Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin, a hormone that regulates blood sugar, or when the body cannot effectively use the insulin it produces.
Type 2 diabetes, once known as non-insulin dependent diabetes or adult-onset diabetes, is the most common form of diabetes, according to the U.S. Centers for Disease Control and Prevention (CDC). The number of people worldwide with diabetes nearly quadrupled from 108 million in 1980 to 422 million in 2014, and it continues to grow.
In the U.S. alone, the prevalence of diabetes has risen dramatically and, today, more than 34 million people have the disease. One of the biggest increases in recent years has been among men, the CDC says. Of the 13 million U.S. men with diabetes, roughly 95 percent have type 2 diabetes.
“Unlike people with type 1 diabetes, people with type 2 diabetes make insulin,” says Sol Harari, M.D., a family medicine physician with Baptist Health Primary Care. “But it’s not enough, or their body doesn’t recognize the insulin and use it the way it should. This is called insulin resistance.”
Although it is far more common than type 1 diabetes, type 2 diabetes is less well understood, according to Dr. Harari, and is probably caused by the confluence of several things and not one single problem. “Type 2 diabetes can run in families, but the exact nature of how it’s inherited or the identity of a single reason for it in your genes isn’t known,” he says. The risk for type 2 diabetes usually goes up with age, he adds. “People who don’t have other risk factors for the condition should start getting tested after age 45.”
Diabetes can cause a cascading array of other health problems, Dr. Harari says. “When there isn't enough insulin or the insulin isn’t used as it should be, sugar – or glucose – can’t get into your cells to be used for fuel. When sugar builds up in your blood, your cells don’t work the way they should.”
What are the symptoms of diabetes?
Symptoms of type 2 diabetes can differ from person to person but according to Dr. Harari they commonly include:
- Increased thirst
- Increased hunger (especially after eating)
- Dry mouth
- Nausea and occasional vomiting
- Frequent urination
- Unintentional weight loss
- Fatigue (a persistent weak or tired feeling)
- Blurred vision
- Numbness or tingling of the hands or feet
- Frequent infections of the skin or urinary tract
Other problems can also be linked to the buildup of sugar in the blood, Dr. Harari says, including:
Dehydration: The buildup of sugar in the blood can make you urinate more, as your kidneys try to clear the sugar from your body. Frequent urination means you’re losing a lot of fluid, which can lead to dehydration.
Hyperosmolar nonketotic diabetic coma: When a person with type 2 diabetes becomes severely dehydrated and doesn’t drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication.
Damage to the body: Over time, high sugar levels in the blood can damage nerves and small blood vessels of the eyes, kidneys and heart, and also put someone at risk of atherosclerosis, or hardening of the large arteries, which can cause a heart attack or stroke.
Who’s at risk for type 2 diabetes?
Dr. Harari reminds patients that anybody can get type 2 diabetes. However, he says the risk tends to be highest in people who:
- Are overweight or obese
- Have a family history of type 2 diabetes
- Have metabolic syndrome – a cluster of problems that include high cholesterol, high triglycerides, low HDL or “good” cholesterol and high LDL or “bad” cholesterol, as well as high blood pressure)
- Aren’t physically active
- Consume excessive amounts of alcohol
- Eat a diet high in sugar and refined carbohydrates and low in fiber and whole grains
In addition, Dr. Harari says, older people are more likely to get diabetes because aging makes the body less tolerant of sugars.
If your doctor suspects you may have type 2 diabetes, they will first check for signs of it in your blood, looking for high blood sugar levels). They may also look for sugar or ketone bodies in your urine, says Dr. Harari. “Tests used to diagnose type 2 diabetes include a fasting plasma glucose test and a casual plasma glucose test.”
What are some common complications of type 2 diabetes?
Dr. Harari cautions that if you have type 2 diabetes and aren’t controlling it well, you could develop serious and even life-threatening complications, including:
Retinopathy: People with type 2 diabetes may already have eye problems related to the disease. Over time, people who don’t have eye problems related to diabetes may get some form of eye problem. “To stop eye diseases from getting worse, it’s important to control not only your sugars, but also your blood pressure and cholesterol,” Dr. Harari says. “Fortunately, however, the vision loss isn't significant in most cases.”
Kidney damage: The longer you have diabetes, the greater your risk of developing kidney disease, says Dr. Harari. This carries with it a significant risk of serious illness such as kidney failure and heart disease.
Poor blood circulation and nerve damage: Damage to nerves and hardening of the arteries lead to less sensation and poor blood circulation in the feet, according to Dr. Harari. “This can bring on more infections and a higher risk of ulcers that heal poorly, which in turn can significantly raise the risk of amputation,” he says. Damage to nerves may also lead to digestive problems such as nausea, vomiting and diarrhea, he adds.
Can diabetes be prevented?
“Diabetes is one of the most preventable diseases,” says Dr. Harari. “Studies have shown that 90 percent of all type 2 diabetes cases could be prevented, or significantly delayed, simply by eating healthier and getting enough physical activity.”
In one study cited by Dr. Harari, researchers followed 3,234 people who were considered at risk of developing diabetes because they were overweight and had higher blood glucose levels. Those who participated in a program of exercise and diet geared to losing excess weight – in this case, an average of 15 pounds – lowered their risk of diabetes by close to 60 percent.
“Those over the age of 60 were able to cut their risk by more than 70 percent – and these were people who already had a high risk of diabetes,” notes Dr. Harari. “The lesson here is, stay active, keep your weight in the normal range and you’ll probably never get diabetes.”
What happens if I get diagnosed with diabetes?
A diabetes diagnosis isn't a death sentence, assures Dr. Harari. “In some cases, lifestyle changes can keep the disease entirely under control,” he says. “Still, many people with diabetes need to take oral medications that lower blood sugar levels. When these aren't enough to do the job, insulin may be necessary, sometimes along with oral drugs.”
Dr. Harari notes that the FDA has recently approved several new drugs that work with insulin to improve blood sugar management. “Although treatment has improved, controlling diabetes remains a challenge, which is why we focus on prevention.”
Book an appointment
Now more than ever, it’s important to establish a relationship with a primary care doctor – someone who will get to know you and your healthcare needs. Baptist Health Primary Care providers can help guide and manage your overall health and wellness, both in-person and through virtual visits. Our doctors and advanced practitioners aid in the early detection of disease and long-term health problems, help address any worrisome symptoms, manage chronic conditions, prescribe medications and advise on achieving overall health goals. Should you require specialized care, we provide access to Baptist Health’s comprehensive network of expert physicians and resources, keeping your health at the heart of what we do.