Type 2 Diabetes
Diabetes is a metabolic disorder that arises from high blood glucose levels resulting in the body’s inability to produce or use insulin, a hormone generated by the pancreas to control blood sugar in the body. Both insufficient insulin and resistance to insulin can cause diabetes. However proper diabetes care and following diabetic diet can help you a lead a healthy life.
Diabetes can be better understood by looking at the process of breaking down food by the body. When food is digested a sugar called Glucose, a source of fuel, enters the bloodstream. Insulin, produced by the Pancreas, then helps to move this Glucose into muscle, fat and liver cells, to be used as a fuel. Patients with Diabetes, have high levels of blood sugar, due to the inability to move sugar into fat, liver and muscle cells. This can happen because their Pancreas create insufficient insulin or their cells do not respond to insulin normally, or both.
According to the World Health Organization, over 70% of people with diabetes live in low and middle-income countries. India however, has the unfortunate distinction of being known as the Diabetes capital of the world. The International Diabetes Federation estimates that:
- The number of diabetes patients in India has grown from 19 million in 1995 to over 63 million currently
- 11 percent of Indians living in urban areas over the age of 15, has diabetes
- By 2030, the number of Diabetes patients in India will exceed 100 million
- In 2011, India witnessed the largest number of deaths due to diabetes, at 983,000
Type 2 Diabetes
Type 2 Diabetes is the most common form of diabetes. While it usually occurs in adults, it has been known to affect teens and young adults. It is a form of diabetes that occurs over time. A majority of people with Type 2 diabetes are overweight, when diagnosed. Increased fat levels, makes it more difficult for your body to properly use insulin. However, especially amongst the elderly, Type 2 diabetes can also occur in people who are thin. While genetic predisposition and family history play a large role, factors that increase your risk include low activity levels, poor diets and excessive body weight around the waist.
- 90 to 95% of diabetes is of type 2 or maturity onset type – affecting middle aged people
- Over 80% of patients with type 2 diabetes are also found to be obese.
Type 2 diabetes creates excess glucose in the bloodstream, leading to serious health problems including heart ailments, kidney failure and eye problems. In this case, your body either produces insufficient insulin or the cells ignore the presence of glucose, leading to excessive build-up of glucose in the bloodstream. Management of this condition can be achieved by making changes to lifestyle, including a healthy diet and regular exercise.
Often, people with type 2 diabetes do not exhibit symptoms for years. Early symptoms of type 2 diabetes include:
- Frequent bladder, kidney, skin, or other infections that take longer to heal
- Increased thirst
- Increased urination
Symptoms may also include:
- Blurred vision
- Erectile dysfunction
- Pain or numbness in the feet or hands
If your blood sugar level is over 200 mg/dL, your physician will prescribe the following tests to confirm the diagnosis of diabetes:
- Fasting blood glucose level – diabetes is diagnosed levels are over 126 mg/dL twice
- Haemoglobin A1c test
- Normal: Less than 5.7%
- Pre-diabetes: 5.7% – 6.4%
- Diabetes: 6.5% or higher
- Oral glucose tolerance test – diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours
Diabetes screening is recommended for:
- Overweight children with other risk factors for diabetes, from age 10, every 2 years
- Overweight adults (BMI greater than 25) who have other risk factors
- People over the age of 45, every 3 years
For patients diagnosed with Type 2 diabetes, it is recommended that you visit your physician every 3 months to:
- Check blood pressure levels
- Check skin and bones on the feet and legs
- Check to see if your feet are becoming numb
- Check the back part of your eyes with a specially lit instrument called an ophthalmoscope
The following tests will help you and your doctor monitor your diabetes and prevent further complications:
- Blood sugar test every year – goals should be 130/80 mm/Hg or lower
- Haemoglobin A1c test (HbA1c) once in 6 months if your diabetes is under control; else every 3 months
- Cholesterol and triglyceride tests once a year (goal: LDL levels less than 70-100 mg/dL).
- Kidney tests, once a year (micro albuminuria and serum creatinine).
- Eye tests, once a year. This needs to be done more often if you have signs of diabetic eye disease.
- Dentist visit every 6 months for a thorough dental cleaning and exam – ensure your dentist knows you have diabetes.
The primary goal of treatment is to lower high blood glucose levels. Prevention of problems due to diabetes is seen as long-term goals of treatment. Management of type 2 diabetes is primarily through exercise and diet.
Learning basic diabetes management skills will help you prevent problems and reduce the need for medical care. These include:
- How to test and record your blood glucose level
- What to eat and when – diet management is key
- How to take medications, if required
- How to recognize and treat low and high blood sugar symptoms
- How to handle sick days
- Where to buy diabetes supplies, and how to store them
Learning the basic skills takes time. It is an investment that is worth the effort and will go a long way in keeping your diabetes under check. In addition, we recommend that you stay up-to-date on new research and treatment options as well as continue to learn about diabetes, its complications and how to keep it under control. This would help you to keep winning with diabetes.