Overview
Type 2 diabetes is a common and serious medical condition. It affects an estimated 30 million people in the United States — almost 10% of the population.
Type 2 diabetes develops when the body is unable to produce or use insulin. Insulin is a hormone that helps us process sugar. When there is not enough insulin, or our body can’t use it properly, the sugar (glucose) levels in our blood rise higher than what is safe.
Diabetes is a life-long condition. It can develop at any time in your life, and it often does not have any symptoms in the early stages of the disease. Here we include information to help you to understand:
- Your risk for developing diabetes
- How you can be screened and tested for diabetes
- Lifestyle changes that decrease your risk of developing diabetes, reverse the stages of early diabetes, or keep you healthy if you live with diabetes
- The different treatment options for Type 2 diabetes
- Some of the complications that can develop from diabetes, and steps you can take to prevent them
Types
Type 2 diabetes is not the only type of diabetes, but it is by far the most common. It affects about 95% of all people with diabetes.
There are several different types of diabetes:
- Type 1 diabetes (T1D)
- Type 2 diabetes (T2D)
- Prediabetes
- Gestational (diabetes that is diagnosed in pregnancy)
- Other rare types of diabetes (for example, diabetes related to medications, or problems with the pancreas)
Some of them are temporary or reversible, like prediabetes or gestational diabetes. Other types are long-term and permanent, like Type 1 and Type 2 diabetes.
The different types of diabetes are more like a spectrum, rather than distinct categories. And people can have more than one type of diabetes. For example, someone with Type 1 diabetes can also develop Type 2 diabetes. And someone with gestational diabetes is at higher risk for developing prediabetes and Type 2 diabetes down the line.
Causes
Type 2 diabetes is caused by two problems: either the body doesn’t make enough insulin, or it doesn’t respond normally to insulin (sometimes referred to as insulin resistance). When our body can’t produce or respond to insulin properly, our blood sugar rises.
Type 2 diabetes also has a genetic link, and tends to run in families. But other factors play an important role as well:
- Increased weight
- Not enough exercise
- Smoking
- Poor sleep
- Metabolic syndrome, which is a collection of conditions that increase your risk of developing diabetes
Symptoms
Type 2 diabetes develops over time. Most people with mild or early diabetes do not have any symptoms. This is why it is so important to have regular checkups and blood tests for screening.
As blood sugar levels go up, and stay up, people will start to experience symptoms, like:
- Fatigue
- Loss of appetite
- Thirst and dry mouth
- Frequent urination
- Blurry vision
- Headaches
In rare cases, elevated blood glucose levels can lead to a life-threatening condition called diabetic ketoacidosis (DKA). This is often associated with severe lethargy or fatigue, confusion, dizziness, or repeated episodes of vomiting.
Treatment
Diagnosis
Type 2 diabetes is diagnosed with blood and urine tests.
The main tests used to diagnose diabetes are:
- A fasting blood glucose test, which is performed at least 8 hours after your last meal (a normal fasting blood glucose is less than 100 mg/dl)
- A “hemoglobin A1C” level, which measures how high your average glucose has been over time (normal A1C is less than 5.7%)
- An oral glucose tolerance test, which tests your blood sugar 2 hours after sugar intake (normal is less than 140 mg/dl)
These are typically used to screen for diabetes, even before you have symptoms. If you have symptoms of diabetes, your provider will often first obtain:
- A fingerstick glucose (this is a quick way to measure your blood sugar levels with a finger prick and handheld monitor)
- A random plasma glucose (this is slightly more accurate than a fingerstick test, and allows your provider to check your other electrolyte levels as well)
Treatment
Type 2 diabetes treatment often is a combination of helpful lifestyle changes as well as medications. Some lifestyle changes that are helpful for most people diagnosed with Type 2 diabetes include:
- A healthy diet
- Weight loss
- Exercise
- Quitting smoking
- Stress reduction
- Healthy sleep habits
For some people, lifestyle changes are enough to keep their blood sugar levels well controlled. More often, lifestyle changes are combined with medications. There are two main categories of medications for Type 2 diabetes:
- Oral medications that help you respond better to your body’s existing insulin
- Injectable insulins and injectable non-insulins that supplement the body’s lower-than-normal insulin levels and help it work better
Treatment starts with lifestyle change. Your provider may add medications if and when you need them. It is common that your treatment plan will change over time as your body’s insulin needs change. Your care team will help you figure out the right treatments for you.
Medications
When you need medications to help control your blood sugar levels, there are two main categories: oral medications and injectable medications.
1. Oral medications (pills)
Oral medications help your body make more insulin, or respond better to your existing insulin. There are a number of different types of oral medications, and some people take more than one. Examples of these include:
- Metformin
- Sulfonylureas, like glipizide
- Thiazolidinediones, like pioglitazone
- DPP-4 inhibitors, like Januvia
- SGLT2 inhibitors, like Jardiance
There’s also a type of inhaled insulin that you can use alongside a long-acting injectable insulin.
2. Injectable medications
Sometimes, these medications are not enough to keep your blood sugar down. You may need injectable medications as well. This requires using a very small needle to inject a medication underneath the skin.
There are different types of injectable medications: insulins and non-insulins.
Insulins supplement your body’s lower-than-normal insulin levels. They’re categorized by how long they last in your body after you inject them:
- Rapid-acting (lasts 1 to 2 hours)
- Short-acting (lasts 2 to 4 hours)
- Intermediate-acting (lasts 6 to 14 hours)
- Long-acting (lasts 24 hours)
- Ultra-long-acting (lasts 40 hours)
- Combinations of short- and long-acting (lasts 24 hours)
Injectable non-insulins are medications that mimic other hormones associated with eating and storing energy. They can increase how much insulin your pancreas makes, slow down your digestive process, and lower how much glucose your liver releases. Examples include:
Medications & Collections
These drugs are vital for controlling and improving the health of individuals with this condition. They include both preventive and symptomatic treatments.