Noninsulin-dependent diabetes; Diabetes - type II; Adult-onset diabetes; Diabetic - type 2 diabetes; Oral hypoglycemic - type 2 diabetes
Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.
Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy.
When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy.
When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes.
Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.
Type 2 diabetes can also develop in people who are thin. This is more common in older adults.
Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease.
Over the past several years, our collective diets have grown unhealthier, and our waistlines have expanded as a result. Doing so, we're putting ourselves at risk for a number of diseases, including type 2 diabetes. Diabetes is serious stuff, if it's not treated, it can lead to some pretty dangerous complications, including nerve and kidney damage. The good news is you can often avoid type 2 diabetes and its complications.You need sugar, or glucose, to keep your body running. Normally when you eat, your pancreas releases a hormone called insulin, which moves the sugar from food out of your blood and into your cells, where it can either be used for energy, or stored. But if you have type 2 diabetes, this system doesn't work as well as it should, in part because your cells have a harder time responding to insulin. As a result, sugar builds up in your blood.Why is that a problem? Well, that excess sugar can damage organs like your eyes and kidneys, and it can lead to complications like nerve damage and heart disease. Diabetes complications could leave you blind, lead to amputation of your toes or feet, and maybe even kill you.You can help prevent diabetes complications by keeping good control over your blood sugar, but first you need to know that you have type 2 diabetes. Sometimes it can be hard to tell because you may not have any symptoms at first. Being very thirsty, tired, or having to go to the bathroom a lot may be pretty good clues that you might have developed diabetes. Blurry vision might also be a clue. Your doctor can confirm it with a blood test.Once you know that you have diabetes, it's your job to keep it under control. You'll need to check your blood sugar at home and talk to your doctor about how to lower it with diet, exercise, and possibly medicine.To avoid serious complications, you'll need to see not just one doctor, but a team of health care professionals. That includes a podiatrist to check your feet, an ophthalmologist to check your eyes, and a dentist for cleanings and exams. Because type 2 diabetes increases your risk for heart disease, you'll also need to see your primary care doctor regularly to have your blood pressure, cholesterol, and triglycerides checked, and to make sure your kidneys are working as well as they should.Like any other disease, it's better to avoid getting type 2 diabetes then to have to treat it. If you're at risk because you're overweight or over age 45, ask your doctor for a blood sugar test at your next check-up. If you have already developed diabetes, you can help avoid complications by staying on top of your health, checking your blood sugars, eating a healthy diet, exercising, and seeing all of your specialists on schedule. Make your doctor a partner in your care. Call right away if you have any problems, like numbness or tingling in your legs or feet, blurry vision, extreme thirst, weakness, or fatigue.
People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years.
Early symptoms of diabetes caused by a high blood sugar level may include:
After many years, diabetes can lead to serious health problems, and as a result, many other symptoms.
Your doctor may suspect that you have diabetes if your blood sugar level is higher than 200 milligrams per deciliter (mg/dL) or 11.1 mmol/L. To confirm the diagnosis, one or more of the following tests must be done.
Diabetes screening is recommended for:
If you have been diagnosed with type 2 diabetes, you need to work closely with your doctor. See your doctor as often as instructed. This may be every 3 months.
The following exams and tests will help you and your doctor monitor your diabetes and prevent problems.
The goal of treatment at first is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems from diabetes.
The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods.
Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your doctor about seeing a diabetes nurse educator and a dietitian.
LEARN THESE SKILLS
Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include:
It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well with the disease. Stay up-to-date on new research and treatments.
MANAGING YOUR BLOOD SUGAR
Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.
To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar.
Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind:
Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range.
HEALTHY EATING AND WEIGHT CONTROL
Work closely with your health care providers to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like.
Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes.
Very obese people whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery.
REGULAR PHYSICAL ACTIVITY
Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it:
Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise.
MEDICINES TO TREAT DIABETES
If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medicine. Since these drugs help lower your blood sugar level in different ways, your doctor may have you take more than one drug.
Some of the most common types of medicines are listed below. They are taken by mouth or injection.
You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Most commonly, insulin is injected under the skin using a syringe, insulin pen, or pump. Another form of insulin is the inhaled type. Insulin cannot be taken by mouth because the acid in the stomach destroys the insulin.
Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including:
People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make your feet less able to feel pressure, pain, heat, or cold. You may not notice a foot injury until you have severe damage to the skin and tissue below, or you get a severe infection.
Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected.
To prevent problems with your feet:
There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes.
Diabetes is a lifelong disease and there is no cure.
Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level.
After many years, diabetes can lead to serious health problems:
Call 911 right away if you have:
These symptoms can quickly get worse and become emergency conditions (such as convulsions, hypoglycemic coma or hyperglycemic coma).
Also call your doctor if you have:
You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.
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Last reviewed on: 7/24/2015
Reviewed by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.