Causes Of Type 2 Diabetes
Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin. This means glucose stays in the blood and isn’t used as fuel for energy.
Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. Due to increased obesity, type 2 diabetes is now being seen in young people and all ages. It’s far more common than type 1 diabetes.
Read about the causes and risk factors for type 2 diabetes
What Are The Warning Signs Of Heart Attack And Stroke
- pain or pressure in your chest that lasts longer than a few minutes or goes away and comes back
- pain or discomfort in one or both of your arms or shoulders, or your back, neck, or jaw
- shortness of breath
- indigestion or nausea
- feeling very tired
Treatment works best when it is given right away. Warning signs can be different in different people. You may not have all the listed symptoms.
Women may experience chest pain, nausea, and vomiting; feel very tired ; and have pain that spreads to the back, neck, throat, arms, shoulders, or jaw. People with diabetes-related nerve damagemay not notice any chest pain.
If you have , its important to know how and when to seek medical treatment.
- weakness or numbness of your face, arm, or leg on one side of your body
- confusion, or trouble talking or understanding
- dizziness, loss of balance, or trouble walking
- trouble seeing out of one or both eyes
- sudden, severe headache
If you have any one of these warning signs, call 9-1-1. You can help prevent permanent damage by getting to a hospital within an hour of a stroke.
Sglt2 Inhibitors And Glp
In 2018, new guidelines also recommended prescribing additional drugs for people with:
- atherosclerotic cardiovascular disease
- chronic kidney disease
These are sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists.
For those with atherosclerotic cardiovascular disease and a high risk of heart failure, the guidelines advise doctors to prescribe an SGLT2 inhibitor.
GLP-1 receptor agonists work by increasing the amount of insulin the body produces and decreasing the amount of glucose that enters the bloodstream. It is an injectable drug. People may use it with metformin or alone. Side effects include gastrointestinal problems, such as nausea and a loss of appetite.
SLGT2 inhibitors are a new type of drug for lowering blood glucose levels. They work separately from insulin, and they may be useful for people who are not ready to start using insulin. People can take it by mouth. Side effects include a higher risk of urinary and genital infections and ketoacidosis.
Learn more about other medications and treatments for managing diabetes by .
effective diabetes management , helping to regulate meal scheduling, physical activity, and when to take medication, including insulin.
While self-monitoring blood glucose machines vary, they will generally include a meter and test strip for generating readings and a lancing device to prick the skin for obtaining a small quantity of blood.
Take the following precautions:
Extremely Dry Itchy Skin
Dry, itchy skin
If you have diabetes, youre more likely to have dry skin. High blood sugar can cause this. If you have a skin infection or poor circulation, these could also contribute to dry, itchy skin.
Take action
- Tell your doctor about your extremely dry skin. Gaining better control of diabetes can reduce dryness.
- If you continue to have dry skin after you gain better control of your diabetes, a dermatologist can help.
Obesity And Belly Fat
Being overweight or having obesitycan make it harder to manage your diabetes and raise your risk for many health problems, including heart disease and high blood pressure. If you are overweight, a healthy eating planwith fewer calories and more physical activity often will lower your blood glucose levels and reduce your need for medicines.
Excess belly fat around your waist, even if you are not overweight, can raise your chances of developing heart disease.
You have excess belly fat if your waist measures
- more than 40 inches and you are a man
- more than 35 inches and you are a woman
What Are The Other Types Of Diabetes
Gestational diabetes
Diabetes can occur temporarily during pregnancy, and reports suggest that it occurs in 2% to 10% of all . Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 35% to 60% of women with gestational diabetes will eventually develop type 2 diabetes over the next 10 to 20 years, especially in those who require insulin during pregnancy and those who remain overweight after their delivery. Women with gestational diabetes are usually asked to undergo an oral glucose tolerance test about six weeks after giving birth to determine if their diabetes has persisted beyond the pregnancy, or if any evidence is present that may be a clue to a risk for developing diabetes.
Secondary diabetes
“Secondary” diabetes refers to elevated blood sugar levels from another medical condition. Secondary diabetes may develop when the pancreatic tissue responsible for the production of insulin is destroyed by disease, such as chronic pancreatitis , , or surgical removal of the pancreas.
Hormonal disturbances
Medications
Certain medications may worsen diabetes control, or “unmask” latent diabetes. This is seen most commonly when steroid medications are taken and also with medications used in the treatment of infection .
