Type 2 diabetes is an acquired chronic disorder in which the body’s ability to convert blood sugar (glucose) into energy becomes impaired. It is one of the most common and harmful chronic disorders in the US and is highly correlated with being overweight or obese. However, even people who are at their ideal body weight can develop type 2 diabetes.

Around 29 million Americans have type 2 diabetes and another 89 million are prediabetic, meaning their typical blood sugar levels are elevated but not yet at the threshold criteria for full-blown type 2 diabetes.

For anyone at-risk or type 2 diabetes, have concerns about the disease, or want to help care for someone who has it, it’s important to know more about the disease, it’s causes, and how you can treat type 2 diabetes.

Understanding Glucose, Insulin, and Type 2 Diabetes

When we eat, food is digested and turned into glucose, which is then absorbed into our blood stream. The cells of our bodies rely on glucose to generate the energy that keeps us alive and going. In order to move the glucose from the bloodstream and into the cells that need it, the pancreas releases the hormone insulin, which triggers cells to open channels for glucose to enter.

In pre-diabetes and type 2 diabetes, many of the receptors on the cells respond less effectively and efficiently to insulin, causing more glucose to stay circulating in the bloodstream. The failure of glucose to enter the cells not only starves the cells of enough fuel to give us the energy we need, but also leads to toxic levels of glucose in the blood. This process is called insulin resistance because the receptors on the cells are “resistant” to insulin. The amount of insulin resistance, and very high levels of glucose in the blood, is what differentiates pre-diabetes from type 2 diabetes.

Symptoms of Type 2 Diabetes

Type 2 diabetes develops slowly. Many of its symptoms are shared with other disorders and may be mistaken for them. Over time, when diabetes is left untreated, many organs in the body may become damaged.

These are the most common symptoms of type 2 diabetes:

• Excessive Thirst and Urination. Constant excessive thirst and frequent urination are key symptoms of type 2 diabetes. When blood sugar reaches an elevated level, the body triggers feelings of intense thirst to help bring in more fluids to both dilute the blood sugar and to help it pass out of the body. Consequently, people with untreated type 2 diabetes or prediabetes may feel extremely thirsty all the time.
  As a result of all the extra fluid intake, a person will urinate much more often than they otherwise would. This excessive fluid intake and excretion overworks the kidneys and contributes to kidney damage, which may become chronic kidney disease (CKD).
• Impaired wound healing. When blood sugar can’t get into the cells, it accumulates in the bloodstream and slows wound healing, particularly in the extremities. Untreated type 2 diabetes is a major cause of amputation of the feet and toes because of slow wound healing.
• Feeling of “pins and needles” in feet and hands. Excessive blood sugar interferes with the way the delicate nerves of the hands and feet work, leading to painful feelings of burning or tingling in the extremities. If a person’s blood sugar goes too long without being treated, tingling and burning in the hands and feet can become a chronic condition called diabetic neuropathy.
• Weight Changes. It is more commonly known that diabetes is associated with obesity. It is less commonly known that weight loss can also signal the onset of type 2 diabetes. As the sugar in the blood can’t get into the cells to energize them, the cells send out hunger signals while the body is getting rid of the sugar in the blood via urine. This leads to a constant feeling of hunger, and eating more, all while the body loses weight as it can’t use the sugar it is getting.
  
  

While these symptoms are characteristic of diabetes, they can also indicate other health concerns. This is one reason it is important to check with your health care provider any time you have new symptoms to determine the root cause and receive treatment.

Implications of Type 2 Diabetes

Going beyond symptoms of type 2 diabetes, there are a number of complications that can affect other systems and parts of your body.

