Type 2 diabetes
Diabetes is an endocrine condition characterised by high blood sugar levels. There are two types diabetes: Type 1 and type 2. According to the estimates of the American Diabetes Association, in 2018 alone, the global prevalence of type 2 diabetes was 500 million. This type of diabetes is majorly caused due to lifestyle factors such as sedentary lifestyle, obesity, lack of physical activity and unhealthy eating habits. It can be prevented or managed by making simple changes in your daily life.
What is Type 2 Diabetes?
Blood sugar levels are regulated by a hormone called insulin that is synthesised by beta cells of the pancreas. The main function of the hormone is to bind to receptors on the fat, liver and muscle cells so as to allow the entry of glucose molecules inside them. Inside the cells, glucose is stored and then utilised as an energy source whenever needed.
In type 2 diabetes, the cells of the fat, liver and muscles fail to respond to the presence of insulin. This means that even in the presence of insulin, glucose can’t enter cells. It results in an increased level of sugar in the blood. In other word, this condition, known as insulin resistance, triggers a spike in your blood sugar level.
Type 2 Diabetes Symptoms
In most cases, symptoms of diabetes aren’t pronounced. So, millions of people live with type 2 diabetes without even knowing that they have it. Here are the red flags to watch out for.
Increased appetite: Diabetics are unable to utilise glucose. So, their cells keep craving for glucose all day long giving them hunger pangs.
Increased thirst: A blood spike in blood sugar levels can make diabetics dehydrated, inducing thirst all the time.
Frequent urination: Thanks to dehydration along with the constant feeling of thirst, diabetics tend to drink more water. This increases their urge to pee frequently.
Sudden weight loss: In diabetics, the body isn't able to utilise glucose for energy. Therefore, the body utilises fat to draw energy. This causes weight loss even without exercse and dietary changes.
Poor wound healing: Increased sugar levels in the body causes hardening of blood vessels affecting circulation. When blood flow to injured tissues gets affected, blood clotting proteins and other factors that promote healing do not reach the site of injury. This causes wounds to heal slowly.
Other symptoms include blurred vision, pain in the hands and feet or numbness, depression, frequent infections of the kidney, bladder and skin.
What causes Type 2 Diabetes?
A combination of factors contributes to diabetes. Here is a low-down on it:
Genes: Research observes that different parts of DNA influence your body’s capacity to produce insulin.
Excessive glucose production by your liver: When your blood is low on sugar, your liver produces and sends glucose to the blood. After your meals, your blood sugar levels spike up and your liver slows down and reserves the glucose for future use. However, in some cases, the liver doesn’t function like this. It keeps producing sugar even when your blood isn’t depleted of sugar levels. This triggers diabetes.
Poor cell-to-cell communication: Sometimes, your cells send wrong signals or fail to pick up the signals in the right manner. These physiological circumstances influence your cell’s capacity to make and use insulin, leading to diabetes in a chain reaction.
Broken beta cells: If your insulin-producing cells start making the wrong amount of this hormone, your blood sugar levels go haywire.
Type 2 Diabetes Risk Factors
Type 2 diabetes is a silent killer as it progresses slowly over a period of time. Although non-modifiable factors like age, genetics and ethnicity do play a role in the development of type 2 diabetes, it's the modifiable risk factors like diet and lifestyle habits that have increased the incidence of this condition in the past few years. Try these 10 yoga poses to keep diabetes under control!
Obesity: Most people who get diagnosed with type 2 diabetes are overweight. That's simply because increased fat stores make it harder for your body to use insulin in the right way.
Physical inactivity: Sedentary lifestyle is one of the main contributing factors for the development of obesity which is linked to diabetes.
Family history: Inheritance of faulty genes can cause type 2 diabetes. It has been estimated that children with one parent having diabetes have double the risk of developing it as an adult, while those having both parents with this condition have six times greater risk of developing diabetes compared to healthy individuals. The average age at which diabetes may develop in such people is dependent on the kind of lifestyle they follow. A person who follows a healthy lifestyle may develop the condition at a much later stage compared to a person who follows unhealthy eating and lifestyle habits.
Type 2 Diabetes Complications
This condition comes with a lot of associated complications. Here is a low-down on them:
Peripheral neuropathy: This is a disorder characterised by malfunction of nerves which send wrong or no signal. Diabetes may damage your nerves leading to this condition.
Diabetic retinopathy: Diabetics often start experiencing blurred vision, vision loss or swelling around the eyes. This is known as diabetic retinopathy.
Diabetic gastroparesis: It is a complication that results in digestion problems among people with diabetes. The condition may occur as a result of damage to the vagus nerve that controls contractions of the stomach muscles. So, the food moves slowly or stops moving through the digestive tract.
Erectile dysfunction: It’s true that erectile dysfunction and other sort of sex-related problems are extremely common among diabetics. It’s estimated that 60-70% men who live with diabetes suffer from erectile dysfunction.
