Newly Diagnosed With Type 2 Diabetes
Knowing where to get started following a type 2 diagnosis can be a challenge. You may feel overwhelmed, but its important to know there isnt a one-size fits all approach to managing the condition.
As well as using the information on this page to understand your condition, you can meet other people with type 2 diabetes in our Learning Zone. Youll hear advice from others in your position, and get practical tools to help you feel more confident managing your condition.
Favorite Alternative Medicine Resource
Want to give the ketogenic diet a whirl to better manage diabetes? This pioneering program from the Cleveland Clinic offers a way to do just that, with trained counselors who can help you adjust your diet and medication along the way.
The FOMO on diabetes products ends now. This feature by the magazine and website Diabetes Forecast rounds up the best of the best in CGMs , glucagon kits, insulin pens, and more.
Is Type 2 Diabetes Increasing
Type 2 diabetes is increasing at an epidemic rate, and is being diagnosed at younger and younger ages. The most likely reason for this increase is that individuals with a genetic susceptibility to type 2 diabetes are developing the disease due to lifestyle changes namely less physical activity, weight gain, and longer life span.
The good news is that scientific research confirms that by eating healthy foods, exercising regularly and maintaining an ideal body weight, you can delay or prevent the onset of type 2 diabetes.
How To Wean Off Of Diabetes Medication
One of my greatest pleasures in life is to help patients achieve remission of their type 2 diabetes. This means their blood sugar levels have become normal in the absence of any diabetes medication.
Many clinicians and patients are interested in learning my views about how to go about decreasing and discontinuing diabetes medications. The main role for medications is to help reduce or delay the risk of nasty complications of diabetes, particularly the damage to the retina, kidney, nerves, and circulation. The higher the average blood sugar level, as indicated by the hemoglobin A1c level, the greater the complication risk . We know from clinical trials that using medication to keep the A1c at or below 7% can help reduce the risk of these complications. There is broad agreement that clinicians should recommend starting or increasing diabetes medications to patients who cannot get their A1c level to 7% or less via lifestyle change.
Most patients I see are already taking metformin, which is the preferred second line treatment after lifestyle change. Opinions differ about when to start this drug. Some experts advocate starting it in patients who have pre-diabetes because clinical trial evidence demonstrates that it can delay the progression to type 2 diabetes, while other experts could argue that there is little evidence that it reduces diabetes complications when the A1c is below 7.0%, so no point in starting it until 7.0% It is important to discuss these issues with patients.
Monitoring Your Own Blood Glucose
If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.
Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels.
Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.
A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful for detecting high blood glucose or low blood glucose .
If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.
Blood glucose meters aren’t currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you’re unsure.
Read about diabetic eye screening.
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If You Have Questions About Your Diagnosis
It’s usually difficult to take in everything the GP tells you during the appointment.
Talk to family and friends about what the GP told you, and write down any questions you have.
Then make another GP appointment and take your list of questions with you.
There’s also a lot of information on diabetes available.
These Are Some Of The Statistics:
- 80-90% of people with Type 2 diabetes have other family members with diabetes.
- 10-15% of children of a diabetic parent will develop diabetes.
- If one identical twin has type 2 diabetes, there is up to a 75% chance that the other will also be diabetic.
- There are many genetic or molecular causes of type 2 diabetes, all of which result in a high blood sugar.
- As yet, there is no single genetic test to determine who is at risk for type 2 diabetes.
- To develop type 2 diabetes, you must be born with the genetic traits for diabetes.
- Because there is a wide range of genetic causes, there is also a wide range in how you will respond to treatment. You may be easily treated with just a change in diet or you may need multiple types of medication.
The hallmark of type 2 diabetes is resistance to the action of insulin and insufficient insulin to overcome that resistance
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About Type 2 Diabetes
Diabetes is usually a lifelong condition that causes a person’s blood glucose level to become too high.
The hormone insulin produced by the pancreas is responsible for controlling the amount of glucose in the blood
There are two main types of diabetes:
- type 1 where the pancreas doesn’t produce any insulin
- type 2 where the pancreas doesn’t produce enough insulin or the body’s cells don’t react to insulin
This topic is about type 2 diabetes.
Read more about type 1 diabetes
Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth.
How To Lower Blood Sugar With Diet
What happens if you remove foods that raise your blood sugar from your diet? Is there anything good left to eat? We think so. In fact, we have a whole guide on the best foods to control diabetes.
