Type 2 Diabetes
Type 2 diabetes (type 2 sugar disease) or diabetes mellitus is a long-term disease that occurs when the body cannot use insulin effectively.
This disease is a common condition that causes blood sugar (glucose) levels to become too high.
If not treated properly, this disease can increase the risk of serious disorders of the heart, eyes, and nerves in the body.
Diabetes mellitus is a lifelong condition, so it can affect the sufferer’s daily life.
Sufferers need to change their diet, take medication, and have regular check-ups to manage this disease.
Diabetes is often associated with being overweight, having an inactive lifestyle, or having a family history of the condition.
Symptoms of Type 2 Diabetes
Many sufferers are not aware that they have the disease.
Generally, you only become aware of the disease when the following symptoms appear:
- Increased frequency of urination, especially at night.
- Feeling thirsty all the time.
- Feeling very tired.
- Often feel hungry.
- Sudden weight loss.
- Itching around the genitals.
- Recurrent canker sores.
- Wounds that are difficult to heal.
- Blurred vision.
- Susceptible to infection.
- Pain or numbness in the feet and hands.
- Tingling.
Risk Factors for Type 2 Diabetes
There are a number of factors that can increase a person’s risk of developing diabetes mellitus. Here are some of them:
- Being overweight or obese. This is a major risk.
- There is an accumulation of fat in the abdomen, not in the hips or thighs.
- Not moving actively. Whereas when moving actively glucose will change into energy and make cells more sensitive to insulin.
- Having a family history of the same condition.
- Blacks, Hispanics, Native Americans and Asians, and Pacific Islanders are at high risk for diabetes mellitus.
- Low levels of high-density lipoprotein (HDL) cholesterol and high levels of triglycerides in the blood.
- The risk of diabetes mellitus increases with age, especially in people over 45 years of age.
- Having polycystic ovary syndrome, the symptoms of which include irregular menstrual periods, excessive hair growth and obesity.
- Darkened areas of skin, usually in the armpits and neck. This condition is a sign of insulin resistance in the body.
Causes of Type 2 Diabetes
The causes of diabetes mellitus are two interrelated conditions, namely:
- Cells in muscle, fat, and liver become resistant to insulin. Because they cannot interact normally with insulin, excess sugar cannot be removed.
- The pancreas cannot produce enough insulin to regulate blood sugar levels.
The exact cause is unknown, but being overweight and physically inactive are major contributing factors.
Before knowing what the triggering factors are, here is an explanation regarding how insulin works and the role of glucose in the body:
1. How insulin works
Insulin is a hormone that comes from the pancreas gland. This gland is located behind and below the stomach.
Insulin regulates how the body uses sugar in the following ways:
- Sugar in the bloodstream triggers the pancreas to produce insulin.
- Insulin circulates in the bloodstream, allowing sugar to enter cells in the body.
- Reduces the amount of sugar in the bloodstream. By reducing the amount of insulin produced.
2. The role of glucose in the body
Glucose or sugar is the main source of energy for cells that form muscles and other tissues.
Glucose use and regulation includes:
- Glucose comes from two main sources, namely food and the liver.
- The liver functions to store and produce glucose.
- Glucose is absorbed into the bloodstream and enters cells with the help of insulin.
- When glucose levels are low, the liver breaks down stored glycogen into glucose to maintain glucose levels within normal limits.
In diabetes mellitus, this process does not work properly. Instead of entering the cells, sugar builds up in the bloodstream.
When blood sugar levels rise, insulin-producing beta cells in the pancreas release more insulin.
Eventually, the insulin-producing cells become damaged and cannot make enough insulin to meet the body’s needs.
Differences Between Type 2 and Type 1 Diabetes
In type 1 diabetes, people with the disease produce little or no insulin.
This is because insulin-producing cells have been destroyed by the immune system and type 1 diabetes is an autoimmune disease.
Meanwhile, in type 2 diabetes, the body can make enough insulin at the beginning of the disease but does not respond to it effectively.
As type 2 diabetes progresses, the pancreas gradually loses its ability to produce enough insulin.
This disease is related to hereditary factors and lifestyle risk factors such as being overweight or obese, poor diet, and lack of physical activity.
Read more about other types of diabetes:
Diagnosis of Type 2 Diabetes
Diagnosis of diabetes mellitus usually uses a glycated hemoglobin (A1C) test.
This blood test shows your average blood sugar level over the past two to three months.
The results are interpreted as follows:
- Below 5.7 percent is normal.
- 5.7-6.4 percent were diagnosed as pre-diabetic.
- 6.5 percent or higher on two separate tests indicates diabetes.
If an A1C test is not available, or if you have certain conditions that interfere with the A1C test, your doctor will use the following tests to diagnose diabetes:
1. Random blood sugar test
Regardless of when you last ate, if the result shows a level of 200 mg/dL (11.1 mmol/L) or higher.
The results show that a person is a diabetes sufferer.
2. Fasting blood sugar test
You can take a blood sample after fasting overnight. The results are interpreted as follows:
- Less than 100 mg/dL (5.6 mmol/L) is normal.
- 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is diagnosed as prediabetes.
- 126 mg/dL (7 mmol/L) or higher on two separate tests is diagnosed as diabetes.
3. Oral glucose tolerance test
This test is usually for pregnant patients. Before the test, the patient must fast overnight and drink a sweet liquid.
Blood sugar levels are checked periodically over the next two hours. Results are interpreted as follows:
- Less than 140 mg/dL (7.8 mmol/L) is normal.
- 140 to 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) is diagnosed as pre-diabetes.
- 200 mg/dL (11.1 mmol/L) or higher after two hours indicates diabetes.
4. Screening procedure
Doctors can recommend screening for all adults aged 45 years or older and in the following groups:
- People who are under 45 years of age and are overweight or have risk factors for diabetes.
