In Type 2 diabetes, there are primarily two interrelated problems at work. Your pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into your cells — and cells respond poorly to insulin and take in less sugar.
Type 2 diabetes is primarily the result of two interrelated problems:
- Cells in muscle, fat and the liver become resistant to insulin. Because these cells don't interact in a normal way with insulin, they don't take in enough sugar.
- The pancreas is unable to produce enough insulin to manage blood sugar levels.
Exactly why this happens is unknown but being overweight and inactive are key contributing factors.
Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of Type 2 diabetes in younger people.
There's no cure for Type 2 diabetes, but losing weight, herbal teas, eating well, plenty of sleep, and exercising can help you manage the disease. If these activities aren't enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.
In 2014 total prevalence of diabetes in the United States in all ages was 29.1 million people (15.5 million adult men and 13.4 adult women), or 9.3% of the population.
Of great concern, are the 86 million people (37% of adults 20 years or older and 51% of adults 60 years or older) with prediabetes. All are a high risk for conversion to Type 2 diabetes and cardiovascular disease if lifestyle prevention strategies are not implemented.
According to L. Kathleen Mahan and Janice L Raymond, (authors of Krause’s Food & the Nutrition Care Process) in the healthy individual, omission of a specific food group or intake of high-energy, nutrient-poor foods does not lead to failed nutritional status overnight. It is the prolonged imbalance intake that leads to chronic disease.
This is the significance of our eight practices at Pathology Prevention. Following the eight practices will reduce the risk of diabetes, and other chronic diseases.
Prevention is much more effective than waiting until you're either within the prediabetes stage, or already diagnosed with Type 2 diabetes. Of course, regardless of when performed, any pathology prevention activity will help prevent further susceptibility and damage. Changes in lifestyle requires planning and goal-setting, followed by the selection of interventions that deal with the cause of the problem, and not just any symptoms that may be presented.
These lines of thinking reflect the evolution of nutritional science, from the identification of nutrient requirements and the practical application of this knowledge to the concepts that relate to nutrition, to the prevention of chronic and degenerative disease, and to optimization of health and performance.
Signs and symptoms of Type 2 diabetes often develop slowly. In fact, you can be living with Type 2 diabetes for years and not know it. When signs and symptoms are present, they may include:
- Increased thirst
- Frequent urination
- Increased hunger
- Unintended weight loss
- Blurred vision
- Slow-healing sores
- Frequent infections
- Numbness or tingling in the hands or feet
- Areas of darkened skin, usually in the armpits and neck
In no other disease does lifestyle—healthy and appropriate food choices and physical activity—play a more important role in prevention and treatment than in diabetes. Studies comparing lifestyle modifications to medication have provided support for the benefit of weight loss (reduced energy intake) and physical activity as the first choice to prevent or delay diabetes. Factors that may increase your risk of Type 2 diabetes include:
- Being overweight or obese is a main risk.
- Fat distribution. Storing fat mainly in your abdomen — rather than your hips and thighs — indicates a greater risk. Your risk of Type 2 diabetes rises if you're a man with a waist circumference above 40 inches (101.6 centimeters) or a woman with a measurement above 35 inches (88.9 centimeters).
- The less active you are, the greater your risk. Physical activity helps control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
- Family history. The risk of Type 2 diabetes increases if your parents or siblings has Type 2 diabetes.
- Race and ethnicity. Although it's unclear why, people of certain races and ethnicities — including Black, Hispanic, Native American and Asian people, and Pacific Islanders — are more likely to develop Type 2 diabetes than white people are.
- Blood lipid levels. An increased risk is associated with low levels of high-density lipoprotein (HDL) cholesterol — the "good" cholesterol — and high levels of triglycerides.
- The risk of Type 2 diabetes increases as you get older, especially after age 45.
- Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to Type 2 diabetes.
- Pregnancy-related risks. Your risk of developing Type 2 diabetes increases if you developed gestational diabetes when you were pregnant or if you gave birth to a baby weighing more than 9 pounds (4 kilograms).
- Polycystic ovary syndrome. Having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
- Areas of darkened skin, usually in the armpits and neck. This condition often indicates insulin resistance.
Type 2 diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Also, factors that increase the risk of diabetes are risk factors for other serious chronic diseases. Managing diabetes and controlling your blood sugar can lower your risk for these complications or coexisting conditions (comorbidities).
Potential complications of diabetes and frequent comorbidities include:
- Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis).
- Nerve damage (neuropathy) in limbs. High blood sugar over time can damage or destroy nerves, resulting in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
- Other nerve damage. Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. For men, nerve damage may cause erectile dysfunction.
- Kidney disease. Diabetes may lead to chronic kidney disease or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
- Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
- Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
- Slow healing. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
- Hearing impairment. Hearing problems are more common in people with diabetes.
- Sleep apnea. Obstructive sleep apnea is common in people living with Type 2 diabetes. Obesity may be the main contributing factor to both conditions. It's not clear whether treating sleep apnea improves blood sugar control.
- Type 2 diabetes seems to increase the risk of Alzheimer's disease and other disorders that cause dementia. Poor control of blood sugar levels is linked to more-rapid decline in memory and other thinking skills.
Healthy lifestyle choices can help prevent Type 2 diabetes, and that's true even if you have biological relatives living with diabetes. If you've received a diagnosis of prediabetes, lifestyle changes may slow or stop the progression to diabetes.
A healthy lifestyle includes:
- Eating healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains.
- Getting active. Aim for 150 or more minutes a week of moderate to vigorous aerobic activity, such as a brisk walk, bicycling, running or swimming.
- Losing weight. Losing a modest amount of weight and keeping it off can delay the progression from prediabetes to Type 2 diabetes. If you have prediabetes, losing 7% to 10% of your body weight can reduce the risk of diabetes.
- Avoiding inactivity for long periods. Sitting still for long periods can increase your risk of Type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.