The Centres for Disease Control and Prevention defines diabetes as achronic (long-lasting) health condition that affects how your body turns food into energy. We are most familiar with prediabetes, Type 2 diabetes, Type 1 diabetes and gestational diabetes.
But there have been more variations of diabetes discovered. Two newer diabetes diagnosis are MODY (maturity onset diabetes of the young) and LADA (latent autoimmune diabetes in adults). In fact, they are so new that they are often misdiagnosed.
The Most Common Types of Diabetes
As a review, here’s a brief summary of the most common types of diabetes:
Type 1 diabetesis an autoimmune condition. People diagnosed with Type 1 diabetes must takeinsulinbecause their immune system has attacked the insulin producing cells in the pancreas blocking production of insulin.
Type 2 diabetesis a condition in which the body becomes resistant to using insulin properly and efficiently. Over time people with Type 2 diabetes may stop making enough insulin, becoming insulin deficient. Type 2 diabetes is associated with genetic and lifestyle factors.
Gestational diabetesis a temporary condition where higher levels of hormones during pregnancy lower the body’s sensitivity to insulin leading to blood sugar levels that are out of target range.
Maturity onset diabetes of the young (MODY) is yet another type of diabetes that is directly attributable to a genetic condition. MODY occurs before 25 years of age.
Latent autoimmune diabetes in adults (LADA) is considered an “other type of diabetes” because it doesn’t follow the same metabolic path as Type 1 or Type 2 diabetes but has characteristics of bot.People who are diagnosed with LADA tend to be over age 35 and have a family history of autoimmunity, but they continue to produce some insulin naturally in contrast to Type 1 diabetes.
Type 3 diabetes is an anomaly, often linked with Alzheimer’s disease. This type is not an official diabetes diagnosis, nor is it currently used in the health care system. The theory is that insulin resistance in the brain is part of the progression with Alzheimer’s disease.
But could there be more types of diabetes on this growing list?
Type 4 Diabetes
Sit back and read on because there is yet another new diabetes to add to this list, referred to as “Type 4” Diabetes. Type 4 diabetes is not diabetes as we know, and it isn’t an official diagnosis yet. But there are some findings in mice that have revealed an interesting twist to a potentially new diabetes diagnosis.
Unlike Type 2 diabetes or Type 1 diabetes, “Type 4” diabetes is not associated with excess body weight or a deficiency of insulin. Rather, the condition is connected to age related insulin resistance in lean, older mice which appears to be caused by a variation in the accumulation of certain immune system cells.
By comparing the immune systems of healthy mice, obese mice with Type 2 diabetes and certain lean, older mice with “age-related diabetes,” researchers at the Salk Institute discovered the older, lean mice had abnormally high levels of T-regulatory immune cells accumulating in fat tissue. This condition was leading to unnatural accumulations of internal fat in areas such as the liver causing insulin resistance similar to Type 2 diabetes. Importantly, blocking the accumulation of T-regulatory cells in older mice prevented the development of this “Type 4” diabetes.
The concern is that if this same insulin resistance pathway is occurring in older, lean humans, their diabetes may go undiagnosed because they don’t have the “standard” obesity risk factor for Type 2 diabetes even while the researchers have already identified an effective treatment. The work to survey older people who may experience this variation of diabetes is underway.
At this moment in time, we aren’t able to make any solid recommendations on how to prevent changes in T-regulatory cells that are associated with Type 4 diabetes. Even though this potential Type 4 diabetes is unrelated to an increase in body weight, we continue to recommend following a healthy lifestyle, no matter what age. With all the more common types of diabetes, a healthy lifestyle is part of the equation of diabetes management.
Metformin as a medicine for diabetes came up in a discussion with someone who recently found out that their test for blood sugar over three months, A1c, was just in the diabetic range. The doc suggested metformin as a medicinal treatment. But there was concern over the most common adverse effect of digestive upset, either or both ends. Not being completely familiar with the drug, I did what we always told our kids to do if they asked a question: look it up.
Metformin has become, worldwide, the preferred first-line oral blood glucose/sugar lowering agent to manage Type 2 diabetes mellitus. The word diabetes comes from Greek, meaning to walk or stand with legs apart. Mellitus means honey sweet. It was coined because the urine of diabetics has lots of sugar in it. Type 1 diabetes occurs when pancreatic cells don’t make enough insulin, which keeps blood glucose under control. Type 2 is when cells can’t utilize insulin correctly and sugar levels escalate.
