Type 2 diabetes is a metabolic disorder. It happens when your body can't make enough insulin, or can't use it properly. If you cannot make enough insulin or use the insulin made, your body cannot move blood sugar into the cells. Type 2 diabetes is a chronic disease that has no known cure. It is the most common type of diabetes. It is also called adult onset diabetes.
In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. But many people with prediabetes develop type 2 diabetes within 10 years. Prediabetes also greatly increases the risk for heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent the progression to type 2 diabetes.
The exact cause of type 2 diabetes is unknown. But some genetic factors that run in families contribute to the risk of developing type 2 diabetes. Although you can inherit a tendency to develop type 2 diabetes, it usually takes other factors, such as obesity or physical inactivity, to bring on the disease.
The following are the most common symptoms of type 2 diabetes. But each person may have slightly different symptoms. Symptoms may include:
Frequent bladder and skin infections that don't heal easily
High blood sugar when tested
High sugar in the urine when tested
Weight loss despite an increase in appetite
Nausea and vomiting
Extreme weakness and fatigue
Irritability and mood changes
Dry, itchy skin
Tingling or loss of feeling in the hands or feet
Some people who have type 2 diabetes may have no symptoms. Symptoms may be mild and almost unnoticeable, or easily confused with normal signs of aging. Half of all Americans who have diabetes do not know it.
The symptoms of type 2 diabetes may look like other conditions or medical problems. Always consult your doctor for a diagnosis.
Risk factors for type 2 diabetes include the following:
Age. People age 45 or older are at higher risk for diabetes.
Family history of diabetes
Not exercising regularly
Race and ethnicity. Being a member of certain racial and ethnic groups increases the risk for type 2 diabetes. African-Americans, Hispanic Americans, and American Indians are more prone to develop type 2 diabetes than white Americans.
History of gestational diabetes, or giving birth to a baby who weighed more than 9 pounds
A low blood level HDL (high-density lipoprotein--the "good cholesterol")
A high blood triglyceride level
Specific treatment for type 2 diabetes will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
The goal of treatment is to keep blood sugar levels as close to normal as possible.
Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine health care. Treatment of diabetes is an ongoing process of management and education that includes not only the person with diabetes, but also health care professionals and family members.
Often, type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone. However, in some cases, these measures are not enough and either oral or injected medications and/or insulin must be used. Treatment often includes:
An appropriate exercise program
Regular foot inspections
Oral medications, other medications, and/or insulin replacement therapy, as directed by your doctor. There are various types of medications that may be used to treat type 2 diabetes when lifestyle changes such as diet, exercise, and weight loss are not enough. Oral medications of several different types are available, with each type working in a different manner to lower blood sugar. One medication may be combined with another one to improve blood sugar control. When oral medications are no longer effective, insulin or other non-insulin injected medications may be prescribed.
New medications for treating diabetes are in development.
Regular monitoring of the hemoglobin A1c levels. The hemoglobin A1c test (also called HbA1c or A1C test) shows the average amount of sugar in the blood over the last three months. The result will indicate if the blood sugar level is under control. The frequency of HbA1c testing will be determined by your doctor. It is recommended that testing occur at least twice a year if the blood sugar level is in the target range and stable, and more frequently if the blood sugar level is unstable.
Untreated or poorly-treated diabetes can cause problems with the kidneys, legs, feet, eyes, heart, nerves, and blood flow, which could lead to kidney failure, gangrene, amputation, blindness, or stroke. For these reasons, it is important to follow a strict treatment plan.
Advances in diabetes research have led to improved methods of managing diabetes and treating its complications. However, scientists continue to explore the causes of diabetes and ways to prevent and treat the disorder. Other methods of giving insulin through inhalers and pills are currently being studied. Scientists are investigating genetic factors involved in type 1 or type 2 diabetes, and some genetic markers for both types have been identified. Bariatric surgery has been used effectively to help spur weight loss and treat type 2 diabetes.
The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.
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