What To Know About Type 2 Diabetes

According to the CDC, over 37 million Americans have diabetes and approximately 90 to 95% of them have type 2 diabetes. Understanding how type 2 diabetes impacts your body can help you take steps to keep your blood sugar in control and prevent the harmful effects that we see when our blood sugar is left unchecked.

Here is your guide to type 2 diabetes, how to treat it and lead a happy and healthy life.

Type 2 diabetes is a chronic illness that occurs when the body has difficulty regulating its blood sugar. Your body creates blood sugar by digesting the food you eat into sugar (glucose) – which is then transported through the bloodstream to be used for energy and stored in your cells for later use. Your pancreas produces an important hormone called insulin that helps your cells absorb and store glucose.

In individuals with type 2 diabetes, their cells have increasing resistance to insulin, making it difficult for cells to absorb glucose and thus leading to high levels of blood sugar. This is not to be confused with type 1 diabetes, which is from the body unable to produce enough insulin, resulting in high blood sugar. Contrary to popular belief, type 2 diabetes is not caused by eating too much sugar, but has more to do with how we process glucose in our body. That being said, our body is able to quickly absorb and convert simple carbohydrates which can result in a spike in blood sugar compared to complex carbohydrates and protein which are absorbed more slowly.

The CDC lists several risk factors for type 2 diabetes. You may be at risk for diabetes if you:

• Are overweight or obese
• Are 45 years or older
• Have a family history of type 2 diabetes (think parent, brother, or sister; not so much extended family)
• Are physically active less than 3 times a week
• Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds

Certain racial and ethnic groups are associated with higher rates of type 2 diabetes, however it's important to note that race is a social construct that is not founded in genetics. The relationship we see between race and type 2 diabetes may be greatly influenced by family history along with social and societal factors that impact certain racial and ethnic groups in America.

Just because you have risk factors for type 2 diabetes does not mean you will develop it, but your primary care provider may recommend screening for diabetes if you have one or more risk factors.

Type 2 diabetes is diagnosed through lab testing checking blood sugar (with different thresholds depending on the type of test and if you were fasting beforehand) and by identifying symptoms, if present. The lab test may check your blood sugar directly or calculate your hemoglobin A1C, a measure of your average blood sugar level over the past three months. If you have multiple readings that show high blood sugar levels, then your healthcare provider may diagnose you with diabetes. Which type of diabetes will depend on your risk factors (age and family history to name a few) and presentation, but your healthcare provider will help you understand the diagnosis and if additional testing is needed.

Individuals with type 2 diabetes don’t always experience symptoms, but they can occur. Some of the most common symptoms of diabetes and high blood sugar include:

• Increased thirst
• Frequent urination
• Excessive hunger
• Unexplained weight loss
• Fatigue
• Irritability
• Slow-healing sores or wounds
• Frequent infections (for example, gum, skin, or vaginal infections)
• Vision changes
• Tingling or numbness of your feet or hands.

High blood sugar levels over time can cause significant damage to our organs through microvascular (small blood vessel) and macrovascular (large blood vessel) changes. Macrovascular changes such as heart attacks and strokes are life threatening, with cardiovascular disease being the main cause of death for people with type 2 diabetes. Microvascular changes, on the other hand, cause the diseases that we frequently associate with type 2 diabetes, such as damage to your eyes, kidneys, and nerves. If left untreated, high blood sugar levels can lead to blindness, kidney failure, and severe neuropathy. High blood sugar also suppresses your immune system, which makes it difficult to fight off infection. This places you at risk for severe complications from viruses and bacteria. It is not uncommon for an individual with type 2 diabetes to get a cut on their foot that is not noticed because of nerve damage, which then becomes infected and leads to serious illness. Lastly, diabetes can take a major toll on a person’s quality of life and mental health, resulting in stress, anxiety and depression.

It’s important to note that these complications can be managed or prevented through lifestyle changes and medication, so people with diabetes should work closely with their healthcare providers to work out a treatment plan that’s best for them.

Being diagnosed with diabetes is stressful, but with the right support and guidance, it can be managed. Your healthcare provider may recommend starting a medication, but there are lifestyle changes you can make to help prevent the harmful effects of type 2 diabetes, such as:

• losing weight if you’re overweight or obese,
• increasing your physical activity
• controlling your cholesterol levels
• maintaining healthy blood pressure
• quitting smoking
• eating a healthy diet that includes lots of fruits, vegetables, whole grains, and proteins low in saturated fats while avoiding processed sugars.

At One Medical, patients with diabetes can access group classes and more through our multidisciplinary chronic care management program, Impact by One Medical. Through the program, patients work with their dedicated care team led by a primary care provider to set health goals and make a personalized plan to meet them. This can include 1:1 behavioral coaching sessions, group classes, and self-guided educational resources, as well as syncing data from wearable devices, and coordinated care with specialists at our health systems partners. You can learn more about Impact By One Medical here.

If you think you may be at risk for diabetes or are experiencing symptoms, talk to a healthcare provider, who can help assess your risk and come up with a plan for staying healthy.