What Is Type 2 Diabetes?

Type 2 diabetes is a chronic condition that occurs when your body isn't able to properly use insulin. Insulin is a hormone made by the pancreas. People with type 2 diabetes either can't produce enough insulin, have cells that are resistant to the insulin they make, or have a combination of both. Your blood glucose (blood sugar) rises when your body lacks insulin.

The way your body uses insulin can seem complicated. Your body converts the nutrients from your food into glucose. The glucose enters your bloodstream, and then your pancreas is able to release insulin into your bloodstream. Insulin uses glucose as energy to fuel your body or store it for later use.

That process doesn't work as it usually does if you have type 2 diabetes. Your cells may be resistant to the insulin your pancreas produces, or your pancreas might not produce enough insulin. The glucose remains in your bloodstream instead of your body using it as energy. High glucose levels in the blood can affect your organs and tissues over time.

Getting treatment for type 2 diabetes is important. Complications like heart disease, kidney disease, nerve damage, and vision loss can happen if left untreated. Type 2 diabetes is a common disease that you can manage with the right treatment and lifestyle changes.

Types of Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes mellitus (diabetes), accounting for 95% of all cases. There are subtypes of type 2 diabetes, which include:

• Mild age-related diabetes (MARD): This is the most common subtype of type 2 diabetes and represents 39% of cases. People with MARD have some difficulty controlling their blood sugar levels. They generally have few complications. The risk of MARD usually increases with age.
• Mild obesity-related diabetes (MOD): MOD usually affects people who have obesity, representing nearly 22% of cases. People with MOD do not resist insulin. MOD is generally a mild form of type 2 diabetes and causes very few complications.
• Severe insulin-deficient diabetes (SIDD): This subtype represents about 18% of cases. People with SIDD generally are young and have a healthy weight. They produce little insulin and may have a poor metabolism. Common complications of SIDD are blindness and nerve damage. 
• Severe insulin-resistant diabetes (SIRD): SIRD accounts for about 15% of cases. People with SIRD may have obesity and can have insulin resistance. Kidney and liver issues are common.

Some people may have prediabetes. This health condition occurs when your blood sugar is slightly higher than normal but not yet in the range for type 2 diabetes. Prediabetes affects one in three adults in the United States. You can reverse prediabetes through lifestyle changes, such as managing weight, eating nutritious foods, and exercising regularly.

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Type 2 Diabetes Symptoms

You may experience a wide range of type 2 diabetes symptoms. These include:

• Blurry vision
• Dry skin
• Fatigue and weakness
• Feeling very hungry or thirsty
• Frequent urination
• Irritability
• Pain, tingling, or numbness in your hands and feet
• Sores, cuts, and bruises that are slow to heal
• Unintentional weight loss

Symptoms can sometimes be so mild that you don't even notice any changes in your health. Approximately half of all Americans with type 2 diabetes are unaware of their health condition.

What Causes Type 2 Diabetes?

The primary cause of type 2 diabetes is insulin resistance. Other factors can also increase your risk of type 2 diabetes—unlike type 1 diabetes, which is not preventable.

Risk factors include:

• Age: Type 2 diabetes affects all ages. People older than 45 are more likely to develop the disease.
• Family history: Type 2 diabetes is genetic. You are at a higher risk of type 2 diabetes if your family members have the disease.
• Gestational diabetes: This type of diabetes occurs when you have high blood sugar levels when you are pregnant. Blood sugar levels usually return to normal after giving birth. Gestational diabetes may increase your risk of type 2 diabetes later in life.
• High blood pressure: Some medications that treat high blood pressure can increase your risk.
• Low HDL cholesterol: Having low HDL ("good") cholesterol can increase your risk.
• Physical activity: A lack of exercise puts you at risk of type 2 diabetes. Getting regular exercise can keep your blood sugar low and help your body convert glucose into energy.
• Polycystic ovary syndrome (PCOS): This hormonal disorder that affects the ovaries. People with PCOS may also have insulin resistance. About half of people with PCOS older than 40 have type 2 diabetes.
• Smoking: People who smoke are 30% to 40% more likely to have type 2 diabetes than non-smokers.
• Weight: Obesity has been linked to type 2 diabetes.
  

