Type 2 diabetes (also called type 2 diabetes mellitus) is a disorder that is known for disrupting the way your body uses glucose (sugar); it also causes other problems with the way your body stores and processes other forms of energy, including fat.
All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin or if your body stops responding to insulin, sugar builds up in the blood. This is what happens to people with diabetes. High blood sugar levels can lead to problems if untreated.
There are two different types of diabetes, type 1 and type 2:
This is a chronic medical condition that requires regular monitoring and treatment throughout your life in order to keep your blood sugar levels as close to normal as possible.
This involves lifestyle changes (including your diet and exercise habits), self-care measures, and sometimes medications. Fortunately, these treatments can keep your blood sugar levels under control and minimize your risk of developing complications.
Being diagnosed with type 2 diabetes can be a frightening and overwhelming experience, and you likely have questions about why it developed, what it means for your long-term health, and how it will affect your everyday life.
For most people, the first few months after being diagnosed are filled with emotional highs and lows. If you have just been diagnosed with diabetes, you and your family should use this time to learn as much as possible so that caring for your diabetes (including testing your blood sugar, going to medical appointments, and taking your medications) becomes a part of your daily routine.
Type 2 diabetes can lead to health complications, some of which can be serious. However, there are things you can do to reduce your risk of developing these problems.
Most people with diabetes can lead active lives and continue to enjoy many of the foods and activities that they previously enjoyed. Diabetes does not mean an end to “special occasion” foods like birthday cake, and most people with diabetes can enjoy exercise in almost any form.
Type 2 diabetes is thought to be caused by a combination of genetic and environmental factors.
Many people with type 2 diabetes have a family member with either type 2 diabetes or other medical problems associated with diabetes, such as high cholesterol levels, high blood pressure, or obesity.
The lifetime risk of developing type 2 diabetes is 5 to 10 times higher in first-degree relatives of a person with diabetes compared with a person with no family history of diabetes. The likelihood of developing type 2 diabetes is greater in certain ethnic groups, such as people of Hispanic, African, and Asian descent.
Eating an unhealthy diet and not getting enough exercise can lead to weight gain, which increases your risk of developing type 2 diabetes.
A small number of pregnant women develop diabetes during pregnancy, called “gestational diabetes.” Gestational diabetes is similar to type 2 diabetes, but it usually resolves after the woman delivers her baby. Women who develop gestational diabetes during pregnancy are at increased risk for developing type 2 diabetes later in life.
The main goals of treatment in type 2 diabetes are to keep your blood sugar levels within your goal range and treat other medical conditions that go along with diabetes; it is also very important to stop smoking if you smoke. These measures will reduce your risk of complications.
It is important to keep your blood sugar levels at goal levels. This can help prevent long-term complications that can result from poorly controlled blood sugar (including problems affecting the eyes, kidney, nervous system, and cardiovascular system).
Your doctor may instruct you to check your blood sugar yourself at home, especially if you take certain oral diabetes medicines or insulin. Home blood sugar testing is not usually necessary for people who manage their diabetes through diet only.
A random blood sugar test is based on blood drawn at any time of day, regardless of when you last ate. A fasting blood sugar test is a blood test done after not eating or drinking for 8 to 12 hours (usually overnight). A normal fasting blood sugar is less than 100 mg/dL (5.6 mmol/L), although people with diabetes may have a different goal. Your doctor or nurse can help you set a blood sugar goal and show you exactly how to check your level.
Blood sugar control can also be estimated with a blood test called glycated hemoglobin, or “A1C.” The A1C blood test measures your average blood sugar level over the past two to three months.
The most common, serious, long-term complication of type 2 diabetes is cardiovascular disease, which can lead to problems like heart attack, stroke, and even death. On average, people with type 2 diabetes have twice the risk of cardiovascular disease as people without diabetes.
Diet and exercise are the foundation of diabetes management.
Changes in diet can improve many aspects of type 2 diabetes, including helping to control your weight, blood pressure, and your body’s ability to produce and respond to insulin.
The single most important thing most people can do to improve diabetes management and weight is to avoid all sugary beverages, such as soft drinks or some juices, or if this is not possible, to significantly limit consumption.
Limiting overall portion size is also very important.
Regular exercise can also help control type 2 diabetes, even if you do not lose weight. Exercise is related to blood sugar control because it improves your body’s response to insulin.
Bariatric surgical procedures in patients with type 2 diabetes and obesity that result in sustained major weight loss have been shown to lead to remission of diabetes in a substantial fraction of patients. Surgical treatment of obesity is an option to treat type 2 diabetes in appropriate surgical candidates with:
There are a growing number of trials comparing bariatric surgery with medical therapy for the treatment of type 2 diabetes.
In a meta-analysis of trials comparing bariatric surgery with medical/lifestyle treatments for type 2 diabetes, surgery reduced weight and improved glycemia more effectively than medical/lifestyle interventions. In an prospective observational study of 316 patients with type 2 diabetes, previously participating in a trial of surgery versus medical/lifestyle therapy, diabetes remission at three years was achieved in 37.5 and 2.6 percent of patients, respectively.
Remission of diabetes is generally defined as a return to “normal” measures of glucose metabolism without glucose-lowering medication for at least one year.
Nevertheless, bariatric surgery improves glycemia substantially and significantly more than medication therapy, and most patients have substantial improvement in glycemic management for at least 5 to 15 years after surgery.