Metformin’s history is linked to the plant French lilac or goat’s rue, a traditional herbal medicine in Europe, found to be rich in guanidine, which in 1918 was shown to lower blood sugar. Guanidine derivatives, including metformin, were synthesized, and some were used (not metformin) to treat diabetes in the 1920s and 1930s, but were discontinued because of toxicities and the increased availability of insulin.
Metformin was rediscovered in the search for antimalarial drugs in the 1940s. It proved useful to treat influenza, but it was found to lower blood sugar. This was pursued by the French physician Jean Sterne, who introduced it to treat diabetes in 1957. He proposed its brand name Glucophage because it “ate” glucose. It was less potent than other biguanide drugs, phenformin and buformin, which were discontinued in the 1970s due to a high risk of lactic acidosis, a serious fatal reaction. Metformin was late to be introduced into the U.S. in 1994-95 because of that biguanide chemical association.
Metformin is prescribed with diet and exercise, the toughest treatments to get many folks to use faithfully. It inhibits liver glucose production by about 1/3. It increases the insulin sensitivity of body tissues, which are called “insulin resistant” when sugar and insulin are both high. It also increases secretion of a protein called GDF15, which reduces appetite and caloric intake. It can foster some moderate weight loss, always helpful in overweight diabetics.
It can’t be given to everyone, especially those with compromised kidney function. When it is given with other antidiabetic meds, especially insulin, caution has to be taken not to make blood sugar too low, called hypoglycemia. Another pretty rare complication is the development of lactic acidosis, where too much lactic acid builds up. This produces a systemic acid metabolism, which is damaging to all tissues and seems to happen related to impaired liver or kidney function. There are several drug interactions. You and your doc duke that out.
It can be used in polycystic ovary syndrome, a complicated genetic condition with infertility and some insulin resistance. That’s too much to discuss now. Happily, it can be given during pregnancy with no real risk. Dosing and continued management is an entirely personal medical issue.
It has been studied to a degree in several other conditions including cardiovascular disease, cancers, premature puberty, aging (slowing it — good luck) and non-alcoholic fatty liver disease. Results are mixed in most cases.
If it can benefit your blood sugar in conjunction with other tools to decrease all the damage that diabetes can do, it is worth it, and at not too bad a cost. When you can get your blood sugar and A1c down, then you can say “how sweet it isn’t.”
People with type 2 diabetes who have full chewing function have a blood glucose level that is significantly lower than patients whose ability to chew effectively is impaired, a new study shows
The retrospective study, published in PLOS ONE, looked at data gathered from 94 patients with type 2 diabetes who had been seen at an outpatient clinic in a hospital in Istanbul, Turkey. The researchers divided the patients into two groups: the first group included patients who had good “occlusal function”—enough teeth placed properly and making contact in such a way that a person can chew their food well.
That group’s blood glucose level was 7.48. The second group couldn’t chew well, if at all, because they were lacking some or all of those teeth; their blood glucose level was almost 2% higher, at 9.42.
CHEWING’S LINK TO DIABETES
When you sit down at a picnic table with family and friends, mastication—chewing—is the last thing on your mind. However, as you bite into your burger, several things start to happen.
Digestion, the process by which your body extracts nutrients from food, begins as chewing stimulates the production of saliva. Nutrients that are important to reduce blood glucose levels include fibre, which is obtained in large part through chewing appropriate foods.
Chewing also has been reported to stimulate reactions in the intestine that lead to increased insulin secretion, and the hypothalamus that promote a feeling of satiety, resulting in less food intake. Eating less decreases the likelihood of becoming overweight, which is a major risk factor for developing type 2 diabetes.
“My special clinical interest is to treat dental patients who are systemically compromised,” says Mehmet A. Eskan, a clinical assistant professor in the department of periodontics and endodontics at the School of Dental Medicine at the University at Buffalo.
The new research notes that, as of 2019, almost half a billion people worldwide had diabetes, and at least 90% of those patients with diabetes have type 2 diabetes.
Addressing oral health has recently become part of the approach to managing diabetes along with encouraging patients to maintain a healthy weight, eat a healthy diet, and quit smoking.
“Our findings show there is a strong association between mastication and controlling blood glucose levels among T2D patients,” Eskan says.
