THE BASICS: “What is type 2 diabetes?”

Type 2 diabetes (formerly called adult-onset or noninsulin-dependent diabetes) is a chronic disease in which your body is unable to maintain a normal blood sugar (glucose) level. Derived from the food you eat, glucose is your body’s “fuel”—its main source of energy and, in untreated type 2 diabetes, a potentially serious threat to your health. Maintaining normal blood sugar levels throughout the day depends on a normal supply of insulin, a hormone made in the pancreas.

In people who do not have type 2 diabetes, the body maintains a level of insulin in the blood that keeps blood sugar levels steady. When food is eaten, the pancreas releases “extra” insulin to move the “extra” sugar into body cells for energy or storage, an action that takes it out of the blood. This doesn’t happen in untreated type 2 diabetes, because there isn’t enough insulin available. Instead, blood sugar levels rise to harmful levels and can even be life-threatening.

If you have type 2 diabetes, your body is either:

  • Blocking the sugar-regulating effects of insulin (called insulin resistance)
  • Not producing enough insulin to keep your blood sugar at normal levels

Maybe you’re not sure if you may have type 2 diabetes. Many people have it and don’t know it.

The symptoms of type 2 diabetes include:

  • Being more thirsty than usual and urinating more often
    • Blood sugar buildup pulls fluid out of your tissues.
    • This can make you thirsty so you drink more fluids, leading to more frequent urination.
  • Being hungrier than usual
    • When insulin can’t move sugar into the muscle and organ cells, they become “starved” for energy, and you may become very hungry.
  • Weight loss
    • You may be losing weight even though you’re eating more.
    • The excess glucose your body can’t use, and the calories it represents, are eliminated in your urine instead of contributing to your body weight.
  • Feeling more tired and/or irritable than usual
    • This can happen when your body doesn’t have enough sugar for energy.
  • Blurry vision
    • High blood sugar levels can pull fluid from the lenses in your eyes so you can’t focus clearly.
  • Slow healing and/or frequent infections
    • This is a common effect of type 2 diabetes.
  • Patches of dark, velvety skin (called acanthosis nigricans) in body creases and folds, most often in the neck and armpits
    • This condition may signal insulin resistance.

If you have any of these symptoms and haven’t been diagnosed with type 2 diabetes, see your doctor. Type 2 diabetes develops most often in adults however, with childhood obesity on the rise, it is becoming more common in children. Type 2 diabetes can’t be cured but fortunately, eating well, exercising, and maintaining a healthy weight can help keep it under control. If these lifestyle choices aren’t enough, you may need to add diabetes medications and/or insulin treatment to your disease management program.

The cause of Type 2 diabetes is unknown. What is known is that:

  • Overweight, lack of sufficient exercise, abdominal fat, family history, race, and age seem to contribute to its development.
  • Prediabetes (high blood sugar but not high enough for a diabetes diagnosis) and gestational (pregnancy) diabetes may increase the risk of type 2 diabetes.

Controlling your blood sugar can have widespread benefits for your health, helping to prevent serious complications involving major organs:

  • Heart and blood vessels: Type 2 and other forms of diabetes greatly raise the risk of heart attack, stroke, high blood pressure, and other cardiovascular problems.
  • Nervous system: Too much blood sugar can damage nerves (neuropathy)—particularly in the legs and feet, causing uncomfortable or painful symptoms that can progress to numbness, and in the digestive system.
  • Kidneys: Excess blood sugar can damage the kidneys’ complex filtering system severely, causing kidney failure or irreversible end-stage kidney disease.
  • Eyes: Eye damage to the blood vessels in the retina (diabetic retinopathy) can lead to blindness, and diabetes increases the risk of eye conditions such as glaucoma and cataracts.
  • Feet: Untreated, diabetic foot conditions such as nerve damage and poor blood flow raise the risk of complications including serious infection and amputation.
  • Skin and mouth (gum) infections: These are more common in people with type 2 as well as the other types of diabetes.
  • Bones: Excess blood sugar can lead to abnormally low bone mineral density and increase the risk of osteoporosis.
  • Mental state: Doctors now believe that type 2 diabetes may increase the risk of Alzheimer’s disease and dementia related to poor circulation.

Diabetes complications typically develop over time. Day to day, some problems may arise despite your best efforts at blood sugar control:

  • Low blood sugar (hypoglycemia)—When this occurs, raise your blood sugar level quickly by eating or drinking something sugary, such as fruit juice, hard candy, or a regular (NOT diet) soda.
    • If this happens frequently, contact your doctor.
  • High blood sugar (hyperglycemia)—When this occurs, contact your doctor. Please note: Exercising may help bring your sugar level down temporarily.
    • Important: If your sugar level is higher than 240 mg/dL, DO NOT EXERCISE, as this could actually raise the level higher.
    • Not treating high blood sugar could lead to diabetic coma (diabetic ketoacidosis from high levels of ketones, toxic acids, in your urine), which can be life-threatening.
  • Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)—This is a life-threatening medical emergency with blood sugar levels higher than 600 mg/dL, thickening the blood into a kind of syrup.
    • Seek medical help immediately.
    • Other symptoms include fever higher than 101oF (38oC), dark urine, confusion, vision loss, sleepiness, and hallucinations.
    • HHNS develops over time, often in older people with type 2 diabetes and people who’ve been ill.

When any emergency occurs, getting immediate medical care can be life-saving. If you have type 2 diabetes, an important way to be sure you get the right care quickly in an emergency is to wear a medical ID (identification) bracelet or necklace.

Now that you know more about what happens in type 2 diabetes, you’re better prepared to seek the care you may need if you have it. Next step: Getting to know the health professionals who can help.

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