This disease strikes people of all ages, and early symptoms are subtle. In fact, about one out of three people with type 2 diabetes don't know they have it. It’s a chronic condition that thwarts your body's ability to use the carbohydrates in food for energy. The result is elevated blood sugar. Over time it raises your risk for heart disease, loss of vision, nerve and organ damage, and other serious conditions.
Warning Sign: Thirst
People with type 2 diabetes frequently have no symptoms. When they do appear, one of the first may be an increase in thirst. Others include dry mouth, increased appetite, frequent urination -- sometimes as often as every hour -- and unusual weight loss or gain.
Warning Sign: Headaches
As your blood sugar levels get higher, you may have other problems like headaches, blurred vision, and fatigue.
Warning Sign: Infections
In many cases, type 2 diabetes is not discovered until it takes a serious toll on your health. One red flag is troubling infections, such as:
Cuts or sores that are slow to heal
Frequent yeast infections or urinary tract infections
Itchy skin, especially in the groin area
Warning Sign: Sexual Problems
Diabetes can cause damage to blood vessels and nerve endings in your genitals. This can lead to a loss of feeling and make orgasm difficult. Other issues include vaginal dryness and impotence in men. It's estimated between 35% and 70% of men with diabetes will have at least some degree of impotence in their lifetime. And about 1 in 3 women with diabetes will have some form of sexual trouble.
Risk Factors You Can Control
Some health habits and medical conditions related to your lifestyle can increase the odds of developing type 2 diabetes, including:
Being overweight, especially at the waist
A sedentary lifestyle
A diet high in red meat, processed meat, high-fat dairy products, and sweets
Abnormal cholesterol and blood fats, such as HDL "good" cholesterol lower than 35 mg/dL and /or a triglyceride level over 250 mg/dL
Risk Factors You Can't Control
Other risk factors are out of your control, including:
Race or ethnicity: Hispanics, African Americans, Native Americans, and Asians have a higher than average risk.
Family history of diabetes: Having a parent or sibling with diabetes boosts your risk.
Age: Being 45 and older increases your risk of type 2 diabetes.
The more risk factors you have, the greater your odds of developing type 2 diabetes.
Risk Factors for Women
Having gestational diabetes when you're pregnant or puts you at higher risk for developing type 2 diabetes later on. So does giving birth to a baby that weighs over 9 pounds. A history of polycystic ovary syndrome can also cause insulin resistance that leads to diabetes.
How Does Insulin Work?
In a healthy person, insulin helps turn food into energy. Your stomach breaks down carbohydrates from food into sugars. They enter the bloodstream, prompting your pancreas to release the hormone insulin in just the right amount. It gets the sugars to cells throughout your body, which use them for fuel.
In type 2 diabetes, your cells can’t absorb sugar properly. That means there's a lot of it in your blood. If you have a condition called insulin resistance, your body makes excess the hormone, but your muscle, liver, and fat cells don’t use it or respond properly to it. If you’ve had type 2 diabetes for a while but haven’t treated it, your pancreas will make less insulin.
How Is It Diagnosed?
A simple blood test can tell if you have diabetes. The A1C test gives a snapshot of your average blood glucose level over the past 2-3 months. An A1C level of 6.5% or higher may mean diabetes. Other tests can also back up that diagnosis. If you take a fasting plasma glucose test, a result above 126 is considered diabetes. If you already have classic symptoms of diabetes, your doctor might give you a random blood glucose test. A result higher than 200 probably means diabetes.
You can control blood sugar levels by changing your diet and losing excess weight. That will also cut your risk of complications. Carefully track the carbs in your diet. Keep amounts the same at every meal, watch your total fat and protein intake, and reduce calories. Ask your doctor to refer you to a registered dietitian to help you with healthy choices and an eating plan that will work for you.
Routine exercise, like strength training or walking, improves your body's use of insulin and can lower blood sugar levels. Being active also helps reduce body fat, lower blood pressure, and protect against heart disease. Try to get 30 minutes of moderate exercise on most days of the week.
Stress can cause blood pressure to rise. It can also increase glucose levels in your blood as part of your "fight or flight" response. Or you may turn to food to cope with stress. None is a good choice when you’re living with diabetes. Instead of letting stress take its toll, practice relaxation techniques like deep breathing, meditation, or visualization. Sometimes talking to a friend, family member, counselor, or member of the clergy can help. If you can’t beat the stress, reach out to your doctor.
If diet and exercise can’t get your blood sugar under control, your doctor may add medication. There are many types of diabetes pills available, and they’re often combined. Some work by telling your pancreas to make more insulin. Others help your body use it better, or block the digestion of starches. Some slow insulin breakdown.
Your doctor may prescribe insulin early on in your treatment and in combination with pills. It can also help people with type 2 diabetes who develop "beta-cell failure." This means the cells in the pancreas no longer produce insulin in response to high blood sugar levels. In this case, insulin -- injections or an insulin pump -- will become part of your daily routine.
New drugs called non-insulin injectables are available for people with type 2 diabetes. Whereas insulin pulls glucose into your cells, these medications cause your body to release it to control blood sugar levels.
Your doctor can show you how to use a glucose meter to check your blood sugar. This lets you know how your treatment plan is working. How often and when you test will be based on how well controlled your diabetes is, the type of treatment you use, and how stable your blood sugar is. Common testing times include when you wake up, before and after meals and exercise, and at bedtime.
Over time, untreated type 2 diabetes can damage many of your body's systems. About two out of three people with diabetes die of heart disease. It also puts you at a two to four times higher risk for stroke. People with diabetes are likely to get plaque in their arteries. This sticky substance slows blood flow and increases your risk of clots. It leads to hardening of the arteries (atherosclerosis), which makes you more likely to have a heart attack or stroke.
The longer you have diabetes, the greater the more chances you’ll get chronic kidney disease. Diabetes is the leading cause of kidney failure. It's to blame for about half of new cases. Controlling your diabetes, blood pressure, and cholesterol can lower your risk for this complication. Yearly screenings and medications to slow the onset or progress of disease can keep your kidneys healthy.
High blood sugar can damage the tiny blood vessels that bring oxygen and nutrients to the retina, a critical part of your eye. This is known as diabetic retinopathy, and it can lead to vision loss. It’s the leading cause of new cases of blindness in people between the ages of 20 and 74. Pools of blood, or hemorrhages, on the retina of an eye are visible in this image.
Over time, uncontrolled diabetes and high blood sugar can cause nerve damage. Symptoms include tingling, numbness, pain, and a pins and needles sensation -- often in your fingers, hands, toes, or feet. The damage can’t be reversed, but there are treatments to help with pain and numbness. Controlling your diabetes can help prevent further damage.
Diabetic nerve damage can make it hard to feel your feet and detect injury. At the same time, hardening of the arteries causes poor blood flow to your feet. Foot sores and gangrene can occur, even from small injury. In severe cases, infections can go unchecked and result in an amputation.
Can It Be Prevented?
One of the most surprising things about this life-altering condition is that you can avoid it. To lower your risk, follow the same guidelines for warding off heart disease:
Eat a healthy diet.
Exercise for 30 minutes, five days a week.
Maintain a healthy weight.
Talk to your doctor about being screened for prediabetes.
In people with prediabetes, lifestyle changes and medication can help prevent the progression to type 2 diabetes.
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National Institute of Diabetes and Digestive and Kidney Diseases.
Stumvoll, M. Lancet, 2005.
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Thorens, B. New England Journal of Medicine, 2006.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.