People With Difficulty Maintaining Blood Glucose Levels
The term brittle diabetes has been used to refer to people who have dramatic recurrent swings in blood glucose levels, often for no apparent reason. However, this term is no longer used. People with type 1 diabetes may have more frequent swings in blood glucose levels because insulin production is completely absent. Infection, delayed movement of food through the stomach, and other hormonal disorders may also contribute to blood glucose swings. In all people who have difficulty controlling blood glucose, doctors look for other disorders that might be causing the problem and also give people additional education on how to monitor diabetes and take their drugs.
What Insulin Medications Are Approved To Treat Diabetes
There are many types of insulins for diabetes. If you need insulin, you healthcare team will discuss the different types and if they are to be combined with oral medications. To follow is a brief review of insulin types.
- Rapid-acting insulins: These insulins are taken 15 minutes before meals, they peak at one hour and work for another two to four hours. Examples include insulin glulisine , insulin lispro and insulin aspart .
- Short-acting insulins: These insulins take about 30 minutes to reach your bloodstream, reach their peak effects in two to three hours and last for three to six hours. An example is insulin regular .
- Intermediate-acting insulins: These insulins reach your bloodstream in two to four hours, peak in four to 12 hours and work for up to 18 hours. An example in NPH.
- Long-acting insulins: These insulins work to keep your blood sugar stable all day. Usually, these insulins last for about 18 hours. Examples include insulin glargine , insulin detemir and insulin degludec .
There are insulins that are a combination of different insulins. There are also insulins that are combined with a GLP-1 receptor agonist medication .
What Is The Link Between Diabetes Heart Disease And Stroke
High blood glucose from diabetes can damage your blood vesselsand the nerves that control your heart and blood vessels. Over time, this damage can lead to heart disease.1
People with diabetes tend to develop heart disease at a younger age than people without diabetes. Adults with diabetes are nearly twice as likely to have heart disease or stroke as adults without diabetes.2,3
The good news is that the steps you take to manage your diabetes also help lower your chances of having heart disease or stroke.
Manage Your Diabetes Abcs
Know your diabetes ABCs to help you manage your blood glucose, blood pressure, and cholesterol. Stop smoking if you have diabetes to lower your chances of developing heart disease.
A is for the A1C test. The A1C testshows your average blood glucose level over the past 3 months. This is different from the blood glucose checks you do every day. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. High levels of blood glucose can harm your heart, blood vessels, kidneys, feet, and eyes.
The A1C goal for many people with diabetes is below 7%. Some people may do better with a slightly higher A1C goal. Your A1C goals may also change as you get older and your lifestyle changes. Ask your health care team what your goal should be.
B is for blood pressure. Blood pressure is the force of your blood against the wall of your blood vessels. If your blood pressure gets too high, it makes your heart work too hard. High blood pressure can cause a heart attack or stroke and damage your kidneys and eyes.
The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be.
S is for stop smoking. Quitting smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels, so your heart has to work harder. E-cigarettes arent a safe option either.
If you quit smoking
Preventing Comorbidities In Diabetes
If you have diabetes, you can reduce your risk of developing comorbidities by modifying the lifestyle factors that put you at risk, such as:
- Maintaining a health weight
- Stopping smoking
- Getting adequate sleep
- Reducing stress
In addition, it’s vital to get regular medical check-ups and recommended health screenings. These can identify conditions earlier in their development and may prevent full-blown diseases.
Outbreak Of Small Reddish
When these bumps appear, they often look like pimples. Unlike pimples, they soon develop a yellowish color. Youll usually find these bumps on the buttocks, thighs, crooks of the elbows, or backs of the knees. They can form anywhere though.
Eruptive-xanthomatosis
These bumps appear suddenly and clear promptly when diabetes is well-controlled.
When these bumps appear, they often look like pimples. Unlike pimples, they soon develop a yellowish color. Youll usually find these bumps on the buttocks, thighs, crooks of the elbows, or backs of the knees. They can form anywhere though. No matter where they form, they are usually tender and itchy. The medical name for this skin condition is eruptive xanthomatosis.
Take action
- Tell your doctor about the bumps because this skin condition appears when you have uncontrolled diabetes.
- Talk with your doctor about how to better control your diabetes.
What Is Type 1 Diabetes
In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients’ own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically , though the details are not fully understood.
Exposure to certain viral infections or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. Some of the antibodies seen in type 1 diabetes include anti-islet cell antibodies, anti-insulin antibodies and anti-glutamic decarboxylase antibodies. These antibodies can be detected in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes.
When Should I Call My Doctor
If you havent been diagnosed with diabetes, you should see your healthcare provider if you have any symptoms of diabetes. If you already have been diagnosed with diabetes, you should contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or if you develop any new symptoms.