The study did not find any independent variables that could affect blood glucose levels among the subjects because there were no statistical differences among subjects regarding body mass index (BMI), sex, smoking status, medications, or infection as indicated by white blood cell count (WBC) at the baseline.
Chewing stimulates reactions in the intestine that lead to increased insulin secretion, and the hypothalamus that promote a feeling of satiety, resulting in less food intake. Eating less decreases the likelihood of becoming overweight, which is a major risk factor for developing type 2 diabetes. (Credit: Getty Images)
DROP IN BLOOD GLUCOSE LEVELS
The dramatic improvement in one patient’s case described in a 2020 study co-led by Eskan illustrates the potential benefit of improving occlusal function through dental implants and appropriate fixed restoration.
A type 2 diabetes patient whose chewing function was severely impaired by missing teeth presented initially with a blood glucose level of 9.1. The patient obtained nutrition by using a bottle and eating baby food. Four months after treatment with a full mouth implant-supported fixed restoration, the patient’s glucose level dropped to 7.8. After 18 months, it decreased to 6.2.
Research has shown that an increase of just 1% in blood glucose level is associated with a 40% increase in cardiovascular or ischemic heart disease mortality among people with diabetes, according to Eskan. Other complications can include kidney disease, eye damage, neuropathy, and slow healing of simple wounds like cuts and blisters.
“I’m interested in research that can improve people’s health now,” says Eskan. He and coauthor Yeter E. Bayram from the department of internal medicine at the Hamidiye Sisli Etfal Education and Research Hospital in Istanbul, look forward to further studies that explore possible causal relationships between occlusal support and blood glucose levels.
Struggling with body positivity, overweight, and diabetes can be overwhelming. But it's possible to balance all three and improve your overall well-being.
In high school, when Samantha Puff was working at an amusement park, she remembers telling a co-worker that she had diabetes. The guy stepped back, looked her up and down, and said, “Huh. But you’re not that fat.” In that moment, she realized that to some people, there’s a “look” to having diabetes, she explains.
Puff, now 34 and living in Cincinnati, said she continues to battle body image issues around having diabetes, especially in a culture that promotes mixed messages around bodies — embrace your body as it is (but don’t be too fat). Curves are beautiful (but not too curvy).
These messages can be even more complicated with diabetes in a culture where even the medical field sometimes promotes weight loss as a way to improve diabetes management and overall health.
For example, the American Diabetes Association writes on its webpage for people with diabetes who need to lose weight: “Break the cycle. By losing just a few pounds with healthy eating and exercise, you’ll start to feel better. You’ll have more energy. And it will get easier to manage your diabetes, all while reducing your risk of developing other related problems.”
Puff said that hearing messages like that felt discouraging.
“I know I definitely struggled with body image throughout my life because I've never been skinny. As a teenager, I was extremely active and had more of an athletic build,” Puff says. “It was hard for me to feel good about myself when I was sick with something that had a stigma of being overweight, even though I was very active and fit.”
Mixed Messages
People with and without diabetes are exposed to messages such as singer Lizzo’s attempts to normalise bigger bodies, pushing against the norm that smaller frames and thighs are the only beautiful images, among her other messages. “I want to normalize my body,” she said in a 2020 Vogue cover story. But for people with diabetes, being above an ideal weight can be dangerous, increasing the odds of complications.
“We definitely live in a culture where being ‘healthy’ is synonymous with ‘skinny.’” Puff said, adding that this message can be even more difficult to hear for people with diabetes. “We can't just cut everything out of our diet. If we're hungry, we have to eat or else put ourselves at risk of getting a bad low. We have to be careful with exercise because our bodies react differently to it.”
She explains that she enjoys working out, but it can sometimes have adverse effects on her body. “It's never as easy as just grabbing my keys, heading to the gym, working out for an hour and calling it a day,” she said. “I have to make sure I test my sugar beforehand, lower my basal rate so I don't drop, and make sure I have snacks and juice on hand at all times.”
Diabetes educator Crystal Scott with Top Nutrition Coaching explains that social media contributes to this mixed messaging of telling people with diabetes, and others, that they should feel comfortable in their bodies, but at the same time they should lose weight to be healthier.
“Social media can be great, and it can also be toxic and lead to very unhealthy relationships with food,” she said. Instead, she works with clients through transparent conversations about “being comfortable” in their bodies at each stage, but also focusing on goals that promote health.
