What to Know About Managing Type 2 Diabetes
Here’s why one should pay attention to type 2 diabetes: it’s a sure bet that a person or someone they know either suffers from or is at risk of developing it.
More than 30 million Americans have some form of diabetes, making it the seventh leading cause of death in the country, according to the American Diabetes Association. Approximately 1.25 million of these cases are the genetically linked Type 1 diabetes, but the vast majority of cases are Type 2 diabetes, which is often associated with lifestyle choices. If a person has been diagnosed with Type 2 diabetes or are at risk for developing it, it’s essential for them to be fully informed about the disease’s impact.
What is Diabetes?
Diabetes is a family of diseases, classified as Type 1 and Type 2, that impacts how one’s body produces insulin and processes sugars. While people with Type 1 diabetes do not produce enough insulin to regulate their body’s glucose levels, those with Type 2 diabetes develop cells that are resistant to the effects of insulin.
When most people think of diabetes, they probably think of Type 1 diabetes, which is classified as an autoimmune disease because the immune system attacks insulin-producing cells. This is the kind of diabetes where a patient requires insulin injections to live. This disease often presents itself in childhood, and those suffering from diabetes have to monitor their blood sugar levels by using a needle to test their blood and give themselves insulin injections, all of which can be a painful process, especially for children. Unfortunately, anybody can develop Type 1 diabetes well into adulthood. There is an active genetic link to Type 1 diabetes, although doctors still find it difficult to predict the onset of this disease.
Researchers recognize a clear genetic link with Type 2 diabetes as well, but this form of the disease also has strong lifestyle contributors. Patients with Type 2 diabetes produce insulin, but their receptor cells do not work correctly, causing their body to develop glucose intolerance. The pancreas pushes to produce more insulin, to make up for this deficiency, but often it is still not enough to regulate the glucose levels in the body. Having the genetic markers does not mean a person has or will develop Type 2 diabetes, but they should be more careful than people who are not genetically prone to this condition. More information on the differences between the two types of diabetes is available from the Diabetes Teaching Center at the University of California, San Francisco.
Diagnosis of Type 2 Diabetes
Several tests are used to diagnose Type 2 diabetes, but most involve drawing some blood. Because blood sugar levels can be fairly volatile in diabetes sufferers, patients may have to prick themselves several times a day to test themselves. In every instance, the patient or their doctor will test and record their blood sugar levels to see if they are elevated or fall within a healthy range. The blood sugar test is performed by pricking the patient’s finger with a lancet to obtain a drop of blood which is then placed on a glucose monitor strip to determine if their glucose levels are abnormal.
If the patient is a female who is pregnant, they may be at greater risk for diabetes even though they were not at risk before the pregnancy. Most obstetricians will monitor and test for pregnancy-related diabetes as it can develop quickly and harm both mother and child in a relatively short period.
Cause, Risk Factors and Other Underlying Issues of Type 2 Diabetes
Wouldn’t it be great if there were just a single risk factor that definitively leads to the onset of Type 2 diabetes? Just sidestep that one risk and home free! However, there are more than just one risk factor. Type 2 diabetes most commonly occurs in older people, those who have low levels of activity, and people who are overweight. Further, if a person had blood pressure issues in the past or are a woman who has given birth to a very large baby, they have a higher risk of developing this disease. If people in one’s family have Type 2 diabetes, they are more likely to get it. It is also more common in people who are Latino, African-American, Native American or Asian, according to statistics published by the Centers for Disease Control and Prevention.
Being overweight or obese is the single highest risk factor for developing Type 2 diabetes, according to the Obesity Society. People with a higher BMI (Body Mass Index) place a greater demand on the pancreas to produce insulin, while also increasing the likelihood that stressed cells will be resistant to the glucose-regulating chemical. In fact, the CDC data suggests that 90 percent of patients with Type 2 diabetes are overweight, and lifestyle changes are almost always recommended as part of a comprehensive treatment plan. So, don’t just put that pizza slice down; it may be time to consider replacements like fruits and veggies. And here’s the good news: It’s important to understand that being overweight or eating unhealthy foods doesn’t mean a person will develop diabetes. The American Diabetes Association considers being overweight merely one of several risk factors to be aware of, especially if one also has genetic markers for diabetes.
