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Type 2 Diabetes: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Having type 2 diabetes affects how your body metabolizes sugar (glucose), its main form of fuel. A type 2 diabetes is caused by genetic and lifestyle factors that cause your body to resist insulin or be unable to produce enough insulin to maintain normal blood sugar levels, unlike type 1 diabetes, which is caused by an autoimmune reaction that destroys insulin-producing cells in the pancreas.

Causes of Type 2 Diabetes

Type 2 diabetes is believed to be caused by a complex interaction of genes and environment. Some of the factors that may increase your risk include:

• Family history. Having a parent or sibling with type 2 diabetes increases your chances of developing the condition, especially if they were diagnosed before the age of 40.

• Ethnicity. People of certain ethnic groups, such as African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders, are more likely to develop type 2 diabetes than people of other races.

• Obesity. Being overweight or obese is one of the main risk factors for type 2 diabetes, as excess fat makes your cells more resistant to insulin and increases the demand for insulin production.

• Physical inactivity. Lack of physical activity reduces your muscle mass and lowers your sensitivity to insulin, which can lead to high blood sugar levels.

• Age. The risk of type 2 diabetes increases with age, especially after the age of 45, as your body becomes less efficient at using insulin and your pancreas produces less insulin over time.

• Prediabetes. Prediabetes is a condition where your blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. If left untreated, prediabetes can progress to type 2 diabetes within 10 years.

• Gestational diabetes. Gestational diabetes is a type of diabetes that occurs during pregnancy, when the hormones produced by the placenta interfere with the action of insulin. Women who have had gestational diabetes are more likely to develop type 2 diabetes later in life.

• Polycystic ovary syndrome (PCOS). PCOS is a hormonal disorder that affects women of reproductive age, causing irregular periods, excess hair growth, acne, and infertility. Women with PCOS often have insulin resistance and are at a higher risk of developing type 2 diabetes.

Symptoms of Type 2 Diabetes

Symptoms of type 2 diabetes may not be noticeable at first, but as the condition progresses and your blood sugar levels rise, you may experience some of the following:

• Increased thirst and urination. High blood sugar levels cause your kidneys to work harder to filter out the excess glucose, which leads to increased fluid loss and dehydration. This makes you feel thirsty and causes you to urinate more frequently.

• Increased hunger. When your cells are unable to use glucose as a source of energy, your body signals your brain that you need more food, which makes you feel hungry even after eating.

• Fatigue. Lack of glucose in your cells also makes you feel tired and weak, as your body has to rely on other sources of fuel, such as fat and protein, which are less efficient and produce more waste products.

• Blurred vision. High blood sugar levels can damage the blood vessels in your eyes, causing fluid to leak into the lens and distort your vision. This can also increase your risk of developing eye complications, such as cataracts and glaucoma.

• Slow healing of wounds and infections. High blood sugar levels can impair your immune system and reduce your blood flow, which can delay the healing of wounds and increase your susceptibility to infections, especially in your skin, gums, and feet.

• Tingling or numbness in your hands or feet. High blood sugar levels can also damage the nerves in your body, causing a condition called diabetic neuropathy, which affects the sensation and function of your hands and feet. This can cause symptoms such as tingling, numbness, pain, or burning in your extremities.

Diagnosis of Type 2 Diabetes

The blood sugar levels in your blood should be checked by your doctor if you have any of the symptoms or if you have any of the risk factors for type 2 diabetes. Type 2 diabetes can be diagnosed with several types of blood tests, including:

• An FPG test is one that measures your blood sugar level after fasting (not eating anything) for at least 8 hours. A normal FPG level is less than 100 mg/dL (5.6 mmol/L). An FPG level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) indicates prediabetes. Two FPG levels of 126 mg/dL (7.0 mmol/L) or higher indicate diabetes.

• A normal OGTT result is less than 140 mg/dL (7.8 mmol/L) two hours after you drink 75 grams of glucose. This test measures your blood sugar level before and after drinking 75 grams of glucose. Prediabetes are defined as OGTT results ranging from 140 to 199 mg/dL (7.8 to 11.0 mmol/L). Diabetic results are defined as OGTT results of 200 mg/dL (11.1 mmol/L) or higher on two separate occasions.

• A hemoglobin A1c (HbA1c) test is used to measure your average blood sugar levels over the past two to three months by determining how much glucose is attached to your red blood cells. Normally, HbA1c is less than 5.7%. An HbA1c level of 5.7% to 6.4% indicates prediabetes. An HbA1c level of 6.5% on two separate occasions indicates diabetes.

Treatment of Type 2 Diabetes

Keeping your blood sugar levels within a healthy range is the main objective of type 2 diabetes treatment. Medication and lifestyle changes are usually used to treat type 2 diabetes.

• A healthy lifestyle includes eating a balanced diet that is low in sugar, fat, and salt and high in fiber, fruits, and vegetables; exercising regularly for at least 150 minutes per week; losing weight if you are overweight or obese; quitting smoking if you smoke; and restricting your alcohol consumption.

• The following types of medications can lower your blood sugar levels: metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, and insulin. Based on your blood sugar levels, medical history, preferences, and side effects, your doctor will prescribe the right medication for you.

Prevention of Type 2 Diabetes

Type 2 diabetes can be prevented or delayed by adopting a healthy lifestyle and avoiding the risk factors for the condition. Some of the steps that you can take to prevent type 2 diabetes include:

• Getting screened regularly. If you have any of the risk factors for type 2 diabetes, you should get your blood sugar levels checked at least once a year, or more often if your doctor advises. Early detection and treatment can help prevent or delay the onset of type 2 diabetes.

• Eating healthy. You should follow a balanced diet that is low in sugar, fat, and salt, and high in fiber, fruits, and vegetables. You should also limit your intake of processed foods, fast foods, and sugary drinks, and choose whole grains, lean proteins, and healthy fats instead.

• Being active. You should aim to do at least 150 minutes of moderate-intensity physical activity per week, such as brisk walking, cycling, swimming, or dancing. You should also do some strength training exercises at least twice a week, such as lifting weights, doing push-ups, or using resistance bands.

• Losing weight. If you are overweight or obese, you should try to lose some weight by reducing your calorie intake and increasing your physical activity. Losing even 5% to 10% of your body weight can significantly lower your risk of developing type 2 diabetes.

• Quitting smoking. If you smoke, you should quit as soon as possible, as smoking increases your risk of developing type 2 diabetes and its complications. You can ask your doctor for help with quitting, or use nicotine replacement products, such as patches, gums, or lozenges.

• Limiting alcohol. If you drink alcohol, you should do so in moderation, as alcohol can raise your blood sugar levels and interfere with your medication. The recommended limit is no more than one drink per day for women and two drinks per day for men.

In addition to affecting your quality of life, type 2 diabetes can increase your risk of developing serious complications, including heart disease, stroke, kidney failure, nerve damage, and loss of vision. By following the treatment plan prescribed by your doctor and making some lifestyle changes, you can manage your blood sugar levels and prevent or delay the onset of these complications. You are not alone in this journey, and there are many resources and support groups to assist you.