Getting real about the risks of excess weight with diabetes
Nobody needs a “friend” telling them about the latest weight loss fad while they navigate day-to-day life with diabetes. “My favourite part is when the non-diabetics tell us to ‘just do keto’ and the weight will ‘fall right off.’ For a ‘normal’ person, keto can be okay, but for a diabetic, the keto diet could put us in the hospital,” Puff said. She said she’s glad to see diabulimia finally recognized as an eating disorder.
Weight loss can be a major struggle for people with diabetes, and body acceptance is still essential at any weight. Scott says she does counsel her clients with diabetes on the potential effects of carrying too much weight. “It can lead to other things,” she said, “such as high cholesterol, high blood pressure, cardiovascular disease, chronic kidney disease.”
Your weight is a complex equation, of which diet and exercise only make up one part. You can be healthy at many different sizes. "Losing weight" alone can be hard (and impossible in some cases) but improving health by making small changes is the key. Things like sleep, stress, mental health, access to affordable healthcare are also part of the equation. A cohesive plan should focus on more than weight, Scott said: “How’s your sleep? How’s your energy? How do you feel? Where’s your mental and emotional space?”
Janet Zappe, a certified diabetes educator with The Ohio State University Wexner Medical Centre, explained that it only takes a small reduction in weight to make an impact on diabetes health, and it might not even change your “look” that much anyway.
“A healthy body is a beautiful body,” she said. “Bodies come in all shapes and sizes, and we want people to honour their bodies. If a person is overweight, losing 7% of their body weight yields tremendous health benefits with their pre-diabetes.”
She added that in most cases, 7% is not going to take people down to a size six or some idealized version of thin, and that skinny does not equal healthy.
Taking active steps toward improved body image at any size
Even in the face of trying to improve your overall health with your diabetes care team, mixed messages might mean accepting two realities at once.
Zappe’s colleague at Wexner Medical Centre, psychologist Sophie Lazarus, said, “Acknowledge that sometimes messages that seem oppositional can both be true; for instance, your body being beautiful and acceptable does not depend on its size, and losing weight or increasing exercise can improve your health outcomes.”
Lazarus and Zappe have a few tips for tackling this challenge of accepting your body and improving your health:
Start by working on loving and accepting your body for its uniqueness right now
Set boundaries around media or other sources telling you something different
Prioritize friendships, which are important for weight management and activity levels, especially spending time with like-minded people who have similar goals and values
Attend to emotional distress associated with diabetes, and the burden that can come with managing it by building coping skills
Make time to learn about diabetes and your health to feel more in control
Find new ways to address stress such as social support, prayer, meditation, and exercise
Finally, remember you are far from alone in struggling with body image issues with diabetes.
Did you know: Diabetes can have some severe consequences when left untreated? Scroll down to know what happens inside your body when blood sugar levels rise
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. It is one of those health conditions, which is irreversible as there is no cure for diabetes. This chronic medical condition affects the body's ability to regulate blood sugar levels. When left uncontrolled, or unmanaged, diabetes can cause several harmful side effects on various parts of the body.
How to know if you have diabetes? Look out for these signs and symptoms:
Increased thirst
Unexplained weight loss
Frequent urge to urinate
Blurry vision
Increased appetite
Have very dry skin
Numbness or tingling feeling on the feet
The above-mentioned are just the symptoms associated with diabetes, the condition can wreak havoc inside our body if left untreated. Check out the list of things it can do to your body.
10 Worrying Effects of Diabetes
Take a look at these 10 things that high blood sugar levels or diabetes can do inside your body when left unmanaged, or uncontrolled:
Cardiovascular Complications
When suffering from diabetes, it can increase your chances of developing severe cardiovascular diseases such as heart attacks, strokes, and peripheral artery disease. High blood sugar levels can damage blood vessels and contribute to the formation of plaque, this leads to the narrowing of the arteries and thus the usual blood flow gets disturbed.
Nerve Damage
Neurological damage or neuropathy is another worrying effect of diabetes. Studies have shown how prolonged exposure to high blood sugar levels can damage the nerves inside the body of the patient. This nerve damage can lead to the onset of symptoms such as numbness, tingling, and pain, typically in the hands and feet. This condition is known as diabetic neuropathy.