But a picture is worth a thousand words. These are just a few of the delicious foods that dont raise blood sugar for just about everyone:
Many people with type 2 diabetes are now choosing a diet based primarily on low-carb foods, and many clinicians are catching on as well.14
A person with type 2 diabete will often notice that, starting with the first meal, their blood sugar improves. The need for medications, especially insulin, is usually dramatically reduced. Substantial weight loss and health marker improvements often follow.15 Finally, people usually feel better and have more energy and alertness. 16
Choosing foods low in carbs is an effective way to help you control your blood sugar and is safe for most people. However, if you are taking medications for your diabetes, you must work with your healthcare provider to adjust your medications when you change your diet since the need for medications, especially insulin, may be greatly reduced.17
If you are looking for a doctor who will work with you to control your diabetes with a change in diet, our map may help you find one.
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Can Type 2 Diabetes Be Reversed
Yes! The good news is that several studies have shown that type 2 diabetes can be reversed. You are considered in remission from type 2 diabetes when you have had normal blood sugar levels for a year without medication.
One of the most important components in reversing type 2 diabetes is early detection. Dr. Bergquist explains, The pancreas produces insulin. The longer you have diabetes, the more damage your insulin resistance causes to your pancreas, and the less likely your pancreas is to recover. Hence, the possibility for remission decreases the longer you have diabetes. But theres a wide window during which you can be successful.
What Is Diabetes And Does It Qualify For The Disability Tax Credit
Diabetes prevents the body from either not producing or correctly using insulin. Insulin is a hormone that controls the amount of glucose in the blood. Diabetes leads to high blood sugar levels, which can damage organs, blood vessels and nerves. The body needs insulin to use sugar as an energy source.
There are two types of diabetes:
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What Is The Difference Between Type 1 And Type 2 Diabetes
In type 1 diabetes, people produce little or no insulin, as the insulin-producing cells have been destroyed by the bodys immune system. Type 1 diabetes is an auto-immune disease.
In type 2 diabetes, the body may make enough insulin early in the disease, but doesnt respond to it effectively. As type 2 diabetes progresses, the pancreas gradually loses the ability to produce enough insulin. Type 2 diabetes is associated with inherited factors and lifestyle risk factors such as being overweight or obese, poor diet, and insufficient physical activity.
Monitoring Blood Glucose Levels
If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months.
This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.
The HbA1c test is used to measure blood glucose levels over the previous two to three months.
HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.
A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.
Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 53 mmol/mol or individualised as agreed with your diabetes team.
Read more about the HbA1c test
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What Is The Connection Between Ldl
In a person with diabetes, there is a condition called, diabetic dyslipidemia.
It is characterized by a triad that includes:
- low HDL-C
- high LDL-C
- high triglycerides
In research, they have found that there is a link between the insulin resistance in Type 2 diabetes and diabetic dyslipidemia that tends to cause people with Type 2 diabetes to get heart disease or a stroke at a younger age than people without Type 2 diabetes. Due to the size of LDL-C molecules and other factors in people with diabetes, there exists ability for diabetes to effect the lowering of the good cholesterol in the blood, all while promoting an increase in the bad cholesterol. This premature risk is all the more reason to work with your primary care provider to manage cholesterol when you have diabetes. Lifestyle habits likely play a role in the increased risk, with some people developing dyslipidemia prior to a diagnosis of Type 2 diabetes. Therefore, it is important to manage cholesterol for general health throughout life.
What Are Women’s Type 2 Diabetes Risks
Women who developed gestational diabetes in pregnancy have a higher risk for developing type 2 diabetes later in life. The same goes for women who have babies larger than 9 pounds.
Polycystic Ovary Syndrome
Polycystic ovary syndrome is a health problem characterized by many small cysts in the ovaries, irregular periods, and high levels of androgen hormones. Because one symptom of polycystic ovary syndrome is insulin resistance, women with this condition are considered at higher risk for diabetes as well.
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Cholesterol And Pre Diabetes
A dyslipidemia may clue providers in to the need to test a person for pre-diabetes or diabetes due to the connection between the insulin resistance in Type 2 diabetes and dyslipidemia. A patients A1C may show in the pre-diabetes range of 4.8-5.6 percent. This serves to give the person a heads up related to managing their dyslipidemia and pre-diabetes state with diet and exercise. The goal in pre-diabetes is generally to lose 5-7 percent of overall weight, and to obtain 150 minutes of physical activity in a week, along with healthy eating, in order to prevent Type 2 diabetes.