• Kidney damage. Untreated type 2 diabetes causes the kidneys to work much harder, which can lead to chronic kidney disease (CKD) or total renal failure.
• Nerve damage. Diabetes harms the nerves throughout the body, not just those in the extremities. Type 2 diabetes can even damage the nerves in the heart, causing cardiac arrhythmia
• Heart disease. Type 2 diabetes causes the major blood vessels of the heart to become stiff and it speeds up the process of atherosclerosis (narrowing of the cardiac blood vessels). Both of these increase the chances of a stroke or high blood pressure.
• Eye damage. The rapid and extreme changes in fluid volume in the body can damage the delicate blood vessels in the retinas, which are then further harmed by the high levels of glucose in the blood.
• Dementia. It seems likely that the damage to small blood vessels known to be caused by diabetes also damages blood vessels in the brain. Type 2 diabetes correlates strongly with an increased risk of dementia and an earlier onset of dementia.
  
  

Causes of Type 2 Diabetes

The following conditions are the biggest risk factors for type 2 diabetes:

• Dietary habits and food choices. A diet that’s filled with starches, refined carbohydrates, sugar, and trans fats is a major cause of type 2 diabetes and prediabetes
• Obesity. Being overweight or obese, with a body mass index (BMI) of 30 and above is a common cause.
• Stored organ fat. Fat stored in the abdomen where organs are, is more likely to signal oncoming diabetes than fat in the thighs, hips, or buttocks.
• Sedentary lifestyle. Any physical activity that reduces the levels of glucose in the blood helps reduce the impact of insulin resistance. A lack of physical activity keeps glucose uptake slow and reduces insulin sensitivity, leading to type 2 diabetes.
• Prediabetes. Prediabetes occurs when a person’s blood sugar levels are consistently higher than normal but have not yet crossed the threshold criteria for diabetes. Unless the conditions contributing to a person’s prediabetes are treated, diabetes is the typical result of prediabetes.
• History of gestational diabetes. If you developed gestational diabetes during pregnancy, you have an increased risk of acquiring type 2 diabetes later.
• Ethnicity/race. Black, Hispanic, Asian, and Native American people are statistically more likely to develop type 2 diabetes, although the reasons are still unclear.
  
  

Treatment of Type 2 Diabetes

Type 2 diabetes cannot be cured, but it can be controlled and managed. The most rapid and healthiest way to treat type 2 diabetes is to make significant lifestyle changes, such as eating a “diabetic diet” and increasing one’s level of physical activity. By eating a healthier diet, you can reduce the level of excess blood glucose in your blood, and even moderate physical activity will increase insulin’s effectiveness at getting sugar out of your bloodstream and into cells.

Works Cited

• American Diabetes Association. Gestational Diabetes (Retrieved November 15th, 2021). https://www.diabetes.org/diabetes/gestational-diabetes.
• Centers for Disease Control and Prevention. (2020, June 11). Prediabetes - your chance to prevent type 2 diabetes. Centers for Disease Control and Prevention. Retrieved November 13, 2021, from https://www.cdc.gov/diabetes/basics/prediabetes.html.
• Centers for Disease Control and Prevention. (2020, June 11). Prediabetes - your chance to prevent type 2 diabetes. Centers for Disease Control and Prevention. Retrieved November 13, 2021, from https://www.cdc.gov/diabetes/basics/quick-facts.html
• Centers for Disease Control and Prevention. (2021, August 10). Type 2 diabetes. Centers for Disease Control and Prevention. Retrieved November 13, 2021, from https://www.cdc.gov/diabetes/basics/type2.html
• Jaffe, L. (2020). What is insulin? (2021, October 3). https://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin
• Khan, M., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. Journal of epidemiology and global health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001
• Mayo Foundation for Medical Education and Research. (2021, January 20). Type 2 diabetes. Mayo Clinic. Retrieved November 15, 2021, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193.
• Sami, W., Ansari, T., Butt, N. S., & Hamid, M. (2017). Effect of diet on type 2 diabetes mellitus: A review. International journal of health sciences, 11(2), 65–71.
• Team, C. C. (2021, April 5). The best (and worst) diets if you have diabetes. Cleveland Clinic. Retrieved November 15, 2021, from https://health.clevelandclinic.org/the-best-and-worst-diets-if-you-have-diabetes/.