Kidney Damage
Nephropathy is another side effect of diabetes. Unmanaged high blood sugar can give rise to kidney diseases. As per studies, when left untreated, high blood sugar levels can damage the blood vessels inside the kidneys, impairing their ability to filter waste and excess fluid from the body. This can lead to the onset of chronic kidney disease.
Eye Complications
Eye complications, or retinopathy are another side effect of diabetes. Unregulated high blood sugar levels can affect the blood vessels inside the retina, causing severe issues for the eyes known as diabetic retinopathy. This condition can lead to severe vision problems and, if not managed, it can also result in serious vision loss or even blindness.
Foot Problems
Diabetic foot is a condition which is caused by poor circulation and nerve damage in the feet. This can make the patient vulnerable to foot ulcers, and infections, and also can slow the wound healing capacity. In some severe cases, diabetic foot treatment can also lead to foot or leg amputation.
Skin Conditions
High blood sugar can give the required environment for the bacteria and fungi to grow, thus leading to skin problems. Some of the skin issues that a diabetic can experience include dry skin, fungal and bacterial infections, itching, and slow wound healing.
Increased Risk of Infections
Diabetes can weaken a person's immunity and make their body prone to infections such as urinary tract infections, skin infections, and recurring yeast infections.
Poor Oral Health
High blood sugar can contribute to serious bacterial growth inside the mouth of the patient. It reduces the ability of the body to fight oral infections.
Mental Health Issues
Yes, you read that right. Poorly managed diabetes can also increase your risk of developing mental health disorders, such as depression and anxiety.
How To Manage Diabetes At Home?
Managing a chronic health condition like high blood sugar, or diabetes can be challenging both mentally and physically. It requires proper guidance from the experts to keep the blood glucose levels under control. However, since there is no cure for diabetes, and only lifestyle changes can help a patient deal with the side effects that comes with it, here are some diabetes management tips you need to follow:
Exercise regularly
Eat healthy and light
Get rid of extra body weight (fat)
Keep track of your blood sugar levels
Drink enough water throughout the day
Include foods in your diet which are lower in calories, saturated fat, trans fat, sugar, and salt.
Disclaimer: The above-given tips to manage diabetes or high blood sugar levels are only suggestions. They shouldn't be taken as a medical remedy. We suggest anyone who is experiencing the symptoms of diabetes, must visit the doctor and get their check-up done.
The right combination of food groups in the breakfast can help manage glucose levels for people with diabetes
Planning and preparing meals in summer can be a tedious affair. The discomfort of cooking in kitchen, often the warmest area of the house, may discourage one to experiment with their culinary skills in the season. Thinking of food that can whet appetite and takes less time to prepare is surely a challenge in hot summer months. However, having a meal plan ready for the sweltering summer days can come handy, especially for people with diabetes, who can't afford to take short cuts or skip important food groups that can aid in managing their blood glucose levels.
Diabetes as we all know is a metabolic disorder, that's on rise all over the world mainly due to the modern lifestyle that allows lesser time to stay active and eat healthy. Diabetes can lead to many complications for your heart, kidney, eyes and other health issues if the disease management is not up to the mark and the excess sugar remains in the bloodstream to wreak havoc on health.
Breakfast can play a crucial role in diabetes management considering it's the most important meal of the day. The right breakfast can also keep your energy levels up throughout the day and your moods better.
"Diabetes is a lifestyle disorder and can be managed well by making lifestyle changes. Breakfast is the most important meal of the day as it will kick start the day and help people with diabetes, especially on medication, prevent hypoglycaemia, better sugar control, and give the right nourishment to keep them active in the day. But the right combination of foods for breakfast is very important which will decide if it will spike the sugar levels or maintain them," says Avantii Deshpaande, Clinical Nutritionist, in an interview with HT Digital.
Breakfast can play a crucial role in diabetes management considering it's the most important meal of the day. (Freepik)
Avantii suggests 5 best breakfast ideas for people with diabetes this summer:
1. Yoghurt fruit parafait
This will help combine all good groups. A simple recipe which has a fruit, yoghurt or dahi along with granola can be a quick and easy on-the-go breakfast recipe. For people with diabetes, the original recipe can be tweaked a bit by replacing flavoured yoghurt with plain Greek yogurt or regular home-made curd. In summer, the choice of fruit could be a mango and you can also enjoy the delicious fruit in the best way possible. In place of granola, one can use roasted nuts and seeds mixture so that there is no extra sugar. The whole recipe can be topped with soaked sweet basil seeds to give a summer cooling effect.
