The Mass General Diabetes Clinical Center is one of the oldest outpatient centers in the country dedicated to the comprehensive treatment of persons with diabetes, pre-diabetes, and associated disorders.
Learn more about diabetes eye screening programs at Massachusetts General Hospital's Chelsea HealthCare Center and Revere HealthCare Center.
The Diabetes Self Management Education and Support (DSME/S) Program is an outpatient program designed for adults, children, and seniors with Type 1 or Type 2 Diabetes.
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Type 2 Diabetes
What is type 2 diabetes?
When your body can’t make enough insulin or can’t use insulin, it is called type 2 diabetes. Insulin helps the cells in the body absorb glucose, or sugar, for energy. Without insulin, glucose builds up in the blood resulting in “high blood sugar.”
Type 2 diabetes is a chronic disease that has no known cure. It is the most common type of diabetes.
What causes type 2 diabetes?
The exact cause of type 2 diabetes is unknown. It seems to run in families. But, it often takes other factors to bring on the disease. This might be obesity or physical inactivity.
What are the risk factors for type 2 diabetes?
Risk factors for type 2 diabetes include:
- Age, people age 45 or older are at higher risk for diabetes
- Family history of diabetes
- Being overweight
- Not exercising regularly
- Race and ethnicity (African-Americans, Hispanic Americans, and American Indians are more prone to develop type 2 diabetes than white Americans)
- History of gestational diabetes (pregnancy induced diabetes)
- Giving birth to a baby who weighed more than 9 pounds
- A low HDL (high-density lipoprotein, or the "good cholesterol")
- A high triglyceride level
What are the symptoms of type 2 diabetes?
Symptoms of type 2 diabetes may include:
- Frequent bladder and skin infections that don't heal easily
- Unusual thirst
- Frequent passing urine
- Weight loss despite an increase in appetite
- Blurred vision
- 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 don’t have symptoms. Symptoms may be mild and almost unnoticeable. Half of all Americans who have diabetes do not know it.
The symptoms of type 2 diabetes may look like other conditions or health problems. Always consult your doctor for a diagnosis.
How is type 2 diabetes diagnosed?
There are several ways to diagnose diabetes. It is best to repeat the tests on a second day to confirm the diagnosis.
A1C. The hemoglobinA1C test measures your average blood glucose for the past 2 to 3 months. Diabetes is diagnosed if your A1C is 6.5% or greater.
Fasting plasma glucose (FPG). This test checks your blood glucose levels after 8 hours of fasting. You usually get this test before your first meal of the day. This is called your fasting blood glucose level. Diabetes is diagnosed if your fasting blood glucose is greater than or equal to 126 mg/dl.
Oral glucose tolerance test (OGTT). For this test, your glucose level is measured before and then after 2 hours after you drink a sugary drink. This test tells your doctor how well your body processes glucose. Diabetes is diagnosed if after 2 hours, your blood glucose is 200 mg/dl or higher.
Random glucose test. This blood test is done at any time of the day. Diabetes is diagnosed if your blood glucose is 200 mg/dl or higher with symptoms of hyperglycemia or hyperglycemic crisis.
How is type 2 diabetes treated?
Your health care provider will figure out the best treatment based on:
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medications, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
The goal of treatment is to keep blood sugar levels as close to normal as possible. To do this, you will need to control your blood sugar (glucose). You will also need to check it regularly. Regular physical activity, meal planning, and routine health care are also important.
You may be able to control type 2 diabetes with weight loss, exercise, and healthy eating habits. But, in some cases, you will also need either oral or injected medications and/or insulin. You will also need to check your feet regularly.
Treatment also includes:
- Taking oral medications, other medications, and/or insulin replacement therapy, as directed by your doctor. There are various types of medications to treat type 2 diabetes. Oral medications of several different types are available. Each type works in a different way 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 may be required.
- Regularly checking your hemoglobin A1c levels. Experts recommend testing at least twice a year if the blood sugar level is in the target range and stable, and more often if the blood sugar level is unstable.
What are the complications of type 2 diabetes?
Untreated or poorly controlled diabetes can cause problems with:
- Blood flow
This can lead to:
- Kidney failure
For these reasons, it is important to follow a strict treatment plan.
- When your body can’t make enough insulin or is unable to use insulin, it is called type 2 diabetes.
- Insulin helps the cells in the body absorb glucose for energy. Without insulin, glucose is left in the blood resulting in “high blood sugar.”
- Type 2 diabetes is a chronic disease that has no known cure. It is the most common type of diabetes.
- The exact cause of type 2 diabetes is unknown. However, it runs in families.
- 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.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.