Diabetes is a long-term health condition affecting millions of people worldwide. It is estimated that over a quarter of all diabetes sufferers are undiagnosed and unaware that they have the condition
What is Type 2 Diabetes?
The human digestive system is a complex mechanism. The food we eat is processed by the digestive system, which then releases the nutrients into our bloodstream. One of these nutrients is a type of sugar called glucose. The amount of glucose in the bloodstream is regulated by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). Diabetes occurs when there is not enough properly-functioning insulin in the body to remove glucose from the blood.
There are two types of diabetes: Type 1 and Type 2. Type 1 diabetes occurs when the body does not produce any insulin at all. With Type 2 diabetes, the body either does not produce enough insulin to function properly, or the body does not respond correctly to insulin (often referred to as insulin resistance). In either case, the body is unable to regulate the amount of glucose in the blood. This causes excessive levels of blood glucose, which leads to the symptoms experienced by diabetics. Type 2 diabetes is much more common than Type 1, with around 90% of all diabetics being diagnosed with Type 2.
Type 2 diabetes can sometimes be controlled with just a few lifestyle changes, diet modifications, and regular monitoring of blood glucose levels, particularly when diagnosed early. However, diabetes is a progressive condition, which often worsens over time, and sufferers may eventually need medication to control their symptoms.
What Causes Type 2 Diabetes?
Doctors don’t yet fully understand what causes diabetes. However, there are several risk factors that make your chances of developing the condition more likely. The most common of these include:
- Genetics: you are far more likely to develop Type 2 diabetes if you have a relative with the condition. The more closely related you are (e.g. parent, child, sibling), the greater the risk.
- Origins: while diabetes can affect all types of people, regardless of race, culture, or wealth, your risk of developing the condition is increased if you are of African-Caribbean, South Asian, or Middle Eastern descent.
- Obesity: being overweight or obese significantly increases your risk of developing Type 2 diabetes. The risk is even greater if you tend to store the bulk of your weight around your abdomen. When Type 2 diabetes is associated with being overweight or obese, it is often referred to as maturity-onset diabetes. This is because obesity-related diabetes is mostly diagnosed in older patients.
- Age: while people of all ages, including children as young as 7, are diagnosed with Type 2 diabetes, people over the age of 40 are at the highest risk of developing the condition.
- Health: women who suffer from gestational diabetes (a temporary form of the condition that affects some women during pregnancy) are at a greater risk of developing Type 2 diabetes in later life. There is also a condition know as pre-diabetes in which the level of blood glucose is significantly raised, but not quite high enough to diagnose diabetes. Pre-diabetes will eventually lead to diabetes if the problem is not addressed.
Symptoms of Type 2 Diabetes
Early symptoms of Type 2 diabetes are often so mild and generalized that sufferers may not realize there is anything wrong. Sometimes, symptoms can go unnoticed for several years.
The main symptoms are:
- Excessive thirst
- Frequent urination, especially during the night
- Fatigue and tiredness
- Weight loss and muscle loss.
Other symptoms may also be experienced by some people. These include:
- Blurred vision
- Slow healing of wounds
- Recurring bouts of thrush
- Genital itching.
If diabetes is not properly controlled, it can lead to further health complications. The risk of heart disease and strokes are five times more likely in those with Type 2 diabetes. Other possible complications include kidney disease (sometimes kidney failure), retinopathy (damage to the retina, causing problems with vision), and damage to the tiny blood vessels of nerves.
When the nerves become damaged, it leads to pain (often a tingling or burning sensation) in the fingers and toes, which sometimes spreads through the arms and legs. This often leads to problems with the feet, including ulcers and infections, as cuts and sores may go unnoticed due to reduced sensation in the feet. Damaged nerves may also occur in the digestive system, causing diarrhoea, constipation, or vomiting. Sexual problems, miscarriage, and still birth can also result from uncontrolled diabetes.
Hyperglycaemia (high blood glucose)
Hyperglycaemia occurs when blood glucose levels are too high. Symptoms usually come on suddenly and include severe thirst, blurred vision, drowsiness, and frequent urination. Hyperglycaemia can occur for several different reasons, including illness, stress, eating too much food, and incorrect medication. If hyperglycaemia goes untreated, it can lead to a rare complication known as diabetic ketoacidosis, which can cause unconsciousness and even death.