How it prevents blood sugar spike
If you use a mango or any other fruit in this recipe along with curd and nuts it will reduce the glycaemic load of the fruit, ensuing that the sugar spike does not happen.
2. Paneer paratha, dal chillas, or eggs
Kick-start the day with a protein breakfast rather than carb-rich one like poha or upma. Dal chilas, eggs, idli with sambhar and chutney, parathas made with paneer, mixed besan, methi can be a good choice. For better management of diabetes make sure that you include protein in every meal.
How it prevents blood sugar spike
A protein rich breakfast always has an added advantage of keeping the sugar in control along with muscle building and better satiety.
3. Include loads of fibre
Make sure to include fibre in the breakfast. Fiber-rich foods include fresh fruits and vegetables and whole grains. It is best to add a fruit with a protein-rich breakfast when you have diabetes. A lot of times having a mixed fruit and vegetable juice like cucumber celery juice, tomato and mint juice or orange carrot with spinach, would be a great idea for the summers. But make sure that you keep the fibre intact and do not strain the juice.
How it prevents blood sugar spike
High-fibre foods take more time to digest and thus helps prevent sugar spikes.
4. Include good fats
Make sure to include good fats in your breakfast if you have diabetes. Good fats are the foods high in omega-3 fatty acids. Almonds, walnuts, flax seeds, melon seeds, chia seeds etc are great sources of omega-3 fatty acids. If you are in a hurry and want to ensure you get the nourishment for the day, consume a smoothie made with almonds, chia seeds and a fruit so you get the much-needed nourishment for the day. Having soaked sweet basil seeds with water is also a great way to get the dose of omega-3 fatty acids.
How it prevents blood sugar spike
Healthy fats can play an important role in regulating blood sugar levels by supplying anti-inflammatory and antioxidant benefits that can help regulate metabolism and body's response to insulin.
5. Hydrate well
You can end the breakfast with a glass of lemon water with black or pink salt added. This ensures that you get the electrolytes from the salt along with the lemon juice which is rich in vitamin C. Lemon juice will help in the absorption of the iron from the food too.
How it helps manage blood glucose levels
Studies have suggested that staying hydrated can keep blood sugar levels in control. Drinking adequate fluids in summer can also prevent dehydration which could worsen diabetes.
Type 2 diabetes is a progressive, chronic disease that prevents a person's body from properly using glucose (sugar). People with type 2 diabetes usually have insulin resistance and metabolic syndrome.
In type 2 diabetes, the cells become resistant to insulin, which is a hormone created by the pancreas that controls the amount of glucose in your bloodstream. As a result, the pancreas makes more insulin. Over time, the pancreas cannot produce enough insulin to keep blood sugars in a healthy range.
This article discusses the differences between type 1 and type 2 diabetes, as well as the symptoms, diagnosis, and treatment of type 2 diabetes.
Daisy-Daisy / Getty Images
Type 1 vs. Type 2 Diabetes: What It Means to Have Type 2
Type 1 and type 2 diabetes are both disorders in glucose metabolism. However, their clinical presentation and progression are different. It's important to differentiate between the two conditions since treatment plans differ.
Type 1 diabetes is an autoimmune disease. It occurs when the body mistakenly attacks the pancreas's insulin-making cells (beta cells). People with type 1 diabetes make little to no insulin and must take it via injection or infusion to live. Type 1 diabetes used to be called juvenile diabetes because it was more likely to be diagnosed in childhood. But it can also develop later in life.
Type 2 diabetes accounts for 90% to 95% of all diabetes cases. It is often referred to as a lifestyle disease because your weight, age, smoking, diet, and lack of exercise can increase your risk. People of certain racial and ethnic populations have a higher incidence of the disease, as well.
In addition, people who develop type 2 diabetes are more likely to have a cluster of factors, including high cholesterol, high blood pressure, high triglycerides, and abdominal adiposity (excess fat in the abdomen).
Type 2 Diabetes Symptoms
Type 2 diabetes develops gradually. Often, people do not have noticeable symptoms, especially in the earlier stages (prediabetes). As the disease progresses, you may experience:
Type 2 diabetes occurs when glucose (sugar) cannot enter the cells and stays in the bloodstream above normal levels. A defect in insulin secretion, insulin resistance, or a combination of both causes this. Certain contributing factors to the disease include:
Age: Diabetes occurs more frequently in people over 45.