Signs and Symptoms
Before being tested for Type 2 diabetes, prior to diagnoses, some Type 2 diabetics reported that their body didn’t quite feel “normal,” like being fresh off a carnival ride, but different. People with this disease experience a variety of common symptoms, gathered here by the ADA. One should schedule a visit with their primary care physician to be tested for diabetes if they notice symptoms below:
- Excessive thirst or hunger
- Frequent urination
- Tingling or numbness in the hands or feet
- Blurred vision
- Abnormally slow healing of injuries
These symptoms are important to a doctor to let them diagnose a person, but what is really going inside that person? Because the body uses glucose as fuel, one’s cells are not functioning at full speed when they cannot utilize the sugars from food. Cells that lack energy trigger hunger and fatigue in the body. In addition, the excess and unused glucose needs to be flushed out, making one feel constant thirst as well as impacting other systems that require healthy fluid regulation. As explained in an article by Lana Barhum of Medical News Today, diabetes is a systemic disease that impacts much more than one might expect at first glance, so it’s important to treat it seriously.
We know what everyone is thinking: How can this get any worse? Well, if not managed correctly, it’s safe to say it can indeed get worse.
The American Diabetes Association extensively covers the potential complications caused by diabetes. All parts of the body are affected when a person has diabetes, and failing to treat this disease can result in a variety of complications. People with Type 2 diabetes regularly experience associated disorders that affect the skin, eyes and nerves. In many instances, these difficulties are interconnected. For example, low blood flow and high blood pressure can increase the risk of developing glaucoma, a disease that is common in patients with diabetes. Some eye complications associated with diabetes, such as retinopathy, can even lead to blindness. So it’s not just feeling “off” or “weird” because one’s blood sugar is low. Other parts of a person’s body can become seriously affected as well, making it more of a systemic threat than just limited to managing blood sugar.
Diabetes is also closely connected to nerve damage. In fact, it is estimated that half of all diabetics experience nerve damage, or neuropathy, to some degree. Neuropathy usually affects extremities, notably the hands and feet, but one may also experience a lack of bodily control if they have autonomic neuropathy. In the most extreme cases, nerve damage can lead to amputation of the affected parts. While this complication is undoubtedly alarming, a person can reduce the risk of neuropathy by keeping their blood sugar under control.
There are a variety of other potential complications that a person may experience if they fail to regulate their blood sugar. If a person has Type 2 diabetes, they are at risk for the following other conditions as well:
- Fungal infections and skin rashes
- High blood pressure
- Kidney disease
- Gastrointestinal issues
Cause for Concern
Diabetes has a body count, and it’s not decreasing — it’s growing. The CDC’s National Diabetes Statistics Report found that nearly 80,000 people die each year from diabetes or its associated complications, making it a leading cause of death in America. In addition, while the elderly still account for a quarter of cases, as many as 84 million children and teens under the age of 18 meet the requirements for a diagnosis of prediabetes, showing an alarming trend in the future health of our country.
There is a cost that, while not as alarming as the casualty count, is extremely troubling since it affects taxpayers who are not at risk for the disease. Treating diabetes costs the U.S. an estimated $245 billion every year, including the direct cost of care as well as the loss of productivity for patients. According to the United States Center for Disease Control, over seven million Americans do not know they have this disease, leaving them at high risk of developing complications associated with untreated diabetes. Diabetes doesn’t only hit our health and welfare — it hits our wallets.
Traditional Medical Approach and Treatment
At risk for diabetes, don’t freak out. A person’s primary care doctor will develop a comprehensive treatment plan when they are diagnosed with Type 2 diabetes because so many factors influence this disease. Medical treatments will be prescribed to manage symptoms and keep blood sugar under control. While insulin is commonly associated with Type 1 diabetes, it is also useful in treating Type 2 diabetes, so don’t be surprised if the doctor suggests it as a valuable therapy. In addition, one’s doctor may prescribe a variety of medications for Type 2 diabetes:
- Drugs that help the body produce more insulin. Side effects include weight gain and low blood sugar.
- Medications in the metformin family that make the body more sensitive to insulin and reduce blood glucose levels. Side effects include diarrhea and nausea.
- GLP-1 category drugs that alter normal digestion to keep sugar levels low. These therapies can cause weight loss and are usually used in tandem with other treatments.
- SGLT2 inhibitors pull sugars from the bloodstream into the urine, reducing the body’s overall load. The most common side effect is urinary tract infection.
