Diabetes, Type 2

Type 2 diabetes is a chronic medical condition characterized by high levels of sugar (glucose) in the blood. It occurs when the body becomes resistant to insulin, a hormone produced by the pancreas that regulates blood sugar levels, or when the pancreas does not produce enough insulin.

Symptoms

• Increased thirst and hunger
• Frequent urination
• Fatigue
• Blurred vision
• Slow healing of cuts and wounds
• Tingling or numbness in the hands and feet
• Recurring skin, gum, or bladder infections
• Fluctuations in weight
• Frequent yeast infections

Causes and Risk Factors

Type 2 diabetes is caused by a combination of genetic and lifestyle factors. Risk factors include:

• Obesity or being overweight
• Physical inactivity
• Family history of type 2 diabetes
• Age (risk increases after age 45)
• Prior history of gestational diabetes or delivering a baby over 9 pounds
• Polycystic ovary syndrome (PCOS)
• Sleep apnea
• Certain ethnicities, such as African American, Hispanic/Latino, American Indian, or Asian American

Treatments

The primary goal of treatment for type 2 diabetes is to manage blood sugar levels and prevent complications. Treatment options include:

• Lifestyle modifications: healthy eating, regular physical activity, weight loss (if necessary), stress management, and getting enough sleep
• Medications:
  • Metformin: decreases glucose production in the liver and increases insulin sensitivity
  • Sulfonylureas: stimulate insulin release from the pancreas
  • Meglitinides: stimulate insulin release from the pancreas
  • Thiazolidinediones: increase insulin sensitivity
  • DPP-4 inhibitors: increase insulin release and decrease glucose production in the liver
  • SGLT2 inhibitors: reduce glucose reabsorption in the kidneys
  • GLP-1 receptor agonists: increase insulin release and decrease glucose production in the liver
• Insulin therapy: may be necessary if oral medications are not effective or if blood sugar levels are very high
• Bariatric surgery: may be an option for individuals with a BMI of 35 or higher and significant weight-related health issues

Complications

If left unmanaged, type 2 diabetes can lead to serious complications, including:

• Heart disease and stroke
• Kidney damage (nephropathy)
• Nerve damage (neuropathy)
• Blindness (retinopathy)
• Foot damage (ulcers, infections, amputations)
• Hearing loss
• Cognitive impairment and dementia

Prevention

While there is no sure way to prevent type 2 diabetes, the following can reduce the risk:

• Maintaining a healthy weight
• Engaging in regular physical activity (at least 150 minutes/week)
• Eating a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein sources
• Limiting sugary drinks and refined carbohydrates
• Getting enough sleep (7-8 hours/night)
• Managing stress through relaxation techniques or therapy