Category: Endocrine & Metabolic / Endocrine / Metabolic
### Summary Type 2 diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). With type 2 diabetes, the body either doesn't produce enough insulin, or it resists insulin. This leads to high blood sugar levels, which can cause serious health problems over time. ### What It Is Insulin is a hormone that regulates the movement of sugar into your cells. In type 2 diabetes, cells respond poorly to insulin and take in less sugar. This is known as insulin resistance. As a result, blood sugar levels rise, prompting the pancreas to make more insulin. Eventually, the pancreas can't keep up, and blood sugar rises, setting the stage for prediabetes and type 2 diabetes. ### How It Affects The Body High blood sugar is damaging to the body and can cause other serious health problems, such as: - **Heart and blood vessel disease:** Diabetes dramatically increases the risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis). - **Nerve damage (neuropathy):** Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. - **Kidney damage (nephropathy):** The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. - **Eye damage (retinopathy):** Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. ### Who Is At Risk Risk factors include: - Being overweight or obese - Age 45 or older - Family history of diabetes - Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander - High blood pressure - Low level of HDL ("good") cholesterol, or a high level of triglycerides - History of gestational diabetes or giving birth to a baby weighing 9 pounds or more - Not physically active - History of heart disease or stroke - Depression - Polycystic ovary syndrome (PCOS) - Acanthosis nigricans — dark, thick, and velvety skin around your neck or armpits ### ⚠️ Emergency Signs Seek emergency medical help if you experience signs of **Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)** or **Diabetic Ketoacidosis (DKA)**: - Blood sugar level over 600 mg/dL - Dry mouth - Extreme thirst - Warm, dry skin that does not sweat - High fever (over 101 degrees Fahrenheit) - Sleepiness or confusion - Vision loss - Hallucinations - Weakness on one side of the body ### When To See A Doctor See a doctor if you notice any possible diabetes symptoms. Contact your doctor immediately if you've already been diagnosed with diabetes and you have: - High blood sugar levels that persist despite treatment - High ketones in your urine ### Diagnosis - **Glycated hemoglobin (A1C) test:** Indicates your average blood sugar level for the past two to three months. An A1C level of 6.5% or higher on two separate tests indicates that you have diabetes. - **Random blood sugar test:** A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes. - **Fasting blood sugar test:** A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. - **Oral glucose tolerance test:** For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. ### Treatment Options - **Healthy eating:** Focusing on fruits, vegetables, whole grains, and lean proteins. - **Regular exercise:** Aim for at least 150 minutes of moderate aerobic activity a week. - **Weight loss:** Losing a modest amount of weight can improve blood sugar levels. - **Medication:** Metformin is generally the first medication prescribed for type 2 diabetes. Other classes of medications include Sulfonylureas, Glinides, Thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors. - **Insulin therapy:** Some people who have type 2 diabetes need insulin therapy. - **Blood sugar monitoring:** Depending on your treatment plan, you may check and record your blood sugar level every now and then or multiple times a day. ### Prevention - Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains. - Get active. Aim for at least 150 minutes of moderate aerobic activity a week. - Lose weight. If you're overweight, losing 7% of your body weight can reduce the risk of diabetes.
537 million adults (IDF 2021)
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