A Guide To Type 2 Diabetes
A Guide To Type 2 Diabetes
Type 2 diabetes is a chronic condition that affects one in ten people over forty in the United Kingdom. The sugar levels in the blood are too high, which can impact your health, wellbeing and life expectancy.
What is type 2 diabetes?
Type 2 diabetes is a common long-term condition that increases the level of sugar or glucose in your blood. In type 2 diabetes, your pancreas either can’t produce enough of the hormone insulin for its needs, or your body can’t respond appropriately to the insulin produced.
Insulin regulates glucose levels in your blood. It acts as a biological key, unlocking cells so that they can use glucose for energy. It also ensures that all excess glucose is stored for future use.
If you have type 2 diabetes, you do not have enough insulin to meet your body’s needs. As a result, the cells in your organs, muscles and body tissues can’t get the energy needed to fuel their work and keep them alive. The unused glucose builds up in your blood and is passed out in the urine.
The high blood glucose levels in type 2 diabetes can progressively damage your body, causing problems with your heart, blood vessels, eyes, kidneys and nerves.
Who gets type 2 diabetes?
Type 2 diabetes more commonly affects people as they grow older. However, it is linked to being overweight and obese. As obesity becomes more of a problem in childhood, more young people are also developing type 2 diabetes.
Type 2 diabetes can run in families and is more common in certain races and ethnic groups. The risk factors for type 2 diabetes include:
- Increasing age
- Ethnicity: type 2 diabetes is more common in people of African-Caribbean, Black African, Hispanic, Pacific Island or South Asian heritage
- Family history of diabetes
- High blood pressure
- High cholesterol
- Being overweight or obese
- Carrying excess weight around your middle
- High body fat levels
- A history of diabetes in pregnancy
- Medications including corticosteroids
What causes type 2 diabetes?
Type 2 diabetes is caused by a combination of factors, including your genes, your ethnicity and your lifestyle. The leading causes of type 2 diabetes include:
- Overweight and obesity: Type 2 diabetes is linked to being overweight or obese. Obese adults are five times more likely to develop diabetes than those with a healthy weight. Nine in ten adults with type 2 diabetes are overweight or obese
- Body fat distribution: Fat around the waistline can increase your risk of type 2 diabetes
- Physical inactivity: Physically inactive People are more likely to get type 2 diabetes. Exercise helps improve blood glucose levels, helps with weight loss, and enhances wellbeing
- Genetics and ethnicity: Type 2 diabetes can run in families. Scientists have identified genes that can increase your risk of developing type 2 diabetes. However, the inheritance is complex. Not everyone with an identical genetic makeup will get type 2 diabetes- lifestyle factors like diet, weight and exercise also have an effect
- Medications: Drugs like corticosteroids can increase your risk of getting type 2 diabetes, particularly if you take them for prolonged periods
Type 2 diabetes symptoms
Many people with type 2 diabetes notice no symptoms. A healthcare professional may pick up the condition during routine screening or health checks. However, some symptoms can suggest diabetes. These include:
- Tiredness and low energy level
- Passing more urine, getting up at night, and passing urine more frequently
- Feeling more thirsty
- Feeling more hungry, especially after meals
- Blurred vision
- Sudden weight loss without trying to diet
- Slow healing of cuts and other wounds
- Itching of the skin and genitals
- Recurrent infections
If you are worried about diabetes, ask your doctor for a blood test. Prompt, early diagnosis can ensure you get the treatment you need to stay healthy, prevent complications and protect your health.
Type 2 diabetes diagnosis
Your doctor will diagnose type 2 diabetes from your symptoms, your clinical history and blood tests. Your GP or specialist will diagnose type 2 diabetes if you have diabetes symptoms and persistently high blood glucose on testing. Tests include:
- HbA1c: A blood test that indicates your average blood glucose levels over the previous two to three months. A result of 48 mmol/mol or 6.5% or more indicates diabetes
- Finger-prick blood test: A finger-prick blood test can give your doctor an immediate blood glucose reading. If it is over 11.1 mmol/l, you are likely to have diabetes. However, a venous plasma glucose concentration should be sent to the lab to confirm the diagnosis
- Random venous plasma glucose concentration: If you have symptoms, a blood sample showing blood glucose of 11.1 mmol/l or more indicates diabetes. If you don’t have symptoms, your doctor may repeat the test, arrange a fasting plasma glucose test or an oral glucose tolerance test
- Fasting plasma glucose concentration (FPG): A blood test after fasting for eight hours. A result of 7.0 mmol/l or more indicates diabetes
- Oral glucose tolerance test (OGTT): A test of your glucose levels after taking a sugary drink. The test can check for type 2 diabetes and prediabetes
- Urine dip test: When your blood glucose levels are high, glucose is passed out into the urine
Treatment of type 2 diabetes
Type 2 diabetes treatment aims to control your blood sugars, prevent long term diabetes complications and support your physical and mental health. Treatment includes:
- Diet and nutritional advice and support to achieve a healthy BMI if you’re overweight
- Advice on safe ways to exercise
- Support to understand and check blood glucose levels. Guidance on recognising and managing high blood sugars (hypers) and low blood sugars (hypos). Your doctor will check your average blood glucose levels using the HbA1c blood test. They will set a target HbA1c and support you to achieve this
- Annual screening of eyes, kidneys, cholesterol, blood pressure and feet to check for early signs of diabetes complications
- Medication: If blood glucose levels aren’t controlled by lifestyle measures such as changes to diet and activity levels, medication can help improve control
Medication for type 2 diabetes
Most people taking medication for type 2 diabetes take oral medications, these include:
- Metformin: Usually the first line of medical treatment for type 2 diabetes
- Gliptins or DPP-4 blockers
- Prandial glucose regulators
- SGLT2 inhibitors
Injected treatments for type 2 diabetes include:
- Insulin injections
- Incretin mimetics
Type 2 diabetes remission
You may be able to treat your type 2 diabetes naturally, without medication. Changing your diet and lifestyle can help return your blood glucose levels to normal and put your diabetes into remission. Research has demonstrated that many overweight and obese people with type 2 diabetes have maintained non-diabetic glucose levels by losing around 15 kg and keeping the weight off.
To find out more about effective diabetes medications, or to speak to one of our specialists at the London Diabetes Centre about prospective treatment options, contact us today.
Looking to speak with a member of our team?
Carol Willis - Diabetes Clinic Facilitator
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