Are You at Risk?

Diabetes is a common condition, and anyone can develop symptoms. However, your risk level depends on factors such as your age, overall health status, and lifestyle habits. To learn more if you're at risk of diabetes, take this quiz below. Your results can tell you whether you're at low, medium, or high risk, and what to do moving forward.

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How is Type 2 Diabetes Diagnosed?

A healthcare provider can use a few tests that measure your blood sugar levels. They may repeat their testing measures or order multiple tests to confirm or rule out a type 2 diabetes diagnosis.

It's best to only receive a diagnosis from a healthcare provider using one of the following tests. Don't diagnose yourself with type 2 diabetes using over-the-counter (OTC) blood testing equipment, like a blood glucose meter. 

Fasting Plasma Glucose (FPG) Test

A healthcare provider may ask you to take a fasting plasma glucose (FPG) test. This test requires you to fast for at least eight hours. It's usually best to schedule an FPG test early in the morning so you can fast overnight. You will have to skip breakfast, but you are able to sip on water.

A healthcare provider will draw your blood. They will test the blood sample to check your blood glucose levels. Two FPG tests that show a blood glucose level of 126 milligrams (mg) or higher of glucose per deciliter (dL) of blood indicate diabetes. 

A1C Test

An A1C test measures your average blood sugar levels over the last three months from whenever you take it. You do not need to fast before receiving an A1C test, in contrast to the FPG test.

You will give a blood sample, which is usually drawn from a vein in your arm. Your test results will indicate what percentage of your blood proteins are coated with sugar. Normal A1C levels are less than 5.7%, prediabetes is 5.7% to 6.4%, and diabetes is 6.5% or higher.

Random Plasma Glucose (RPG) Test

A healthcare provider may sometimes choose to do a random plasma glucose (RPG) test to measure blood sugar levels. This test does not require fasting. A healthcare provider may ask you to take it at any point in the day. They can determine an official diabetes diagnosis if you have 200 mg or higher of glucose per dL of blood.

Oral Glucose Tolerance Test (OGTT)

An oral glucose tolerance test (OGTT) diagnoses prediabetes and diabetes. This test requires you to fast overnight before your blood is drawn.

A healthcare provider will take a blood sample and ask you to consume a sugary drink. They will repeatedly draw your blood over two to three hours. An OGTT measures how your blood sugar levels respond to the sugary drink. If you have 200 mg or more of glucose per dL of blood after two hours, it is considered diabetes.

Urine Test

Urine tests were historically more common to use than blood tests. However, the results are now less accurate than blood test results and are not often used to diagnose diabetes. A healthcare provider may still use a urine test to measure blood sugar if there is any difficulty drawing your blood. They might also use a urine test as an alternative to a diabetes screening.

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Treatments for Type 2 Diabetes

The goal of treatment is to bring your blood sugar levels down and keep them in a healthy range. Type 2 diabetes treatments can vary based on the severity of your condition, your lifestyle, and your overall health.

Some people with type 2 diabetes take oral medications to keep their blood sugar in control. Insulin injections are more common for people with type 1 diabetes. A healthcare provider may offer insulin injections if other treatments aren't working for you.

You can often manage your blood sugar by making healthy lifestyle changes, such as:

• Eating a nutritious diet: A heart-healthy diet helps manage diabetes. Focus on fruits, vegetables, whole grains, lean proteins, and non- or low-fat dairy to keep your blood sugar in check. The American Diabetes Association (ADA) advises following their Diabetes Plate Method. This method involves filling half your plate with non-starchy vegetables, a quarter with lean proteins (e.g., chicken or fish), and a quarter with carbs (e.g., beans and whole grains).
• Getting regular exercise: Staying active can keep your blood sugar low. Walking, bike riding, and strength training are good options. What's most important is finding exercise that is enjoyable and accessible.
• Losing weight, if needed: In some cases, obesity can be linked to high blood sugar levels. A healthcare provider may suggest losing a small amount of weight through a healthy diet and moderate exercise.
  