Heart disease: People with diabetes undoubtedly have a greater than average risk of suffering from heart disease because they carry a larger number of risk factors. According to statistics, the risk is four times higher in adults with type 2 diabetes compared to those without diabetes. In fact, heart disease and stroke are the leading causes of death in people with type 2 diabetes.
Hair loss: Diabetes negatively affects the body’s circulatory system. This means that less amount of nutrients and oxygen reach the upper and the lower extremities of the body i.e. the feet and the scalp areas. If diabetes is causing poor blood circulation to the scalp, the hair follicles will die resulting in hair loss. Furthermore, this poor circulation may prevent further hair growth.
Diagnosis of Type 2 Diabetes
You need to see a doctor if you experience the already-mentioned signs of type 2 diabetes. He will go through your medical history and review the manifestations. He may suggest the following blood tests for confirmatory diagnosis.
A1C test or glycohaemoglobin test
This blood test calculates a person’s average blood glucose levels over the past three months. Here’s how to read the result:
Normal: A1C level below 5.7%
Prediabetes: A1C ranging between 5.7 to 6.4%
Diabetes: A1C level of 6.5% or above.
Fasting Plasma Glucose (FPG) test
This blood test is conducted after an 8-hour fasting window to check a person’s glucose levels. A reading of 126 mg/dL or above confirms diabetes. Your doctor may advise you to repeat the test to be doubly sure. You can perform the test at home with a glucometer.
Postprandial Plasma Glucose Test
This blood test checks your body’s tolerance towards glucose. For this, you need to take 75g of glucose orally. Your blood will be drawn 2 hours after this activity. A reading of 200 mg/dl or above confirms diabetes. If the result shows a reading is between 140 mg/dl and 200 mg/dl, your doctor will diagnose impaired glucose tolerance.
Treatment of Type 2 Diabetes
Diabetes cannot be cured or reversed. Treatment options involve medication for controlling and preventing a sudden spike in blood sugar levels. Here are medications and different treatment options for type 2 diabetes.
Sulfonylureas: They are prescribed to lower blood glucose levels by increasing the release of insulin from the pancreas. These drugs decrease blood sugar rapidly but may cause abnormally low and dangerous levels of blood sugar (hypoglycemia) leading to confusion and even coma.
Meglitinides: They aid in insulin production and work faster than sulfonylureas.
Biguanides: Metformin is an example of this type of drug. It lowers the amount of glucose released from the liver and reduces its absorption in the intestines.
Thiazolidinediones: They lower blood glucose by increasing the sensitivity of the muscle and fat cells to insulin. These drugs may be taken with metformin and/or a sulfonylurea. They can cause mild liver problems but are reversible with discontinuation of the drug. Here's what you should know about treatments for diabetes – the latest advances including Glifozins, Incretins, DPP-4 inhibitors & more.
Insulin injections: Insulin is also important in type 2 diabetes when blood glucose levels cannot be controlled by diet, weight loss, exercise and oral medicines. There are different types of insulin depending on their range of acting. Rapid-acting insulin like Insulin lispro starts working in about 15 minutes and lasts for 3 to 5 hours, while short-acting insulin starts working within 30 to 60 minutes of infusion and lasts 5 to 8 hours.
Bariatric surgery: Bariatric surgery or weight management surgery is recommended for diabetics who are morbidly obese. The surgery changes hormonal levels in the blood. Post-surgery, the insulin produced by the pancreas becomes insufficient and resistance is increased and blood sugar is controlled.
Type 2 Diabetes Diet
What you eat is extremely important in influencing your blood sugar levels. You need to consult a nutritionist alongside your diabetologist to chalk out a meal plan. Make sure that your diet has balanced proportions of carbohydrates, proteins and fats. Your nutritionist will tell you about the quantity after examining your blood sugar levels, body weight and personal preferences. If you are overweight, she may recommend a low-carb, low-fat, and low-calorie meal. Avoiding trans fats and high-sugar foods is a must if you are diabetic. High intake of fruits and vegetables, moderate consumption of alcohol, and other food rules suggested by your nutritionist need to be followed diligently. Remember, mealtimes matter a lot for diabetics.
Prevention of Type 2 Diabetes
There is no sure-fire way to prevent type 2 diabetes. However, sticking to a healthy lifestyle can reduce your risk of getting type diabetes.
Watch your weight: Several studies have revealed that overweight people can decrease their chance of type 2 diabetes just by shedding 7% to 10% of their weight.
Work out regularly: Research suggests that 30 minutes of brisk walking every day is likely to reduce your type diabetes risk by almost one third.
Know what you should eat and what you shouldn’t: Stay away from highly processed carbs, sugar-loaded foods and beverages, and trans and saturated fats. Make sure you have a lot of high-fibre options in your meals alongside fruits and vegetables.
Quit smoking and go slow on alcohol: Both of them make you more susceptible to high blood sugar levels, thanks to the chemicals released from them.
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