Hypoglycaemia (low blood glucose)
Hypoglycaemia, also known as a hypo, occurs when blood glucose levels are too low. In mild cases, it can make you feel hungry, weak, and shaky. A hypo can usually be relieved by eating a chocolate bar or having a sugary drink. In more severe cases, a hypo can make you feel drowsy and even lead to unconsciousness. If the hypo is severe, you will need to be treated with glucagon, a hormone that is injected directly into the muscle.
Medical Treatment for Type 2 Diabetes
Early diagnosis of Type 2 diabetes is an important factor in reducing the risk of developing complications later on. As soon as you become aware of the symptoms, you should make an appointment to see your doctor. In the first instance, your doctor will usually ask about your symptoms and take a urine sample to check for glucose. If glucose is found in your urine, the next step will be a blood test to confirm that you have diabetes.
Once you have been diagnosed with Type 2 diabetes, your doctor will advise you on how to control your condition. In many cases, diet, exercise, and lifestyle changes will be enough, especially when diagnosed early. However, Type 2 diabetes usually worsens over time and you may need medication to help control your condition.
There is currently no cure for diabetes. Medical treatment focuses on stabilizing blood glucose levels, controlling symptoms, and preventing complications in later life. Insulin may be prescribed to control your blood glucose levels, either in tablet or injection form. Medication may also be prescribed to control blood pressure, cholesterol, and other conditions that may contribute toward future complications.
Your doctor will also need to monitor your blood glucose levels regularly to see how stable they are. Stress, illness, exercise, diet, alcohol, and hormone changes can all affect your blood glucose levels. Readings will usually be taken by your doctor every 2-6 months. If you wish, you can also check your own blood glucose levels using a finger prick blood test.
Living with Type 2 Diabetes
If you have been diagnosed with Type 2 diabetes, you will need to make changes to your lifestyle in order to control the condition. It is important to maintain a healthy lifestyle, with good levels of physical and mental health.
Eating a healthy balanced diet with plenty of fruit, vegetables, and fibre, along with ensuring that your diet is low in fat, salt, and sugar, can help to effectively control your blood glucose levels. Special diabetic foods are unnecessary. A health professional, nutritionist, or dietician can help you to draw up a diet plan, if necessary.
Regular exercise also plays a large part in controlling blood glucose levels. You should aim to do some form of physical activity for half an hour, five times a week. Losing excess weight, learning to relax, quitting smoking, limiting your alcohol intake, and controlling your blood pressure and cholesterol levels are very important aspects of controlling diabetes.
There are also some special considerations for Type 2 diabetics. These include:
- Eye health: diabetes can lead to retinopathy, a condition affecting the eyes. Retinopathy can cause damage to your sight, and sometimes even blindness. It is important to have an eye examination at least once a year to check for early signs of retinopathy.
- Foot care: because excessive levels of glucose in the blood can damage nerves in the feet, diabetics may not be able to feel cuts, blisters, or other foot problems. This can lead to minor wounds becoming infected or ulcerated. To avoid serious problems, you should take extra care with your feet. Only wear shoes that fit properly, wash and dry your feet thoroughly every day, and keep your toenails short and smooth. You should also visit a chiropodist or other foot specialist every 2-3 months.
- Pregnancy: if you are pregnant, or planning to get pregnant, you need to consult your doctor. Ideally, you should talk to your doctor before trying for a baby, as your blood sugar levels will need to be carefully monitored and controlled, especially in the first eight weeks of pregnancy. Some of your medications may also harm your baby, so it is essential to tell your doctor as soon as possible if you think you might be pregnant.
Diabetics are at greater risk of developing other health conditions, including circulatory diseases, heart disease, muscle wasting, and damage to ligaments. It is important to attend regular appointments with your doctor or other healthcare providers, as they can monitor your progress and spot the signs of associated health conditions.
Living with Type 2 diabetes will mean making significant changes to your lifestyle, and it may take you some time to adjust. However, most diabetics can live a normal, full, and happy life, as long as they take extra care with their health.