Weight: You are considered overweight or obese if you have a body mass index (BMI) greater than 25 kilograms per meters squared (kg/m2) for most Americans (greater than or equal to 23 kg/m2 for Asian Americans), or have waist circumference greater than 40 inches in men or greater than 35 inches in women.
Lack of exercise: This generally is defined as less than three days a week of physical activity.
Race: Type 2 diabetes is more common among certain racial and ethnic populations, including African American, Native American, Latinx, and Asian American people.
Genetic predisposition: The lifetime risk of developing type 2 diabetes is 3 times higher in those who have a first-degree relative with the disease.
There is a genetic component to developing type 2 diabetes. However, genetics is complicated, and there is much to investigate and discover. Some genes connected to diabetes are related to insulin resistance, and others to beta cell function. Research shows a wide range of heritability of type 2 diabetes, ranging from 20% to 80%.
Type 2 Diabetes Diagnosis
There are several ways to diagnose type 2 diabetes, including with blood tests and blood draws during an oral glucose tolerance test (a test in which you drink a sugary drink and evaluate how your body responds to the sugar). Your healthcare provider may decide to do a random blood sugar test. A random blood sugar reading greater than or equal to 200 milligrams per decilitre (mg/dL) qualifies for a diabetes diagnosis.
Treatment for type 2 diabetes includes lifestyle changes, eating a nutritious diet, exercise, weight loss (when indicated), adequate sleep, and stress reduction. You can be prescribed oral, insulin, or non-insulin injectable medications to control blood sugar. Medications should always be used in conjunction with lifestyle changes, including changes to diet and exercise.
Receiving diabetes self-management education is important to help lower your risk of diabetes complications and decrease costs. It reduces or eliminates medications and emergency room visits and allows you access to cost-saving programmes.
Can Type 2 Diabetes Be Reversed?
Research shows that intensive lifestyle interventions, including changes in diet, exercise, and weight loss, can put diabetes into remission. There is a greater chance of this happening in people who have had diabetes for a shorter duration of time and those who can still make adequate amounts of insulin.
Type 2 Diabetes Diet: Foods to Eat and Avoid
There is no one-size-fits-all diet for diabetes. And while certain foods can increase blood sugars more quickly than others, there are no forbidden foods. Instead, you will benefit from a modified carbohydrate diet. Carbohydrates found in fruit, dairy, grains, starchy vegetables, legumes, snack foods, and desserts impact blood sugars the most.
Research suggests that people who eat more plants or follow a Mediterranean diet experience many health benefits, including a reduced risk of diabetes. This food plan contains various high-fibre foods, such as vegetables, fruits, nuts, seeds, beans, and whole grains. Foods higher in fibre have a more favourable effect on blood sugar because it is digested slowly, reducing large blood sugar spikes.
Aim for a well-balanced meal, especially concerning the amount of food and the types of carbohydrates you eat. A general rule of thumb is to limit carbohydrates to a portion about the size of your fist, which is equivalent to 1 cup of cooked grain. Fill up half your plate with vegetables, and always add lean protein to each meal.
Mediterranean Style of Eating
In a meta-analysis of 17 studies, the Mediterranean diet improved fasting glucose and A1C levels for those with type 2 diabetes.
To manage inflammation, a key factor in diabetes, choose foods that are lower in saturated and trans fats and higher in heart-healthy fats, such as:
Fatty fish like salmon
Walnuts
Flax
Chia seed
White meat chicken, turkey
Lean beef
Soy or soybean (tofu)
Tempeh
Reduce your intake of fried foods and cured meats like sausage, bacon, ham, and cold cuts. Bagels, white bread, and pasta can increase blood sugar quickly because they are high in carbohydrates and low in fibre. Large glucose fluctuations are associated with diabetes complications and cardiovascular disease. More research is needed to determine the exact effects.
Meeting with a registered dietitian who can help you maintain the pleasure of eating is important. They can teach you how to make some simple changes to your diet.
How to Check Blood Sugar
The number of times you should check your blood sugar depends on your glycaemic control and medication regimen. If you take medications such as insulin, you are at increased risk of developing hypoglycaemia (low blood sugar) and may need to check your numbers more frequently. It's also important to regularly check your blood sugar if you've started a new medication, made changes to your diet or exercise regimen, and want to reduce your intake of medicines.