Complementary and Integrative Health Treatment Options
A treatment plan for Type 2 diabetes may include complementary and integrative treatments, especially dietary adjustments, to supplement basic medical care. To help regulate blood sugar, follow a healthy, balanced diet with plenty of complex carbohydrates, vegetables and low-glycemic fruits, as well as a limited amount of animal proteins. Not the most exciting diet, but it will keeps people alive, and that’s pretty exciting. Taking a blood sample after every meal and keeping a log can help a person identify patterns and determine which foods help to keep their levels in check. Because simple carbohydrates, including table sugar, candy, and soda, can cause blood sugar to spike dangerously, one will want to cut these items out of their diet as much as possible. Sorry, Willy Wonka, but that gobstopper could kill me.
Can a gym membership help with diabetes? No surprise here — yes! Exercise is another integrative treatment for Type 2 diabetes that can have a significant positive impact on one’s prognosis and overall health. Any activity that gets a person moving is beneficial. At a minimum, people should engage in 30 minutes of physical activity a day. A doctor will probably suggest an exercise program that includes a variety of movements, both aerobic and strength training, but any activity is better than none. Think outside the box when developing an exercise program, and choose from a variety of options:
- Running or jogging
- Yoga or Pilates
- Weight lifting
Alternative therapies, like herbs and essential oils, have become more popular, so it’s not surprising that serious scientists are beginning to research the efficacy of these options for treating Type 2 diabetes. According to the study “Complementary and Alternative Medicine for the Treatment of Type 2 Diabetes” published by the Department of Family Medicine at the University of Ottawa, while results are mixed, there has been some indication that certain natural treatments may be beneficial.
It’s important to note that clinical trials for these substances are limited, so never use herbal therapies without a doctor’s knowledge or in place of more traditional treatment options. With that caveat, some alternative medicines, including chromium and Gymnema Sylvestre, seem to positively impact blood sugar levels. Researchers have seen modest improvements after administering cinnamon and fenugreek, but more studies are needed to determine how consistently effective these treatments may be.
It’s not all about the individual. While understanding one’s diagnosis and treatment plan is important, it is just as important to keep the other considerations in mind: One’s actions will impact not only their health, but also the well-being of their family and friends.
Because of the genetic component of Type 2 diabetes, parents should be especially diligent in implementing dietary and lifestyle changes for the entire family, especially in their children, but for themselves as well. All steps one takes to improve their own health will lower the risk that their children will eventually develop the disease.
According to a study by Blackburn, Swidrovich and Lemstra, another thing to be aware of when implementing a treatment plan is the importance of taking medications as directed. The researchers noted that more than half of all patients failed to take their prescriptions according to their doctor’s recommended dosage. Be aware that one may not see the desired improvement in their condition if they do not strictly follow their doctor’s orders. If one struggles when it comes to following their treatment regimen, be honest with the doctors so that they have a full picture of why the symptoms may not be improving as expected. Many patients see increased success in their care plans when developing a reminder system or a way to reward themselves for keeping on track.
While Type 2 diabetes is a highly manageable disease, there is no cure. Once diagnosed, one will need to make significant lifestyle changes to keep their blood sugar under control for the best possible outcome. In fact, one’s ability to stick to their diet and exercise plan will be the single most crucial factor in the success of the care plan. Eat a healthy diet, move around, and keep an open line of communication with the medical team to achieve the best quality of life possible. A person will also want to create a routine for checking their blood sugar, so that it becomes a regular part of their daily activities.
One’s Care Team
Teamwork can make all the difference. Diabetes impacts the body in a in a variety of ways. The patient will most likely be treated by a care team, led by the quarterback — their primary care physician. The team will include nurses, dietitians, and even specialists, such as an eye doctor or a dermatologist.
And there’s a playbook! It’s important that every part of the patient’s team is familiar with the latest standards of care for this often complicated disease. Produced by the American Diabetes Association, “Standards of Medical Care in Diabetes” offers guidelines that a patient and their doctor can reference to make sure that the care plan is the best it can be. This brochure is available to the public. If a person is unsure if their doctor’s recommendations are fully in line with these standards, don’t hesitate to ask questions. The better a patient understands their treatment, the more likely they will be to comply.
The Good News
Is there a silver lining to all of this? The thought of living with Type 2 diabetes can be disconcerting, to say the least. But millions of Americans successfully manage their condition, and so anybody can. In fact, because diet and lifestyle have such a huge impact on Type 2 diabetes, the patient is directly in control of their prognosis. By understanding one’s disease and following a comprehensive treatment plan, including medication, dietary changes and exercise, they can live a normal and healthy life and avoid potentially life-altering complications. Type 2 diabetes will always be part of their life, but it doesn’t have to run their life.