A Complete Overview of Type 2 Diabetes

Type 2 diabetes is a chronic (long-term) condition that occurs when your body isn’t able to properly produce, use, or respond to insulin, a hormone that regulates blood sugar. This can cause glucose (sugar) to remain in your bloodstream instead of entering your cells for energy.

If left untreated, this condition can lead to complications like heart disease, kidney disease, nerve damage, and vision loss.

Type 2 diabetes is the most common type of diabetes mellitus (diabetes), accounting for 95% of all cases. Subtypes of type 2 diabetes include:

• Mild age-related diabetes (MARD): This is the most common subtype of type 2 diabetes, representing 39% of cases. People with MARD have some difficulty controlling their blood sugar levels and generally have few complications.
• Mild obesity-related diabetes (MOD): This usually affects people who have obesity, representing nearly 22% of cases. MOD is generally a mild form of type 2 diabetes and causes very few complications.
• Severe insulin-deficient diabetes (SIDD): This subtype represents about 18% of cases. People with SIDD generally are young and have a healthy weight. They produce little insulin and may have a poor metabolism. Blindness and nerve damage may occur as a result. 
• Severe insulin-resistant diabetes (SIRD): This accounts for about 15% of cases. People with SIRD may have obesity and can have insulin resistance. Kidney and liver issues are common.

Some people may have prediabetes, which occurs when your blood sugar is slightly higher than normal but not yet in the range for type 2 diabetes. You can reverse prediabetes by managing weight, eating nutritious foods, and exercising regularly.

You may experience a wide range of type 2 diabetes symptoms. These include:

• Blurry vision
• Dry skin
• Fatigue and weakness
• Feeling very hungry or thirsty
• Frequent urination
• Irritability
• Pain, tingling, or numbness in your hands and feet
• Sores, cuts, and bruises that are slow to heal
• Unintentional weight loss

Symptoms can sometimes be very mild. Approximately half of all Americans with type 2 diabetes are unaware of their health condition.

The primary cause of type 2 diabetes is insulin resistance. Other factors can also increase your risk of type 2 diabetes, such as:

• Age: People older than 45 are more likely to develop the disease.
• Family history: You are at a higher risk of type 2 diabetes if a family member has it.
• Gestational diabetes: This type of diabetes occurs when you have high blood sugar levels during pregnancy. Having gestational diabetes may increase your risk of type 2 diabetes later in life.
• High blood pressure medications: Some medications that treat high blood pressure can increase your risk of type 2 diabetes.
• Low HDL cholesterol: Having low HDL (“good”) cholesterol can increase your risk.
• Lack of physical activity: A lack of exercise puts you at risk of type 2 diabetes. Regular exercise helps your body convert glucose into energy.
• Polycystic ovary syndrome (PCOS): This hormonal disorder affects the ovaries and may cause insulin resistance.
• Smoking: People who smoke are 30%-40% more likely to have type 2 diabetes than non-smokers.
• Being overweight: Obesity has been linked to type 2 diabetes.

A healthcare provider can use a few tests to measure your blood sugar levels. You should not attempt to diagnose yourself with an over-the-counter (OTC) blood glucose meter. 

Fasting Plasma Glucose (FPG) Test

This test requires you to fast for at least eight hours. You can fast overnight and schedule the test for the first thing in the morning, before breakfast.

A healthcare provider will draw your blood to check your blood glucose levels. Two FPG tests that show a blood glucose level of 126 milligrams (mg) or higher of glucose per deciliter (dL) of blood indicate diabetes. 

A1C Test

An A1C test measures your average blood sugar levels over the last three months. You do not need to fast before this test.

You will give a blood sample, and your test results will show what percentage of your blood proteins are coated with sugar. Normal is less than 5.7%, prediabetes is 5.7%-6.4%, and diabetes is 6.5% or higher.

Random Plasma Glucose (RPG) Test

This test also measures your blood glucose levels and does not require fasting. A doctor can determine an official diabetes diagnosis if you have 200 milligrams or higher of glucose per deciliter of blood.

Oral Glucose Tolerance Test (OGTT)

An oral glucose tolerance test (OGTT) requires you to fast overnight before your blood is drawn.

A healthcare provider will take a blood sample and ask you to consume a sugary drink, then will repeatedly draw your blood over two to three hours to see how your blood sugar levels respond to the sugary drink.

You will be diagnosed with diabetes if you have 200 milligrams or more of glucose per deciliter of blood after two hours.

Urine Test

Urine tests are less accurate than blood tests to measure blood sugar, so they are not often used to diagnose diabetes. However, a urine test can still measure blood sugar if there is any difficulty drawing your blood.

The goal of treatment is to bring your blood sugar levels down and keep them in a healthy range. Type 2 diabetes treatments vary based on the severity of your condition, your lifestyle, and your overall health.

You can often manage your blood sugar by making healthy lifestyle changes, such as:

• Eat a nutritious diet: Focus on fruits, vegetables, whole grains, lean proteins, and non- or low-fat dairy to keep your blood sugar in check. You may find it helpful to follow the Diabetes Plate Method, which involves filling half your plate with non-starchy vegetables, a quarter with lean proteins (e.g., chicken or fish), and a quarter with carbs (e.g., beans and whole grains).
• Get regular exercise: Staying active helps your body convert glucose into energy and keeps your blood sugar low. Walking, bike riding, and strength training are good options.
• Lose weight, if needed: Obesity can lead to high blood sugar levels. A healthcare provider may suggest losing weight to manage blood sugar.

Nearly 90 million adults in the United States have prediabetes, and about 84% of these people have no idea.

The best way to prevent type 2 diabetes is to shift toward a healthier lifestyle as soon as possible. You can take steps to lower your risk, such as:

• Build a support system to hold you accountable to your goals.
• Eat a low-fat diet that is high in fruits, vegetables, whole grains, and lean proteins.
• Exercise regularly.
• Maintain a healthy weight.
• Limit tobacco and alcohol use.

The National Diabetes Prevention Program offers a Lifestyle Change Program that pairs you with a health coach who can help you make necessary lifestyle changes.

People with type 2 diabetes may be at risk for other health conditions that can affect their blood sugar levels and overall health. Some of these conditions include:

• Chronic kidney disease (CKD): This occurs when your kidneys gradually lose function. CKD can lead to kidney failure if untreated.
• Heart disease: Heart disease may occur in people with type 2 diabetes.
• Hyperlipidemia: This refers to a high amount of fat in your blood. Hyperlipidemia impacts more than 75% of people with type 2 diabetes.
• Hypertension: Hypertension (high blood pressure) may affect more than 80% of people with type 2 diabetes and may increase the risk of heart disease.
• Obesity: Obesity is a common risk factor for and complication of type 2 diabetes. Almost 80% of people with type 2 diabetes are overweight or obese.

Type 2 diabetes can impact your physical and emotional health. Getting early treatment and being proactive can significantly improve your symptoms and overall quality of life.

Some ways to manage your physical and emotional health include:

• Cook healthy meals with your loved ones.
• Engage in your favorite hobbies and spend time with family and friends.
• Find a friend to exercise with.
• Keep in contact with a healthcare provider to ensure your blood sugar stays in a healthy range.
• Practice meditation or deep breathing to reduce stress.
• Reach out to a mental healthcare provider if you need additional support.
• Take any necessary medications as prescribed by your doctor.

People with type 2 diabetes do not produce enough insulin or have insulin resistance. As a result, blood sugar rises and puts you at risk for serious complications if untreated.

Getting a diagnosis through various blood tests and receiving proper treatment can help you manage this condition. Prevention strategies include eating a healthy diet, getting regular exercise, and managing stress.