Diabetes type 2 is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Unlike people with type 1 diabetes, people with type 2 diabetes actually produce insulin; however, either their pancreas does not produce enough insulin or the body cannot use the insulin adequately. This is called insulin resistance. When there is not enough insulin in the body or the insulin is not being used as it should be, glucose (sugar) can’t get into the body’s cells. When glucose builds up in the blood instead of going into cells, the body’s cells are deprived of energy and are not able to function properly. If high glucose levels in the blood persist, it may damage the eyes, heart, kidneys, or nerves. In the United States, diabetes type 2 is often considered an epidemic — it has been shown that nearly 21 million people in U.S. have it. Out of them, about 90% to 95% have type 2 diabetes.

General risk factors

The risk factors for developing type 2 diabetes include the following:

  • High blood pressure
  • High blood triglyceride (fat) levels
  • Gestational diabetes or giving birth to a baby weighing more than 9 pounds
  • High-fat diet
  • High alcohol intake
  • Sedentary lifestyle
  • Obesity or being overweight

Causes

  • Genetic: Research shows that type 2 diabetes has strong genetic links. Type 2 diabetes tends to run in families. Several genes have been identified and more are under study, which may relate to the causes of type 2 diabetes.
  • Ethnicity: Certain groups, such as African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of developing type 2 diabetes than non-Hispanic whites.
  • Aging: Age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.

Signs and symptoms

  • Elevated Blood Sugar Levels: High blood sugar level is an early symptom of untreated diabetes. The presence of glucose in the urine is also a sign that there is excess glucose in the body. High amounts of glucose in the urine can cause increased urine output and lead to dehydration.
  • Organ Damage: If your blood sugar levels are not regulated through insulin and diet, it can lead to fairly serious problems. Over time, high blood sugar can lead damage to blood vessels, kidneys, and other vital organs.
  • Weight Gain: Diabetes affects the body’s ability to metabolize sugars leading to elevated levels. Higher blood sugar levels are turned to fat, and this can cause weight gain in persons with diabetes.
  • Fatigue, Nausea, and Vomiting: Some untreated diabetes patients have complained of fatigue, nausea and vomiting.
  • Infections: It has been discovered that patients with diabetes are prone to developing infections of the bladder, skin, and vaginal areas.
  • Blurred vision: Fluctuations in blood glucose levels can lead to blurred vision.

Transmission:
Type 2 diabetes is frequently genetic. Hyperglycemia in pregnancy might also contribute to diabetes in the children of mothers with gestational diabetes mellitus (GDM).

Management:
There is not a cure for type 2 diabetes but it can be managed. Some people can control their particular condition with lifestyle changes, including exercise and following a diabetic diet. Others may need to take medicines or use insulin injections.

Lifestyle Changes: The following lifestyle changes will help control your blood glucose levels:

  • Nutrition: Eat a healthy balanced diet with regular meals, three times a day. Include carbohydrates, such as pasta or potatoes in each meal.
  • Exercise: Aim to do 150 minutes of moderate exercise over a week in bouts of 10 minutes or more. This will help you to stay a healthy weight and control your blood glucose levels.
  • Alcohol: Only drink alcohol in moderation and stick within the recommended limits.
  • Tobacco: If you smoke, give it up. Smoking is unhealthy for everyone, but quitting is especially important for diabetics because you already have an increased risk of developing circulatory problems and cardiovascular disease.
  • Oral Medications: In those cases where lifestyle changes alone will not keep your blood glucose levels under control, you may be prescribed one of the following medicines:
  • Metformin works by reducing the amount of glucose that is released into your bloodstream from your liver. It also improves the way glucose is used by your muscles.
  • Gliclazide (not marketed in US), glipizide, glimepiride, and tolbutamide help your pancreas to produce more insulin.
  • Repaglinide and nateglinide also help your pancreas to produce more insulin, but work more quickly and last for a shorter time.
  • Acarbose lowers your blood glucose by slowing down the rate at which some carbohydrates are absorbed by your body.
  • Pioglitazone reduces your body’s resistance to insulin.
  • Sitagliptin, saxagliptin, and vildagliptin help your body to reduce glucagon levels which leads to less glucose by decreasing conversion of glycogen to glucose.

These medicines are usually taken between one and three times a day.

Injections: You may be prescribed other medicines that are given by injection and work by helping your body to make more insulin when it is needed. They can also reduce your appetite and help you lose weight. You will usually inject yourself with insulin once or twice a day, using either a small needle or a pen-type syringe with replaceable cartridges. There are several different types of insulin that work at different rates and for different lengths of time. Ask your family doctor for advice on which type is best for you. If you have insulin injections, you will need to monitor your blood glucose levels with a home test kit. This involves taking a pinprick of blood from your finger and putting a drop on a testing strip. A meter will read the result automatically. Your family doctor or diabetes specialist nurse will show you how to monitor your blood glucose levels and tell you how often you need to check it.

Prevention:
Onset of type 2 diabetes can be prevented through proper nutrition and regular exercise. Intensive lifestyle measures may reduce the risk by over half.

  • Maintain a Healthy Weight: Being overweight is the number one risk factor for type 2 diabetes. Even modest weight loss can help prevent type 2 diabetes from developing. To find out if you are overweight, you can use the body mass index (BMI) chart for adults or the same chart in metric. If you need to lose weight, losing as few as 10 lb (4.5 kg) to 20 lb (9.1 kg) can help reduce your risk of developing diabetes.
  • Exercise Regularly: Getting enough exercise lowers your risk of developing type 2 diabetes.Do activities that raise your heart rate. It is recommended that you should try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It is fine to be active in blocks of 10 minutes or more throughout your day and week. Aim for aerobic exercise. This does not mean that you have to do strenuous activities or join an expensive gym – anything that increases your heart rate counts, such as raking the yard. Walking groups or programs where you use a pedometer to count the number of steps you take in a day are great ways to start exercising and to stay motivated. If you have problems with the nerves in your legs and feet, your may want to choose activities that do not put any stress in these areas. If you are at risk for type 2 diabetes, using an exercise planning form may help you and your doctor or other health professional to create a personalized exercise program.
  • Eat Healthy Foods: Discipline yourself to eating a balanced diet, including whole grains, lean meat, and vegetables. Limit saturated fats. Limit alcohol. Limit calories in order to avoid gaining weight, or to help you lose weight. Reduce your intake of soft drinks, sugary foods, and junk food. Try to eat smaller meals more often in order to keep blood sugar levels within your target range. Eating more vegetables, whole grains, and nuts and healthy desserts can lower your risk for type 2 diabetes.Eating a lot of sugary foods, fast foods, and red meat (especially processed red meat) and drinking a lot of soft drinks can increase your risk for type 2 diabetes.

Diabetes type 2 is a metabolic disorder caused by high blood glucose. This is due to insulin resistance or relative insulin deficiency. There is no known cure for the condition. Being overweight is the number one risk factor for the condition. By managing your body weight, or changing your lifestyle, the condition can be prevented, or managed. If lifestyle changes cannot keep your blood glucose levels under control, you may need to have oral medications, insulin medications, or insulin injections.