What you need to know about type 2 diabetes

Type 2 diabetes is a chronic metabolic condition characterized by high blood sugar levels. It occurs when the body becomes resistant to the effects of insulin or doesn't produce enough insulin to maintain normal blood sugar levels. Insulin is a hormone that helps regulate blood sugar and allows the cells in the body to use glucose for energy.

Causes of type 2 diabetes

• Family history plays a significant role in the risk of developing type 2 diabetes. If you have close relatives, such as parents or siblings, with the condition, your risk is higher.

• In type 2 diabetes, the body's cells become resistant to the effects of insulin. This means that even though the pancreas produces insulin, the cells don't respond well to it, and blood sugar levels remain high.

• Excess body weight, particularly around the abdomen, is a major risk factor for type 2 diabetes. Fat cells, especially in the abdominal area, can release chemicals that disrupt the normal functioning of insulin.

• A diet high in sugar, saturated fats, and processed foods can contribute to obesity and insulin resistance. High sugar intake, in particular, can raise blood sugar levels.

• A sedentary lifestyle, with little or no physical activity, is associated with an increased risk of type 2 diabetes. Exercise helps the body use insulin effectively.

• The risk of type 2 diabetes increases with age, particularly after the age of 45. This may be due to a natural decrease in muscle mass and physical activity as people get older.

• Women who have experienced gestational diabetes during pregnancy are at a higher risk of developing type 2 diabetes later in life.

• Women with polycystic ovary syndrome (PCOS), a hormonal disorder, have a higher risk of developing type 2 diabetes.

• Hypertension is often associated with type 2 diabetes. High blood pressure can increase the risk of complications related to diabetes.

• Certain ethnic groups, including African-Americans, Hispanic Americans, Native Americans, and Asian Americans, are at a higher risk of developing type 2 diabetes.

• Smoking has been linked to an increased risk of type 2 diabetes and can also complicate the management of the condition.

• Sleep apnea, a condition characterized by interrupted breathing during sleep, has been associated with an increased risk of type 2 diabetes.

What are the symptoms of type 2 diabetes?

• Increased thirst (polydipsia)

• Frequent urination (polyuria)

• Increased hunger (polyphagia)

• Unexplained weight loss

• Fatigue

• Blurred vision

• Slow wound healing

• Frequent infections

• Tingling or numbness

• Darkened skin patches

• Yeast infections

Not everyone with type 2 diabetes will experience all of these symptoms, and some may have no noticeable symptoms at all. Early detection and management are crucial to preventing complications associated with diabetes. If you suspect you may have type 2 diabetes, schedule an appointment with a St. Luke’s Health primary care provider or endocrinologist for diagnosis and appropriate treatment.

Diagnosing type 2 diabetes

The diagnosis of type 2 diabetes involves a series of tests and evaluations to determine whether an individual has high blood sugar levels and meets the diagnostic criteria. The following are the primary methods used for diagnosing type 2 diabetes:

• Fasting Blood Sugar Test: In this test, a blood sample is taken after an overnight fast (typically at least 8 hours without eating). A fasting blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on two separate occasions is usually considered diagnostic of diabetes.

• A1C Test: The A1C test measures the average blood sugar levels over the past two to three months. An A1C level of 6.5% or higher is generally indicative of diabetes.

• Oral Glucose Tolerance Test: This test involves fasting overnight and then drinking a sugary solution. Blood sugar levels are tested at intervals over a few hours. A blood sugar level of 200 mg/dL or higher two hours after the glucose challenge is considered diagnostic for diabetes.

• Random Blood Sugar Test: This test involves measuring blood sugar levels at any time, regardless of when the person last ate. A random blood sugar level of 200 mg/dL or higher, along with classic symptoms of diabetes (such as increased thirst and urination), may indicate diabetes.

Treatment options for type 2 diabetes

The treatment of type 2 diabetes aims to manage blood sugar levels and reduce the risk of complications. Treatment plans are often individualized based on factors such as the severity of the condition, overall health, and patient preferences. Here are common treatment options for type 2 diabetes:

• Lifestyle changes: These are fundamental to diabetes management and may include:

  • Diet: Adopting a balanced diet that focuses on whole grains, lean proteins, vegetables, and controlled portions of carbohydrates. Monitoring carbohydrate intake is often a key component.

  • Exercise: Regular physical activity can help improve insulin sensitivity. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week.

  • Weight management: Maintaining a healthy weight or losing excess weight can improve blood sugar control.

• Oral medications: If lifestyle changes alone aren't sufficient, oral medications may be prescribed. These medications help the body use insulin more effectively or stimulate the pancreas to produce more insulin. Common classes of oral medications include metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, and more.

• Insulin therapy: In some cases, oral medications may not be enough, and insulin therapy may be necessary. This involves taking insulin injections to regulate blood sugar levels. There are different types of insulin, and the treatment plan can be tailored to individual needs.

• GLP-1 receptor agonists: These medications stimulate the release of insulin, suppress glucagon (a hormone that raises blood sugar), and promote a sense of fullness, which can aid in weight loss. They are often used in combination with other treatments.

• Blood glucose monitoring: Regular monitoring of blood sugar levels is crucial for adjusting treatment plans. This can be done using a blood glucose meter, continuous glucose monitoring (CGM) systems, or flash glucose monitoring devices.

What foods should you avoid with type 2 diabetes?

• High-sugar foods and beverages should be limited or avoided, including sugary drinks, candy, pastries, and desserts. These can cause rapid spikes in blood sugar.

• Foods made from white flour and refined grains, such as white bread, white rice, and most breakfast cereals, can lead to sharp increases in blood sugar. Choose whole grains instead.

• Highly processed snacks like chips, pretzels, and crackers are often high in unhealthy fats, salt, and refined carbohydrates. Opt for healthier snacks like nuts or vegetables.

• Even 100% fruit juices can be high in sugar. It's better to consume whole fruits in moderation and watch portion sizes.

• Regular soda is packed with sugar and provides little nutritional value. It's best to avoid it entirely.

• Flavored yogurts often contain added sugars. Choose plain, unsweetened yogurt and add your sweetener with fresh fruit or a small amount of honey.

• Fried foods, such as French fries and fried chicken, are high in unhealthy fats and calories. These can contribute to weight gain and blood sugar spikes.

• Many fast food items are high in unhealthy fats, sugars, and refined carbohydrates. They should be consumed sparingly.

• Alcohol can affect blood sugar levels and may interact with diabetes medications. If you choose to drink, do so in moderation and consult with your healthcare provider.

• High-fat cuts of red meat, such as ribeye steak and bacon, can be detrimental to heart health. Choose lean cuts of meat and poultry.

• Condiments like ketchup, barbecue sauce, and sweet salad dressings often contain added sugars. Opt for healthier, sugar-free alternatives.

• Many breakfast cereals are high in sugar and refined grains. Look for cereals with high fiber content and little or no added sugars.

• Canned fruits packed in heavy syrup are loaded with added sugars. Choose fruits canned in their juice or, better yet, fresh or frozen fruit.

• Full-fat dairy products, like whole milk and regular cheese, can be high in saturated fats. Choose low-fat or fat-free dairy options.

Diabetes is a lifelong condition, but with the right treatment and self-care, people with diabetes can lead healthy, fulfilling lives. Consult with your endocrinologist to create a personalized plan based on your specific condition.