How To Prevent Type 2 Diabetes

Nearly 90 million adults in the United States have prediabetes. About 84% of these people have no idea their blood sugar is higher than average. It's possible to stop prediabetes and prevent it from progressing into type 2 diabetes.

The best way to prevent type 2 diabetes is to shift toward a healthier lifestyle. You can try taking some steps to lower your risk, such as:

• Building a support system to hold you accountable to your goals
• Eating a low-fat diet that is high in fruits, vegetables, whole grains, and lean proteins
  
• Exercising regularly
• Keeping track of your health goals
• Limiting tobacco and alcohol use

The National Diabetes Prevention Program offers a Lifestyle Change Program. This program pairs you with a health coach who helps you change your lifestyle. The coaches can counsel you on adopting a heart-healthy diet, fitting daily physical activity into your schedule, and reducing stress. Some programs are free. Other programs may have a fee, but some insurance plans can help you cover the cost.

Related Conditions

People with type 2 diabetes may be at risk for other health conditions that can affect their blood sugar levels and overall health. Some of these related conditions include:

• Chronic kidney disease (CKD): This occurs when your kidneys gradually lose function. CKD can lead to kidney failure if untreated. The disease affects nearly 25% of people with type 2 diabetes.
• Heart disease: Heart disease may occur in people with type 2 diabetes, affecting about 32.2% of people with the disease.
• Hyperlipidemia: This refers to a high amount of fat in your blood. Hyperlipidemia impacts more than 75% of people with type 2 diabetes. Diabetes may lower your HDL cholesterol and raise your LDL ("bad") cholesterol and triglycerides. Keeping your blood sugar level within a healthy range can help.
• Hypertension: Some evidence suggests that hypertension (high blood pressure) affects more than 80% of people with type 2 diabetes. Hypertension also increases your risk of heart disease.
• Obesity: Obesity is a common risk factor for type 2 diabetes. About 78% of people with type 2 diabetes are overweight or obese. Managing your weight can sometimes help prevent or treat type 2 diabetes.
  

Living With Type 2 Diabetes

Type 2 diabetes can impact your physical and emotional health. Getting early treatment can improve your symptoms and overall quality of life.

You may experience sadness or frustration from time to time if you have a chronic disease. It's OK to feel this way, and it's important to know these feelings are normal. You don't have to deal with type 2 diabetes alone. There are ways to cope with your emotions.

Some ways to manage your overall health include:

• Cooking healthy meals with your loved ones
• Engaging in your favorite hobbies and spending time with family and friends
• Finding a friend to exercise with
• Keeping in contact with a healthcare provider to ensure you are keeping your blood sugar in control
• Listening to comforting music and practicing meditation or deep breathing
• Reaching out to a mental healthcare provider if you need additional support

Type 2 diabetes can be a life-changing diagnosis. Making healthy changes can help you live a fulfilling life.

My Experience

Alysse Dalessandro

Type 2 diabetes advocate

Diagnosed in 2016

Feeling Overwhelmed? Seek Help From an RD

The biggest lifestyle change I made was finally going to an eating disorder-informed nutritionist. 

With so much past trauma surrounding my relationship with food, advice on food and diabetes was really triggering. Seeing a nutritionist helped me get in touch with how certain foods made me feel and how they impacted my blood sugar.

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A Quick Review

People with type 2 diabetes do not produce enough or resist insulin. Your blood sugar rises as a result and leaves you at risk for serious complications if untreated. Getting a diagnosis and receiving proper treatment can help you manage type 2 diabetes. You cannot reverse type 2 diabetes, but medication and lifestyle changes can lower your blood sugar.