A healthcare provider will tell you when and how to test using a glucometer. A continuous glucose monitor may be more appropriate for people who take specific medications, have had diabetes for a long time, or are at higher risk for low blood sugar.
Complications From Type 2 Diabetes
Chronically high blood sugar can cause microvascular and macrovascular complications. This means the small vessels, like those in the eyes, and larger ones, like those in the heart, can be affected.
Complications can impact nearly every body system and organ. Long-term complications include:
Untreated complications occur when someone does not know they have diabetes. Damage to the eyes can happen before a diabetes diagnosis is made, so a dilated eye exam is necessary every year after.
Elevated blood sugar can also cause acute conditions, such as diabetic ketoacidosis (more common in people with type 1 diabetes) or hyperglycaemic hyperosmolar nonketotic syndrome (more common in people with type 2 diabetes). Both conditions are emergencies and should be treated immediately.
Diabetes and Pregnancy: Gestational Diabetes
Gestational diabetes occurs during pregnancy and typically disappears once the baby is born. People with and without risk factors can develop gestational diabetes. Other risk factors include:
Genetics
Age
Weight
Ethnicity
Other health conditions
Previous pregnancy with gestational diabetes
Prediabetes
Changes in the body during pregnancy
Insulin resistance occurs in pregnancy during weeks 20 to 24. Gestational diabetes increases your chances of developing prediabetes and type 2 diabetes later in life. Screening after delivery and every three years after that will be necessary.
How to Prevent Type 2 Diabetes
Certain risk factors for type 2 diabetes, like genetics, are outside your control, but you can take steps to delay or prevent the development of type 2 diabetes. Make changes toward the modifiable factors, such as eating patterns and physical activity. Small, sustainable, and consistent changes are the longest lasting and impactful.
Diet
What you eat can significantly impact your blood sugars and overall health. Eating a variety of foods that are rich in colour, such as fruits and vegetables, provides antioxidants that combat inflammation. Choosing carbohydrates rich in fiber is important for blood sugar control and is associated with a reduced risk of heart disease and diabetes.
Decrease added sugar in foods and beverages, which can significantly improve your blood glucose and promote warranted weight loss. Find healthier alternatives, such as sugar-free beverages or carbonated seltzer without added sugar. Use artificial sweeteners or sugar-free alternatives because these substances do not get digested or metabolized in the body.
Physical Activity
Exercise improves insulin sensitivity; it helps your body use the insulin you make more efficiently. Find an activity you love, start slowly, and build up gradually. If you are new to exercise, get clearance from a healthcare provider before starting.
Weight Loss
A small amount of weight loss (5% to 7%) in those that need to lose weight can significantly impact blood sugars. The scale doesn't have to be your only measurement tool. Another way to measure success is to assess your energy, how your clothes fit, or if you are getting better sleep.
Consult with your healthcare provider to develop the best weight loss management or program that fits your needs. Losing weight is encouraged for people with excess weight with chronic diseases. Following a weight management plan can help you stay on track with your nutrition and fitness goals.
Sleep
Studies have shown that sleep problems can increase the risk of insulin resistance and prediabetes. Aim to get seven to nine hours of sleep per night. If your nightly patterns are way off, make gradual changes, such as going to bed 15 minutes earlier each night.
Other Factors
Having a healthy gut microbiome, reducing stress, and not smoking are all important factors in reducing inflammation.
Daily Management of Type 2 Diabetes
Daily management of type 2 diabetes requires making decisions about food, medicines, exercise, blood sugar testing, and more. You can live a healthy life with diabetes.
Whether you are newly diagnosed or have had diabetes for a long time, finding support and seeking education or further education regarding your condition will help you to manage your disease better. Contact your healthcare provider and insurance carrier to evaluate your options, such as meeting with a certified diabetes care and education specialist (CDCES).
Outlook
Type 2 diabetes is a serious and chronic health condition that needs to be managed daily. People with diabetes are at increased risk of developing complications, especially if they have had it for a long time or it is poorly managed. But you can take steps to delay, prevent, and manage the disease. Your treatment plan will be unique to you and should take into consideration your age, weight, lifestyle, health history, culture, and economics.
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