes can damage your sight. Severe eye diseases like cataracts and glaucoma are associated with high blood sugar, damaging the retina's blood vessels and possibly causing blindness.

Skin conditions

With complicated diabetes, you will be more vulnerable to bacterial and fungal skin infections.

Managing Your Type 2 Diabetes

Managing diabetes and avoiding further health complications are possible. You only need a few tweaks to your lifestyle choices and a treatment plan. You can work with your healthcare provider to adopt any (or a combination) of the following treatment options, depending on what is best for your situation:

• Metformin (Fortamet, Glucophage, Glumetza, Riomet) is the first treatment line for type2 diabetes. It cuts down the glucose your liver produces and enables your body to respond better to the insulin it makes.
• Sulfonylureas are a group of drugs that enable your body to make more insulin from the pancreas. Examples are glipizide (Glucotrol,  Metaglip), glimepiride (Amaryl), and glyburide (DiaBeta,  Micronase).
• Just like Metformin, Thiazolidinediones make your body more sensitive to insulin. Examples are pioglitazone (Actos) and rosiglitazone (Avandia). But since these drugs also raise your risk of heart problems, they are usually not the first-line treatment options.
• Meglitinides boost your body's capacity to make insulin. Examples are repaglinide, nateglinide, and mitiglinide. These treatment options work faster than sulfonylureas.
• DPP-4 inhibitors are a class of oral diabetic medications that lower your blood sugar levels. However, these drugs can inflame your pancreas and cause joint pain. You can consider discussing the side effects with your healthcare team.
• Insulin therapy is another standard, reliable treatment plan you could consider. This therapy can be categorized into fast-acting, short-acting, intermediate-acting, long-acting, and mixed insulin — which are all ideal depending on your doctor's prescription.

Other treatment options include;

• SGLT2 inhibitors
• GLP-1 receptor agonists
• GIP and GLP-1 receptor agonist

Preventing Type 2 Diabetes

While type 2 diabetes is presently incurable, the good news is that it's highly preventable with the following healthy lifestyle changes:

• Physical activity: engaging in regular aerobic activities not only helps you lose weight but also reduces your blood sugar levels.
• Lose weight: If you are pre-diabetic, losing about 10% of your body weight can lower the risk of full-blown diabetes.
• Healthy foods low on fats and high in fiber — like fruits, vegetables, and whole grains — would reduce your chances of getting diabetes.
• Stay active: If your job requires you to sit tight for long periods, ensure to stand up at intervals and walk around. Avoid inactivity by all means.

To prevent further progression of prediabetes, your medical care provider may prescribe drugs like Metformin — especially if you are obese or an older adult finding it hard to manage your sugar levels with lifestyle changes.

Conclusion

Type 2 diabetes is not only a potentially fatal condition but a fairly common one. One in every 10 Americans has the disease, which remains the 7th leading cause of death in the United States. Fortunately, it is preventable and controllable with a healthy lifestyle. Plus, many safe treatment options can effectively manage the condition.