- Women who have had gestational diabetes.
- People who have been diagnosed with pre-diabetes.
- Children who are overweight or obese, and who have a family history of diabetes mellitus or other risk factors.
Type 2 Diabetes Treatment
So far, the process of treating the disease can be done by consuming healthy foods, regular physical exercise, undergoing weight loss procedures, insulin therapy or taking medication, and monitoring blood sugar levels regularly.
Here is the explanation:
1. Eat healthy food
Focus your diet to overcome diabetes mellitus by taking the following steps:
- Schedule regular healthy meals and snacks.
- Eat smaller portions.
- Consume high-fiber foods, such as fruits, non-starchy vegetables, and whole grains.
- Avoid consuming processed grains, starchy vegetables, and sweets.
- Consume low-fat milk, low-fat meat, and fish.
- Use healthy cooking oils, such as olive oil or canola oil.
- Reduce calorie intake.
2. Do physical activity regularly
Exercise is important for losing and maintaining a healthy weight. It also helps regulate blood sugar levels.
If you are having difficulty or have not found a suitable physical activity, it is important to discuss it with your doctor before starting.
Here are some physical activities you can try:
- Aerobic exercise. Choose an aerobic exercise that you enjoy, such as walking, swimming, cycling, or running. Do it for at least 30 minutes a day or 150 minutes a week.
- Resistance training. Resistance training includes weightlifting, yoga, and calisthenics. Do at least two to three resistance training sessions each week to build strength and flexibility.
- Avoid a sedentary lifestyle. Don’t sit for too long. Take a few minutes to stand up, walk around, or do a light activity every 30 minutes.
- Lose Weight. If you are overweight, you need to lose weight to a healthy weight.
Weight loss results in better control of blood sugar, cholesterol, triglycerides, and blood pressure levels.
If you have difficulty choosing a suitable diet, you can discuss it with your doctor first.
3. Monitor Blood Sugar Levels
This step aims to ensure blood sugar levels remain within normal levels.
Sufferers need to be checked once a day and before or after exercise.
4. Taking Diabetes Medication
If you can’t maintain your blood sugar levels with diet and exercise, your doctor may prescribe diabetes medications that help lower insulin levels.
Here are some types of drugs that can be an option:
- Metformin to reduce blood glucose levels.
- Sulfonylureas to increase insulin production in the pancreas.
- Pioglitazone as an insulin trigger.
- Gliptins (DPP-4 inhibitors) to prevent the breakdown of GLP-1.
- SGLT-2 inhibitors that affect urine.
- GLP-1 agonist to stimulate insulin production without the risk of hypoglycemia.
- Acarbose to slow down the digestion of carbohydrates.
- Nateglinide and repaglinide are useful for releasing insulin into the bloodstream.
- Performing Insulin Therapy
Some people need insulin therapy, which doctors often recommend as a last resort if blood sugar doesn’t go down with lifestyle changes and other medications.
Type 2 Diabetes Prevention
You can take preventive steps by changing your lifestyle to be healthier.
In someone who receives a diagnosis of pre-diabetes, lifestyle changes can slow or stop the progression to diabetes.
This healthy lifestyle includes:
- Eat healthy food. Choose foods that are low in fat and calories, and high in fiber. Focus on fruits, vegetables, and whole grains.
- Get active. Do 150 minutes or more of moderate to vigorous aerobic activity a week, such as brisk walking, cycling, running, or swimming.
- Healthy diet. Losing weight and keeping it off can delay the progression from pre-diabetes to type 2 diabetes. If you have pre-diabetes, losing 7 percent to 10 percent of your body weight can lower your risk of diabetes.
- Maintain blood sugar levels. You can do this by monitoring your blood sugar levels. In addition to monitoring, make sure to also take action to lower your blood sugar. This is because high blood sugar levels sometimes do not cause any symptoms at all.
Complications of Type 2 Diabetes
This disease can affect many major organs, including the heart, blood vessels, nerves, eyes, and kidneys.
Managing diabetes by controlling blood sugar can reduce the risk of complications or accompanying conditions (comorbidities).
Here are some complications that sufferers may experience:
- Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure, and narrowing of the blood vessels (atherosclerosis).
- Nerve damage (neuropathy) in the limbs. High blood sugar can damage or destroy nerves. This condition causes tingling, burning sensations, and even paralysis that usually starts in the toes or fingers and gradually spreads throughout the body.
- Other nerve damage. Damage to the heart nerves can contribute to irregular heart rhythms. In addition, nerve damage to the digestive system can cause nausea, vomiting, diarrhea or constipation. In men, nerve damage can cause erectile dysfunction.
- Kidney disease. Diabetes can lead to chronic kidney disease or end-stage renal disease, which may require dialysis or a kidney transplant.
- Eye damage. Diabetes can increase the risk of serious eye diseases, such as cataracts and glaucoma. These diseases can damage the blood vessels in the retina, potentially leading to blindness.
- Skin conditions. Diabetes can make sufferers more susceptible to skin problems, including bacterial and fungal infections. In addition, sufferers of this disease are also prone to itchy skin.
- Risk of amputation. If left untreated, cuts and abrasions can become seriously infected. Severe damage from wounds that do not heal can lead to amputation.
- Hearing loss. Hearing problems are more common in people with diabetes.
- Sleep apnea. Obstructive sleep apnea is common in people with it. Obesity is a major contributing factor to the condition.
- Dementia. Type 2 diabetes increases the risk of Alzheimer’s disease and other disorders that cause dementia.
When to See a Doctor?
Contact your doctor immediately if you notice any symptoms of type 2 diabetes. Remember that early treatment can minimize the risk of fatal complications that lurk.