Diabetes > Diabetes Mellitus > Type 2 Diabetes

What is Type 2 Diabetes?

Type 2 accounts for around 90% of the world's diabetes population. Type 2 diabetes is the case in which the levels of sugar in the blood rise to dangerous levels because it is not being transferred into the body's cells because of low levels of insulin, or because of insulin resistance.

It is usually diagnosed at a later age than Type 1 Diabetes Mellitus, which is why it is sometimes referred to as maturity onset diabetes.

The Cause of Type 2

Type 2 Diabetes is similar to Type 1 Diabetes in that it is an insufficient level of insulin in the blood. However, unlike Type 1, the pancreas of Type 2s still work, but at a lower rate than normal.

Alternatively, Type 2 can be caused by the body becoming what is known as 'insulin resistant' in which case the body cannot efficiently utilise some of the insulin it generates, usually because of obesity and certain chemicals that are released by fat cells.

Although the exact cause of Type 2 diabetes is not known, there are many factors which have been proven to have an influence over the risk of it in several cases.

Age

The most common risk associated with Type 2 diabetes is age. It most commonly seen developing in people over the age of 40. However, this age has been slowly dropping and more and more younger cases of Type 2 diabetes are being diagnosed.

Genetics

As with Type 1, genetics plays a key role in risk. If you have a close relative with Type 2, you are more likely to develop it yourself later in life. In addition, if you are African-Caribbean, African or South Asian, you have a higher risk of developing Type 2 diabetes.

Obesity

Type 2 is closely linked to the health of the person. Being overweight and especially being obese can increase the chances of developing Type 2. The state of being obese is having a body mass index (BMI) of over thirty. Check out the BMI Calculator to see what your BMI is.

Fat cells, particularly those around the abdomen, release a hormone called resistin which is theorised to increased insulin resistance throughout the body.

Symptoms

There are three main, noticeable and common symptoms of both types of diabetes which can be known as the 3Ps. these are:

In Type 2 Diabetes, these symptoms can appear gradually over a long period of time so they may be more noticeable on some days than others, or creep up on you without you immediately noticing.

Having a high blood sugar level damages the small arteries of the body which can bring on several health complications all over the body.

Kidney Damage (nephropathy)

Untreated high glucose levels can damage the fine network of blood vessels that filter the body's blood through the kidneys. If they get to damaged, it can lead to kidney disease or eventually kidney failure. In this case the sufferer would need a kidney transplant or dialysis.

Hypoglycemia

If you are on medication for Type 2, it is possible to drop your blood sugar too far by having too much of the medication or by missing a meal or snack, so the added medication removes too much sugar from your bloodstream. the effects of having a 'hypo' include blurred vision, shakes, loss of concentration and eventually unconsciousness if not acknowledged and treated. However, if you are treating diabetes with just a good diet, you are not likely to have a hypo as this treatment does not lower the blood sugar artificially.

Eyes Damage

Eyes can be damaged in the same manner as kidneys, as they are fed by a network of tiny blood vessels. These again can be damaged by high glucose levels.

Nerve Damage

Nerve damage can occur, especially in the legs which begins as a tingling sensation which will build to a pain and then a numbness if left completely untreated.

Treatment of Type 2

Type 2 diabetes is controlled and regulated by a healthy lifestyle, but has no specific, set, recommended diet to follow. Blood suagr levels can be dropped through healthy lifestyle changes, such as eating healthier foods and incorporating exercise into everyday life.

Ideally, the blood sugar level should be around 5.6 mmol/L but goals differ between people and what their doctors think is currently achievable. In addition, blood sugar levels will rise and fall throughout the day, due to food intake.

Monitoring Type 2 Diabetes

Type 2 diabetics will need to have their blood sugar checked, but this depends on each individual case. The rate can be anywhere between days or months, and is either checked personally by the individual if they have been trained, or by a doctor or nurse.

The main type of testing for a Type 2 Diabetic is the HbA1c test, which gives an average reading of blood glucose levels over a period of about three months.

Diet and Type 2 Diabetes

It is important to eat properly if you suffer from Type 2 diabetes. A healthy lifestyle that is rich in fibre is needed to keep blood sugars down.

The diet also needs to be low in fat as fatty deposits, particularly around the abdomen, can increase insulin resistance.

A low level of sweets and animal products will also help keep blood sugars low.

Exercise

Exercise is important to keep the body trim and the BMI low. This is to try and lower insulin resistance, and to increase general health. It is recommended to do about 30 minutes of low intensity exercise a day, such as walking or swimming.

Understanding Type 2 Diabetes and Blood Sugar Levels

The most important factor to diet is knowing and understanding how blood sugars react to food and exercise.

Blood sugar can change either way, because of the different effects of food and exercise on the body. In general:

  • Blood sugar level rises after eating
  • Blood sugar level falls due to exercise
  • Blood sugar level falls due to medication
  • Blood sugar level falls gradually over time

In non-sufferers, blood sugar levels fall gradually over time, but in diabetics, this is greatly reduced.

Medication and Type 2 Diabetes

In some cases of Type 2, people may be prescribed drugs to take if they cannot control their blood sugar levels with diet and exercise only. There is a myriad of drugs used to lower blood sugar, raise insulin levels or decrease insulin resistance, and your healthcare professional will prescribe the drug most suitable to you.

Medication Administered How it Helps
Metformin Oral tablet Dosage depends on each individual case and what the doctor prescribes.
  • Reduces glucose secreted by the liver
  • Reduces glucose absorbed from food
  • Reduces insulin resistance
Byetta (Exenatide) Twice a dayInjected
  • Stimulating insulin secretion
  • Reduces glucagon action
  • Reduces glucose absorbed from food
Victoza (Liraglutide) Once a day Injected
  • Stimulating insulin secretion
  • Suppressing glucagon secretion
Actos (Pioglitazone) Oral tablet taken once a day
  • Makes body cells more sensitive to glucose
  • This attacks an enzyme that breaks down the GLP-1 and GIP hormones. These hormones reduce blood sugar levels so the more there are, the lower the blood sugar levels.

You may be prescribed several of these medicines to be taken in conjunction with each other.

Prescription Safety

  • As with most drugs, there may be some side effects. Make sure to read the information that comes with any medication so you know what these could be and contact your healthcare professional if you are unsure on anything.
  • Ensure your medication is ok to take with any other medication you are on by asking your doctor.
  • Make sure you know whether alcohol consumption will have negative effects when mixed with the medication.
  • Make sure you know whether you need to stop taking your medication before undergoing any procedures which require general anaesthetic.
  • Do not give your medication to anyone else to take, even if your illnesses are similar, or even identical.
  • Do not take more than the prescribed dosage, and if you do, seek medical advice immediately and take the packaging and information leaflet with you.

Medication is to be used in addition to a healthy lifestyle and careful diet, it is not a convenient replacement.

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