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Type 2 Diabetes

Type 2 diabetes is an impairment in the way the body regulates and uses sugar (glucose) as a fuel. This long-term (chronic) condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.

In type 2 diabetes, there are primarily two interrelated problems at work. Your pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into your cells — and cells respond poorly to insulin and take in less sugar.

Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.

Symptoms

Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can be living with type 2 diabetes for years and not know it. When signs and symptoms are present, they may include:

  • Increased thirst

  • Frequent urination

  • Increased hunger

  • Unintended weight loss

  • Fatigue

  • Blurred vision

  • Slow-healing sores

  • Frequent infections

  • Numbness or tingling in the hands or feet

  • Areas of darkened skin, usually in the armpits and neck

Treatment

Managing type 2 diabetes includes a mix of lifestyle changes and medication.

You may be able to reach your target blood sugar levels with diet and exercise alone.

  • Weight loss. Dropping extra pounds can help. While losing 5% of your body weight is good, losing at least 7% and keeping it off seems to be ideal. That means someone who weighs 180 pounds can change their blood sugar levels by losing around 13 pounds. Weight loss can seem overwhelming, but portion control and eating healthy foods are a good places to start.

  • Healthy eating. There’s no specific diet for type 2 diabetes. A registered dietitian can teach you about carbs and help you make a meal plan you can stick with.

  • Focus on:

  • Eating fewer calories

  • Cutting back on refined carbs, especially sweets

  • Adding veggies and fruits to your diet

  • Getting more fibre

  • Exercise. Try to get 30 to 60 minutes of physical activity every day. You can walk, bike, swim, or do anything else that gets your heart rate up. Pair that with strength training, like yoga or weightlifting. If you take a medication that lowers your blood sugar, you might need a snack before a workout.

  • Watch your blood sugar levels. Depending on your treatment, especially if you’re on insulin, your doctor will tell you if you need to test your blood sugar levels and how often to do it.

Complications

Type 2 diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Also, factors that increase the risk of diabetes are risk factors for other serious chronic diseases. Managing diabetes and controlling your blood sugar can lower your risk for these complications or coexisting conditions (comorbidities).

Potential complications of diabetes and frequent comorbidities include:

  • Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis).

  • Nerve damage (neuropathy) in limbs. High blood sugar over time can damage or destroy nerves, resulting in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.

  • Other nerve damage. Damage to the nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhoea or constipation. For men, nerve damage may cause erectile dysfunction.

  • Kidney disease. Diabetes may lead to chronic kidney disease or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

  • Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.

Prevention

Healthy lifestyle choices can help prevent type 2 diabetes, and that's true even if you have biological relatives living with diabetes. If you've received a diagnosis of prediabetes, lifestyle changes may slow or stop the progression to diabetes.

A healthy lifestyle includes:

  • Eating healthy foods. Choose foods lower in fat and calories and higher in fibre. Focus on fruits, vegetables and whole grains.

  • Getting active. Aim for 150 or more minutes a week of moderate to vigorous aerobic activity, such as a brisk walk, bicycling, running or swimming.

  • Losing weight. Losing a modest amount of weight and keeping it off can delay the progression from prediabetes to type 2 diabetes. If you have prediabetes, losing 7% to 10% of your body weight can reduce the risk of diabetes.

  • Avoiding inactivity for long periods. Sitting still for long periods can increase your risk of type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.

For people with prediabetes, metformin (Fortamet, Glumetza, others), an oral diabetes medication, may be prescribed to reduce the risk of type 2 diabetes. This is usually prescribed for older adults who are obese and unable to lower blood sugar levels with lifestyle changes.

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Eat healthy plant foods. Plants provide vitamins, minerals and carbohydrates in your diet.
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