Diabetes Type 2

Type 2 diabetes is a chronic condition that impairs the body's ability to regulate blood sugar levels effectively. This occurs due to insufficient insulin production or because the body's cells do not respond appropriately to insulin, the hormone that facilitates the entry of sugar into cells for energy use. Consequently, sugar accumulates in the bloodstream, potentially leading to serious health complications such as heart disease, nerve damage, and kidney problems over time. Management of type 2 diabetes typically involves lifestyle changes, including dietary modifications and exercise, sometimes supplemented by medication. Regular monitoring and working closely with healthcare providers are crucial to managing blood sugar levels and preventing complications.

Causes

Type 2 diabetes arises from a combination of factors, including:

• Insulin Resistance: Cells in muscles, fat, and the liver do not respond effectively to insulin, leading to insulin resistance.

• Insufficient Insulin Production: The pancreas struggles to produce enough insulin to maintain normal blood sugar levels, especially as insulin resistance increases.

• Genetic Factors: A family history of type 2 diabetes significantly heightens the risk of developing the condition.

• Lifestyle Factors: Being overweight or obese and leading an inactive lifestyle are major risk factors.

• Dietary Choices: Diets high in processed foods contribute to the risk.

• Other Contributors: Smoking, inadequate sleep, chronic stress, certain medications, and metabolic syndrome—which includes conditions like high blood pressure and abnormal cholesterol levels—are linked to the development of type 2 diabetes.

Recognizing these factors can guide preventive lifestyle changes.

Symptoms

Type 2 diabetes develops gradually, often making early symptoms hard to notice. Common symptoms include:

• Frequent urination as the body attempts to eliminate excess glucose.

• Increased thirst and dry mouth resulting from frequent urination.

• Constant hunger due to ineffective sugar processing.

• Unexplained weight loss despite increased appetite.

• Fatigue from insufficient cellular glucose.

• Blurred vision caused by fluid pulled from eye lenses.

• Slow-healing cuts or sores and frequent infections, like yeast infections, due to compromised immunity.

• Darkened skin areas such as around the neck and armpits (acanthosis nigricans).

• Tingling or numbness in the hands and feet from nerve damage.

Severe cases may lead to diabetic ketoacidosis (DKA) with symptoms like severe fatigue or confusion, requiring immediate medical care. Regular checkups help with early detection and management.

Diagnosis

Diagnosis involves various blood tests to evaluate blood sugar levels, with the glycated hemoglobin (A1C) test being most common, providing an average blood sugar level over the previous two to three months. An A1C of 6.5% or higher on two occasions confirms diabetes. If unavailable, a fasting blood sugar test (126 mg/dL or higher) or an oral glucose tolerance test (blood sugar level of less than 140 mg/dL two hours after consuming a sugary drink) can be used. Immediate glucose assessments can be performed using a fingerstick test. Regular screenings are essential, especially for those with high-risk factors like a family history or being overweight, ensuring early detection for effective management.

Treatments

Management of Type 2 diabetes focuses on lifestyle changes and potentially medications to maintain healthy blood sugar levels. Key lifestyle adjustments include a balanced diet rich in high-fiber foods and low in refined sugars, regular physical activity, weight management, smoking cessation, stress reduction, and healthy sleep patterns. Regular exercise should combine aerobic and strength training for optimal results. If lifestyle modifications are insufficient, medications may be prescribed, ranging from oral medications like Metformin to various insulins or injectable non-insulins. Continuous monitoring of blood glucose and collaborating with healthcare providers is crucial for adjusting treatments and preventing complications, ultimately enhancing life quality.

Medications

Type 2 diabetes management may involve various medications to control blood sugar levels:

• Oral Medications: Assist the body in increasing insulin production or response, including:

• Metformin: Decreases liver glucose production and boosts insulin response.

• Sulfonylureas (e.g., Glipizide): Increase pancreatic insulin release.

• Thiazolidinediones (e.g., Pioglitazone): Improve insulin sensitivity.

• DPP-4 Inhibitors (e.g., Januvia): Enhance hormones that stimulate insulin.

• SGLT2 Inhibitors (e.g., Jardiance): Induce glucose excretion in urine.

• Injectable Medications: Used when oral options are insufficient, include insulin and non-insulin injectables:

• Insulins, categorized by action duration from rapid to ultra-long-acting.

• Non-Insulin Injectables mimic eating and storage hormones, enhancing pancreatic insulin, and slowing digestion.

Medication selection requires healthcare provider consultation to tailor the approach based on health needs and potential side effects.

Prevention

Prevent or delay type 2 diabetes by implementing these lifestyle changes:

• Weight Loss: Aim for a 5-7% weight reduction if overweight to significantly decrease diabetes risk.

• Regular Exercise: Engage in moderate activity for at least 30 minutes most days.

• Healthy Eating: Maintain a balanced diet of fruits, vegetables, lean proteins, and whole grains.

• Preventing Progression: Essential for individuals with prediabetes to prevent type 2 diabetes.

Consult healthcare providers about personalized prevention plans, potentially involving medications like Metformin.