Diabetes - Type 2

I hope you have had the chance to read the last two Health Tips on diabetes - where we first covered the basics, then did a deeper dive into type 1 diabetes.  We will continue our discussion of diabetes today, focusing on type 2 diabetes.  Over 34 million Americans have diabetes, and approximately 90-95% of them have type 2 diabetes.  Type 2 diabetes used to be called "adult-onset" diabetes, because it most often develops in adults over age 45.  However, more and more children, teenagers, and young adults are developing type 2 diabetes.

What is type 2 diabetes and what causes it?

In type 2 diabetes, the cells in your body don't respond normally to insulin, which is called insulin resistance.  This means that although your pancreas is making insulin like it should, the insulin is not effective at helping the glucose move into the cells.  Your pancreas makes more insulin to compensate for the resistance, but eventually the pancreas is not able to keep up because the resistance becomes too great.  Over time, the pancreas may sort of "burn out" because it is working so hard, which may lead to lower insulin production.

We don't know exactly why this happens.  We believe that it is due to a combination of genetic and environmental factors.  Being overweight is one environmental factor that is strongly linked to the development of type 2 diabetes, although not everyone with type 2 diabetes is overweight.

What is prediabetes?

Prediabetes is a condition where your blood sugar levels are higher than normal, but not high enough to be classified as diabetes.  It is often the precursor to diabetes unless you take action to control it.  Prediabetes is reversible if appropriate measures are taken to prevent progression to type 2 diabetes.  The causes and risk factors are the same for prediabetes as they are for type 2 diabetes.

What are the risk factors for developing type 2 diabetes?

• Being overweight or obese - The more fat your body carries, the more resistant your cells become to insulin.
• Physical inactivity - Physical activity on a regular basis uses up glucose as energy, makes your cells more sensitive to insulin, and helps keep your body weight under control.
• Family history - Having a parent or sibling with type 2 diabetes increases your risk.
• Race or ethnicity - It is not clear why, but certain groups of people are at higher risk for type 2 diabetes, including Black, Hispanic, American Indian, and Asian American people.
• Age - Your risk increases as you get older, maybe because you tend to be less active, have less muscle mass, and gain weight as you get older.  But as I mentioned earlier, we are seeing increasing numbers of cases of type 2 diabetes in children, teens, and young adults.
• Polycystic ovary syndrome (PCOS) - Women with PCOS are at higher risk of type 2 diabetes.
• High blood pressure - Blood pressure over 140/90 is linked to increased risk of type 2 diabetes.
• Abnormal cholesterol and triglyceride levels - People with high triglyceride levels and people with low levels of good cholesterol (HDL) are at higher risk for type 2 diabetes.  This is another reason to have your doctor check these levels with a lipid panel.
• Gestational diabetes - We will talk more about this type of diabetes next week.  If you have this when you are pregnant, you are at higher risk of developing type 2 diabetes later in life.
  

Can type 2 diabetes be prevented?

Yes.  Here are things you can do to help prevent type 2 diabetes:

• Eat a healthy diet with plenty of fresh fruits and vegetables and less carbohydrates and sugars.
• Be more physically active - try to get at least 150 minutes of moderate level exercise each week.
• Maintain a healthy weight - aim for a body mass index (BMI) of 25 or less.

These measures can help to prevent the development of type 2 diabetes and can also reverse prediabetes.

We will talk more about type 2 diabetes next week including diagnosis and treatment options.

If you have any questions about diabetes, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor