Type 2 Diabetes: Causes, Risk Factors and Healthy Tips

Diabetes brings health threats that can shorten your life and reduce your quality of life. People with diabetes are two to four times more likely to have a heart attack or stroke than those without. Other complications include eye disease, kidney failure and nerve damage that can lead to foot ulcers and even amputations.

Timely screening for diabetes and prediabetes and getting control early can help limit or avoid complications. “We are learning more and more about diabetes every day,” says Dr. Jessica Shill, an endocrinologist with Henry Ford Health System. “Very powerful treatments and technologies are emerging quickly, especially for type 2 diabetes. There are so many more options for management than there were even 10 years ago.”

More than 23 million American adults have been diagnosed with diabetes, and experts estimate that an additional 7 million have the disease but don't know it, according to the American Diabetes Association, or ADA.

Typical symptoms include unusual thirst, more frequent urination, blurred vision, and recurring yeast or bladder infections. But many patients with type 2 have none of these.

“The cells that make insulin start declining 10 to 15 years before the onset of type 2 diabetes,” Dr. Shill says. “Most people who are diagnosed have had it for many years already.”

Insulin Resistance and Deficiency

Type 2 diabetes is mostly the result of one or two factors: The body does not make enough insulin, and/or it doesn’t respond properly to the insulin it makes. 

The American Diabetes Association recommends that all adults begin diabetes screening at age 45. Those with other risk factors should be tested earlier. Type 2 is diagnosed by one of the following tests, which can also be used to monitor your disease after diagnosis.

  • A1C is the measure of average blood sugar, or blood glucose, for the past two to three months. This is generally the most thorough approach, but it can be less accurate for those who recently had surgery and lost blood, are anemic and recently started taking iron, or have a narrowed heart valve, kidney disease or end-stage kidney failure. A diagnosis of diabetes requires two readings of 6.5 percent or greater. 5.7–6.4 percent is prediabetes.
  • Fasting plasma glucose measures blood sugar when fasting. A reading of 126 or higher indicates diabetes; 100-125 is prediabetes.
  • Oral glucose tolerance test measures how well your body uses glucose. A reading between 140 and 199 indicates prediabetes. 200 and above indicates diabetes.

Risk Factors

Aging is a major risk factor for type 2 diabetes, Dr. Shill says. As our bodies age, the cells that make insulin don't function as well as they should. Other factors include:

  • Family history: a parent or sibling with diabetes.
  • Ethnicity: Asians, Pacific Islanders, African-Americans, Latinos and Native Americans have a higher risk than Caucasians.
  • Body weight: determined by a body mass index of 25 and above, or over 23 for Asians.
  • Other health conditions: a history of heart disease, high blood pressure, high cholesterol or high triglyceride levels.

Managing Blood Sugar

If you’ve been diagnosed, you’ll work with a diabetes team that may include a doctor and/or nurse practitioner, nurse, diabetes educator and dietitian who will help you to manage your disease. They’ll work together with you to help set target blood sugar goals. Laboratory tests and home monitoring help you reach your blood sugar goals.

Treatment may include the oral drug metformin, says Dr. Shill. Some people may need other oral medications and/or hormone injections, including insulin.

But diabetes also depends on self-treatment, which includes lifestyle changes to increase your physical activity and alter your diet. This especially focuses on managing carbohydrates by cutting sugary and high-starch foods and replacing them with whole grains, fruits and vegetables.

Living Longer and Healthier

Dr. Shill says Americans are living longer lives with type 2 diabetes because of early intervention, lifestyle changes and improved drugs.

Our bodies have a “metabolic memory,” Dr. Shill says, which means if we control diabetes early, we can significantly reduce the risk of complications later

HAP’s Care Management Program

If you’ve been diagnosed with type 2 diabetes, HAP can help. We have nurse health coaches who can personalize a plan just for you. This can include telephone coaching and a three-month program to help you learn how to manage your diabetes. We also offer medication monitoring, help managing the ways the disease changes your life, and screening and test reminders. Learn more here.

The American Diabetes Association has tips on improving your diet and developing a healthy exercise regimen. Click here then search food and fitness.

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Categories: Get Healthy