What Is The Trend Of Diagnosed Diabetes Over Time
Between 20032004 and 20132014, there was a relative increase of 37.3%Footnote i in the age-standardized prevalence of diagnosed diabetes, from 5.6% to 7.8%. During the same period, the age-standardized incidence rate fluctuated. It increased until 20062007, from 6.7 to 7.6 per 1,000 population, but then it decreased to 6.3 per 1,000 population by 20132014, slightly below its original level . This implies that factors other than an increase in new diabetes diagnoses contributed to this rise in prevalence, including the fact that Canadians with diabetes now live longer. With the growth and aging of the Canadian population, the number of Canadians living with diabetes is also expected to increase in the coming years.
Figure 3: Age-standardized prevalence and incidence of diagnosed diabetes among Canadians aged 1 year and older, 20032004 to 20132014
| Fiscal year | |
|---|---|
| 7.8 | 6.3 |
Notes: Age-standardized estimates to the 2011 Canadian population. The 95% confidence intervals are not shown as they were too small to be illustrated.Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, May 2017.
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.
What Oral Medications Are Approved To Treat Diabetes
Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. Its beyond the scope of this article to review all of these drugs. Instead, well briefly review the main drug classes available, how they work and present the names of a few drugs in each class. Your healthcare team will decide if medication is right for you. If so, theyll decide which specific drug are best to treat your diabetes.
Diabetes medication drug classes include:
Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose control. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide and lixisenatide .
Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.
Exercise And Diet Tips
If a doctor diagnoses a person with type 2 diabetes, they will often recommend making lifestyle changes to support weight loss and overall health.
A doctor may refer a person with diabetes or prediabetes to a nutritionist. A specialist can help a person with diabetes lead an active, balanced lifestyle and manage the condition.
Steps a person can take to embrace a lifestyle with diabetes include:
- Eating a diet high in fresh, nutritious foods, including whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fat sources, such as nuts.
- Avoiding high-sugar foods that provide empty , or calories that do not have other nutritional benefits, such as sweetened sodas, fried foods, and high-sugar desserts.
- Refraining from drinking excessive amounts of alcohol or keeping intake to less than one drink a day for women or two drinks a day for men.
- Engaging in at least 30 minutes exercise a day on at least 5 days of the week, such as of walking, aerobics, riding a bike, or swimming.
- Recognizing signs of low blood sugar when exercising, including dizziness, confusion, weakness, and profuse sweating.
People can also take steps to reduce their body mass index , which can help some people with type 2 diabetes manage the condition without medication.
Slow, steady weight loss goals are more likely to help a person retain long-term benefits.
What Is Diabetic Ketoacidosis
Diabetic ketoacidosis is a life-threatening condition. It happens when your liver breaks down fat to use as energy because theres not enough insulin and therefore glucose isnt being used as an energy source. Fat is broken down by the liver into a fuel called ketones. The formation and use of ketones is a normal process if it has been a long time since your last meal and your body needs fuel. Ketones are a problem when your fat is broken down too fast for your body to process and they build up in your blood. This makes your blood acidic, which is a condition called ketoacidosis. Diabetic ketoacidosis can be the result of uncontrolled Type 1 diabetes and less commonly, Type 2 diabetes.Diabetic ketoacidosis is diagnosed by the presence of ketones in your urine or blood and a basic metabolic panel. The condition develops over several hours and can cause coma and possibly even death.
Take Medicine To Protect Your Heart
Medicines may be an important part of your treatment plan. Your doctor will prescribe medicine based on your specific needs. Medicine may help you
- meet your A1C , blood pressure, and cholesterol goals.
- reduce your risk of blood clots, heart attack, or stroke.
- treat , or chest pain that is often a symptom of heart disease. Angina can also be an early symptom of a heart attack.
- treat heart failure, which is a form of heart disease in which your heart cannot pump blood well enough for your body to work properly.
Ask your doctor whether you should take daily aspirin. Aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.
Statins can reduce the risk of having a heart attack or stroke in some people with diabetes. In addition, certain diabetes medicines have been shown to reduce the risk of heart attacks and death in patients at very high risk of having a heart attack. Talk with your doctor to find out whether taking a statin or a diabetes medicine that reduces heart attack risk is right for you.
Take medicines the way your doctor or health care team tells you to. Talk with your doctor or if you have questions about your medicines. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the side effects of your medicine bother you, tell your doctor. Dont stop taking your medicines without checking with your doctor first.