Health Problems Linked To Type 2 Diabetes
If your blood sugar is frequently imbalanced, you may be at a greater risk for the following type 2 diabetes complications:
Diabetic Retinopathy In diabetic retinopathy, high blood sugar weakens the capillaries that supply the retina, the light-sensitive layer of tissue at the back of the inner eye.
The capillaries then swell, become blocked, or leak blood into the center of the eye, blurring vision. In advanced stages, abnormal new blood vessels grow.
Diabetic Neuropathy Neuropathy, or nerve damage, can affect any nerve in your body. Most commonly, it affects the nerves in the feet, legs, hands, and arms this condition is called peripheral neuropathy.
Peripheral neuropathy can cause tingling, burning, pain, or numbness in the affected areas.
The pain of peripheral neuropathy is difficult to control, though some find topical products that contain capsaicin to be helpful.
Diabetic Nephropathy In diabetic nephropathy, the nephrons in the kidneys become damaged from chronic high blood sugar.
High blood pressure compounds the problem, and high cholesterol appears to contribute to it as well.
In the early stages of diabetic nephropathy, you may not notice any symptoms, but standard blood and urine tests can detect early signs of dysfunction, and early treatment can stop or slow its progression.
Diabetic Ulcer People with diabetes have an increased risk of developing foot ulcers .
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Dangers Of High Cholesterol And Diabetes
There is an increased risk for cardiovascular disease with diabetes. Dyslipidemia or problems with cholesterol compound the problems presented by high blood glucose. In other words, its a double whammy. A little further along in this article, we will talk about diabetes as an actual risk factor for heart disease.
Carbohydrates And Blood Sugar
Carbohydrates, or carbs, usually come from starches or sugars and turn into glucose when they are digested. When glucose enters the bloodstream, its called blood glucose, or blood sugar.
The more carbohydrate eaten in a meal, the more sugar is absorbed into the bloodstream and usually the higher the blood sugar will be.
Although very few people would agree that sugary foods are good for you, some foods that we think of as healthy such as fruit can have a lot of sugar. And many people dont know that starchy foods such as bread, rice, pasta, and potatoes quickly turn to sugar when you digest them.10
For some people, eating a potato could raise blood sugar as much as eating 9 teaspoons of sugar! It can be hard to predict exactly how someones blood sugar will respond, as this will likely vary based on genetics and baseline insulin sensitivity.11 By testing your blood sugar before eating and every 30-minutes after eating for up to two hours, you can quickly learn how different foods affect your blood glucose level. The results may surprise you!
Chart: Dr. David Unwin
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Genes And Family History
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
- African Americans
- Native Hawaiians
- Pacific Islanders
Genes also can increase the risk of type 2 diabetes by increasing a persons tendency to become overweight or obese.
List Of Statin Drugs To Lower Cholesterol
The doctor may prescribe one of the following medications to help lower cholesterol:
The consensus has been that heart benefits are greater than diabetes risk.
So should I take statins?
If you want to reduce your risk for heart disease, then you should take statins. Currently, statin use is recommended by the American Diabetes Association for people with diabetes who have high cholesterol. Some people stop taking statins due to adverse side effects. Talk with your doctor before stopping any of your medicines. You shouldnt consume grapefruit if you take statins, as grapefruits increase uptake, and may increase side effects. You will want to avoid fibrates, warfarin , some antibiotics, and some HIV medicines. Talk to your pharmacist to see if any drugs you are taking might interact with statins.
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Treatment For Low Blood Glucose
If you have type 2 diabetes that’s controlled using insulin or certain types of tablets , you may experience episodes of hypoglycaemia.
Hypoglycaemia is where your blood glucose levels become very low.
Mild hypoglycaemia can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.
If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets.
This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit.
In most cases, these measures will be enough to raise your blood glucose level to normal. You should aim for a hypo to be treated and to recheck your blood glucose level within 15 minutes.
If blood glucose still less than 4mmol/l then repeat the treatment using a fast acting carbohydrate. When your blood glucose returns to normal then have your longer acting carbohydrate.
If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness.
If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.
You may require input from a health care professional. If the glucagon is not successful, you may require an injection of dextrose into your vein.
Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.