Type 2 Diabetes

Overview

Diabetes is a disease involving an increase in blood levels of glucose, the body's source of energy. Our body needs the hormone insulin to transport glucose into the cells. In people with diabetes, there is either a deficiency of the hormone insulin or a reduction in its effect even though there is enough insulin. In type 1 diabetes there is insulin deficiency, while in type 2 diabetes there is a reduction in the effect of insulin. Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with type 2 diabetes, probably in parallel with the rise in childhood obesity. There is no complete cure. Losing weight, diet and exercise may be enough to control the disease. Sometimes you may need diabetes medications and insulin.

Symptoms

• Drinking a lot of water
• Frequent urination
• Feeling hungry
• Unintentional weight loss
• Fatigue
• Blurred vision
• Frequent infections
• Slow wound healing
• Areas of darkened skin, in the armpits and on the back of the neck

Causes

The exact cause of type 2 diabetes is unknown, but weight gain, inactivity and family history appear to be contributing factors.

Risk factors

• Being overweight
• Abnormal fat distribution, which can be measured by waist circumference
• Inactivity
• Being over 45 years of age
• A history of gestational diabetes
• A history of hidden diabetes, a condition in which blood sugar is high but not high enough to be considered diabetes
• Having areas of darkened skin, in the armpits and on the back of the neck
• A history of polycystic ovary disease

Complications

• Heart and blood vessel diseases
• Nerve damage
• Kidney damage
• Eye damage
• Slow healing of wounds, foot ulcers
• Increased risk of Alzheimer's disease

Diagnosis

In a healthy adult, the blood sugar level measured after 8–12 hours of fasting is between 70 and 100 mg/dl. If this value is 126 mg/dl or higher on two occasions, the person has diabetes. If it is between 100 and 125 mg/dl, the person has hidden diabetes (prediabetes). In this case, the physician recommends a glucose tolerance test, which is performed after 8–12 hours of fasting. If the blood sugar measured at the 2nd hour of the test is 200 mg/dl or higher, the person again has diabetes. If this value is between 141 and 199 mg/dl, the person again has hidden diabetes. If a random blood sugar measured regardless of the last meal is 200 mg/dl or higher, the person also has diabetes. Some centers can also make the diagnosis using the HbA1c value, which shows the average blood sugar over three months; a value of 6.5% or higher is considered sufficient for diagnosis.

Treatment and follow-up

In addition to recommendations for a regular diet and exercise, some patients may need to use diabetes medications and/or insulin. The goal for most patients is an HbA1c value, which shows the average blood sugar over three months, below 7%. This value should be checked every 3–4 months. Appropriate follow-up examinations for complications are also recommended every 3–4 months. If you are planning a pregnancy, it is advisable to talk to your physician beforehand so that your treatment can be adjusted.