Diabetes type 2 occurs when the pancreas can not produce enough insulin or when the body cannot use the insulin. Hyperglycemia, also called raised blood sugar or raised blood glucose, is a common effect of uncontrolled diabetes and over time leads to serious complications in many organs of the body, especially the blood vessels and nerves.[1] [2]
Normal range of glucose
- Normal fasting blood glucose:
The concentration of fasting blood glucose is between 70 mg/dL (3.9 mmol/L) and 100 mg/dL (5.6 mmol/L).
- Prediabetes:
Prediabetes occurs when fasting blood glucose is between 100 to 125 mg/dL (5.6 to 6.9 mmol/L).
- Diabetes:
Diabetes is diagnosed when fasting blood glucose is 126 mg/dL (7 mmol/L) or higher on two separate tests. [2]
Causes of type 2 diabetes
Type 2 diabetes is result from two problems: [1]
- Insulin produced by pancreas isn’t enough to keep blood sugar levels within a normal range.
- Cells don’t take in enough sugar.because of insulin resistance especially in muscle, fat and the liver cells.
Exactly why this happens is not known. The key contributing factors including: [1] [4] [5]
- not being physically active
- overweight and obesity
- Genetics.
- Excess body fat, especially (visceral fat) which accumulates in your belly and around your organs.
- Certain medications, like long-term corticosteroid use.
- Eating highly processed and high saturated fats foods.
- Lack of quality sleep and chronic stress.
- Hormonal disorders, like hypothyroidism and Cushing syndrome.
Glucose (sugar) is a main source of energy for the cells in our bodies. Insulin is a hormone that comes from the pancreas and controls how the body uses sugar by triggering the pancreas to release insulin as a response to increase blood glucose, then insulin circulates in the bloodstream, enabling sugar to enter the cells. [1] [3]
The regulation and use of glucose includes the following: [1]
- Sugar comes from food and the liver.
- Glucose enters cells with the help of insulin.
- The liver makes and stores glucose.
- The liver breaks down glycogen into glucose when glucose levels are low, to keep the body’s glucose level within a normal range.
Symptoms of type 2 diabetes
In fact, you can be living with type 2 diabetes for years and not know it, because Symptoms of type 2 diabetes often develop slowly.Some people do not find out they have the disease until they have diabetes complications, such as blurred vision or heart disease. [1] [3] [4]
Because symptoms can be hard to spot, it’s important to know the risk factors to get your blood sugar tested if you have any of them. When symptoms are present, they may include: [1] [3] [4]
- Frequent urination.
- Increased thirst.
- Increased hunger.
- Fatigue and feeling tired.
- unexplained weight loss.
- Blurred vision.
- Frequent infections.
- Slow-healing sores.
- Dry skin.
- Areas of darkened skin especially in the neck and armpits.
- Numbness or tingling in the hands or feet.
Complications of type 2 diabetes
Type 2 diabetes affects many major organs, including the heart, blood vessels, eyes, nerves, and kidneys.Managing diabetes and controlling blood glucose can lower the risk for the complications which including: [6] [7] [8]
- Nerve damage, include:
- Nerve damage in the digestive system can cause problems with vomiting, nausea, diarrhea or constipation.
- Nerve damage in limbs.That may result in numbness, tingling, burning, pain or eventual loss of feeling.
- Damage to nerves of the heart can lead to irregular heart rhythms.
- Nerve damage also may cause erectile dysfunction.
- Heart and blood vessel disease. Diabetes can increase risk of heart disease, atherosclerosis, high blood pressure, and stroke.
- Eye damage. Diabetes increases the risk of serious eye diseases, such as glaucoma and cataracts.
- Kidney disease. Diabetes associated with chronic kidney disease or end-stage kidney disease that may need dialysis or a kidney transplant.
- Slow healing. Left untreated, blisters and cuts can become serious infections.
- Skin conditions. Diabetes may raise the risk of some skin problems, including fungal and bacterial infections.
- Sleep apnea. Type 2 diabetes may increase the risk of obstructive sleep apnea. The main contributing factor to both conditions may be obesity.
- Hearing impairment. Type 2 diabetes may increase the risk of hearing problems
- Dementia. Type 2 diabetes can increase the risk of Alzheimer’s disease and other conditions that cause dementia.
prevention of type 2 diabetes
Lifestyle changes can delay or prevent the onset of diabetes if you have been diagnosed with prediabetes, and can avoid the serious health complications of diabetes in the future. [8] [9] [10]
1. Lose extra weight
Losing weight reduces the risk of diabetes by diet and changes in exercise. People in one study reduced their risk of diabetes after losing approximately 7% to 10% of their weight by almost 60%.
2. Be more physically active
Many benefits you can reach by exercise and regular physical activity such as:
- Lower blood glucose levels.
- Lose weight.
- Boost your sensitivity to insulin.
3. Eat healthy foods
Plants are a rich source of fiber which is a part of plants your body can’t digest or absorb, so it can promote weight loss and lower the risk of diabetes. Plants also provide minerals, vitamins, and carbohydrates in your diet.
The benefits of fiber include:
- Lowering risk factors of heart disease.
- Lowering the absorption of fat and cholesterol from food
- Lowering blood sugar levels and slowing the absorption of sugars.
- Fiber-rich foods are more filling and energy rich so it can help you eat less
healthy foods for diabetes include:
- Non starchy vegetables, such as broccoli, leafy greens, and cauliflower.
- Fruits, such as peppers, tomatoes, and fruit from trees
- Whole grains, such as whole-grain rice, whole-wheat pasta and bread, whole oats, and quinoa
- Legumes, such as chickpeas, beans, and lentils
Avoid foods that are contain high amount of sugar with little fiber or nutrients such as:
- Pasta from white flour.
- White bread and pastries.
- High-fructose corn syrup.
- Fruit juices.
4. Eat healthy fats
Your diet should include a variety of foods with good fat which is an unsaturated fats to help lose and manage weight. Monounsaturated and polyunsaturated fats promote good heart and vascular health and healthy blood cholesterol levels.
There are many sources of good fats such as:
- Seeds and nuts, such as peanuts, almonds, pumpkin, and flaxseed seeds.
- Plants oils, which include: sunflower oil, olive oil, safflower oil, canola oil, cottonseed oil.
- Fatty fish, such as mackerel, salmon, sardines, cod, and tuna.
Pharmacologic Therapy for type 2 diabetes
Pharmacologic therapy for diabetes type 2 aims to reduce long-term complications by improving glycemic control. Drug classes used for the treatment of type 2 diabetes include the following: [11] [12]
- Sulfonylureas
- Biguanides
- Alpha-glucosidase inhibitors
- Meglitinide derivatives
- Glucagon Like peptide–1 (GLP-1) agonists
- Thiazolidinediones (TZDs)
- Dipeptidyl peptidase IV (DPP-4) inhibitors
- GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonists
- Nonsteroidal mineralocorticoid receptor (MR) antagonists
- Selective sodium-glucose transporter–2 (SGLT-2) inhibitors
- Insulins
- Bile acid sequestrants
- Amylinomimetics
- Dopamine agonists
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