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About Type 2 Diabetes

The most common types of diabetes, affecting over 90 percent of diabetics, is type 2, or non-insulin-dependent diabetes mellitus (NIDDM). Also termed adult-onset diabetes, type 2 diabetes develops when the body still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). Unfortunately, because of the growing obesity problem in children, type 2 diabetes is beginning to show up in this population.

There is also a condition called Impaired Glucose Regulation (commonly known as prediabetes), where people have an increased risk of developing Type 2 diabetes. Having prediabetes also increases risk of heart disease.

What Causes It?

People are more likely to develop Type 2 diabetes if they are overweight; have a large waist, have a close relative with the condition; or are from a black or South Asian background. Being overweight or obese is the biggest risk factor. It usually affects people over the age of 40, though it often affects South Asian people from the age of 25.

Signs and Symptoms of Type 2 Diabetes

Almost half of all North Americans who have diabetes (6 million) may not know it. Because type 2 predominantly occurs in adults over 40, the signs and symptoms of type 2 diabetes may be confused with the general signs of aging and may be mild and go unnoticed. Although they may not experience any symptoms, the disease may be damaging to the heart, blood vessels, nerves, kidneys, eyes, and other organs.

  • increased thirst and need to urinate
  • feeling edgy, tired and sick to the stomach
  • increased appetite but loss of weight
  • repeated or hard to heal infections of the skin, gums, vagina or bladder
  • blurred vision
  • tingling or loss of feeling in the hands or feet
  • dry, itchy skin
  • cuts and bruises that are slow to heal

Treatment for Type 2 Diabetes

Initially, type 2 diabetes can often be controlled with a healthy diet and regular physical activity. Medication is also often required and a significant minority of people eventually progress to needing insulin. Adults over the age of 50 should have their blood sugar levels tested every 2 years, or more often if they are overweight, or have a family history. Treatment of diabetes is an ongoing process of management and education. Its success depends on the patient’s health care team, family members and motivation of the patient to monitor his/her blood sugar levels. Through regular physical activity, meal planning, and routine health care, many people can effectively control their diabetes. Elements of treatment can include:

  • weight control
  • proper diet
  • exercise
  • insulin replacement therapy as directed and monitored by the treatment team

When diet and exercise are not enough to control blood sugars,insulin must be added to the treatment equation. This can be delivered as insulin shots or oral medications.

Only people with type 2 diabetes can take oral medications. Oral insulin is ineffective for people with type 1 diabetes because in type 1 diabetes the pancreas has lost all ability to make insulin. People with type 2 diabetes still make some insulin, but it is inadequate and their bodies can’t metabolize glucose efficiently.

Physicians often combine diabetes oral medications with insulin shots in people who have hard to control type 2 diabetes. These oral medications do not replace other aspects of a treatment plan, especially weight control, exercise and an appropriate diet. In addition, these shots may not be ideal for everyone. Insulin is still needed during illness, pregnancy, or surgery.

Complications of Type 2 Diabetes

Without stable control of blood sugar levels, untreated or inappropriately treated diabetes can cause long-term complications which may affect the kidneys, heart, legs, feet, eyes, nerves, and blood flow. Diabetic patients have a high rate of kidney and heart failure, gangrene and amputation, blindness and stroke. For these reasons, it is imperative to closely monitor blood sugar and follow a regulated treatment plan. Recent studies indicate that people who keep their blood sugars as close to target as possible can reduce developing some of these complications by 50% or more.