Can Diabetes Cause Hair Loss
Yes, its possible for diabetes to cause hair loss. Uncontrolled diabetes can lead to persistently high blood glucose levels. This, in turn, leads to blood vessel damage and restricted flow, and oxygen and nutrients cant get to the cells that need it including hair follicles. Stress can cause hormone level changes that affect hair growth. If you have Type 1 diabetes, your immune system attacks itself and can also cause a hair loss condition called alopecia areata.
What Is Continuous Glucose Monitoring
Advancements in technology have given us another way to monitor glucose levels. Continuous glucose monitoring uses a tiny sensor inserted under your skin. You don’t need to prick your finger. Instead, the sensor measures your glucose and can display results anytime during the day or night. Ask your healthcare provider about continuous glucose monitors to see if this is an option for you.
Open Sores And Wounds
Having high blood sugar for a long time can lead to poor circulation and nerve damage. You may have developed these if youve had uncontrolled diabetes for a long time.
Poor circulation and nerve damage can make it hard for your body to heal wounds. This is especially true on the feet. These open wounds are called diabetic ulcers.
Diabetes and feet
- Get immediate medical care for an open sore or wound.
- Work with your doctor to better control your diabetes.
Older People With Diabetes
Older people need to follow the same general principles of diabetes managementeducation, diet, exercise, and drugsas younger people. However, risking by trying to strictly control blood glucose levels may actually be harmful for people with multiple medical problems.
Managing diabetes can be more difficult for older people. Poor eyesight may make it hard for them to read glucose meters and dose scales on insulin syringes. They may have problems manipulating the syringe because they have arthritis or Parkinson disease or have had a stroke.
Diabetes: 12 Warning Signs That Appear On Your Skin
Diabetes can affect many parts of your body, including your skin. When diabetes affects the skin, its often a sign that your blood sugar levels are too high. This could mean that:
-
You have undiagnosed diabetes, or pre-diabetes
-
Your treatment for diabetes needs to be adjusted
If you notice any of the following warning signs on your skin, its time to talk with your doctor.
Type 2 Diabetes Mellitus
Type 2 diabetes is far more common than type 1 diabetes, accounting for about 90 percent of all cases. The frequency of type 2 diabetes varies greatly within and between countries and is increasing throughout the world. Most patients with type 2 diabetes are adults, often older adults, but it can also occur in children and adolescents. There is a stronger genetic component to type 2 diabetes than to type 1 diabetes. For example, identical twins are much more likely to both develop type 2 diabetes than to both develop type 1 diabetes, and 7 to 14 percent of people whose mother or father has type 2 diabetes will also develop type 2 diabetes; this estimate increases to 45 percent if both parents are affected. In addition, it is estimated that about half of the adult Pima Indian population in Arizona has type 2 diabetes, whereas in the entire United States it is estimated that about 10 percent of the population has type 2 diabetes.
Many patients with type 2 diabetes are asymptomatic, and they are often diagnosed with type 2 diabetes when routine measurements reveal high blood glucose concentrations. In some patients the presence of one or more symptoms associated with the long-term complications of diabetes leads to a of type 2 diabetes. Other patients present with symptoms of hyperglycemia that have been present for months or with the sudden onset of symptoms of very severe hyperglycemia and vascular collapse.
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 Is Diabetes Diagnosed
Diabetes is diagnosed and managed by checking your glucose level in a blood test. There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test and A1c test.
- Fasting plasma glucose test: This test is best done in the morning after an eight hour fast .
- Random plasma glucose test: This test can be done any time without the need to fast.
- A1c test: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months. This test measures the amount of glucose attached to hemoglobin, the protein in your red blood cells that carries oxygen. You dont need to fast before this test.
- Oral glucose tolerance test: In this test, blood glucose level is first measured after an overnight fast. Then you drink a sugary drink. Your blood glucose level is then checked at hours one, two and three.
| Type of test |
|---|
Being Overweight Or Obese
You’re more likely to develop type 2 diabetes if you’re overweight or obese with a body mass index of 30 or more.
Fat around your tummy particularly increases your risk. This is because it releases chemicals that can upset the body’s cardiovascular and metabolic systems.
This increases your risk of developing a number of serious conditions, includingcoronary heart disease,and some types ofcancer.
Measuring your waist is a quick way of assessing your diabetes risk. This is a measure of abdominal, which is a particularly high-risk form of obesity.
Women have a higher risk of developing type 2 diabetes if their waist measures 80cm or more.
Asian men with a waist size of 89cm or more have a higher risk, as do white or black men with a waist size of 94cm or more.
Exercising regularly and reducing your body weight by about 5% could reduce your risk of getting diabetes by more than 50%.
Read aboutmeasuring your waist size