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Type 2 Diabetes

What it is

First of all, let's define diabetes.

  • When you have a meal or a snack, some of the foods you eat - called carbohydrates - break down into sugar and go into your bloodstream.
  • Think of your bloodstream as your highway system, and the blood sugar needs to travel where it is needed - your muscles, all of your organs, everywhere it can be used for energy.
  • However, the sugar needs to be transported, or carried, and what carries it to its many destinations is insulin. So think of insulin as your UPS, FedEx or Post Office carrier. It is made by the pancreas, which sits right by the stomach.
  • When things are normal, the pancreas makes the right amount of insulin all of the time, and blood sugar levels stay in the normal range.
  • However, without insulin, the sugar just sits in the bloodstream, and the level of sugar goes higher and higher. This is what type 1 diabetes is all about.
  • But let's get back to type 2 diabetes. It may be caused by too little insulin, but more often it is due to what is called insulin resistance - which is your body not using the insulin that your pancreas produces. The FedEx/UPS/Post Office folks are trying to do their work, but your body is fighting them. High blood sugar is the result and, over time, a diagnosis of type 2 diabetes.

Type 2 diabetes is the most common form of diabetes, accounting for 90 - 95 percent of all cases. It used to be called adult-onset diabetes, but, unfortunately, both children and adults develop this kind of diabetes. Many people think of it as the kind of diabetes that does not require insulin. However, about half of people with type 2 diabetes will eventually need insulin. This is because the pancreas produces less and less insulin over time, so it must be injected to meet the body's needs.

What causes it

The causes of type 2 diabetes are not completely understood, but it almost always starts with insulin resistance. So what contributes to this insulin resistance? Here are some of the most common risk factors:

  • Family history of diabetes
  • Growing older - your risk increases as you age
  • History of gestational diabetes
  • Lack of exercise
  • Member of a high-risk ethnic group, such as:
    • African American
    • Asian American or Pacific Islander
    • Hispanic American
    • Native American
  • Overweight or obese

How you know you have it

Type 2 diabetes usually develops over years, so you may or may not experience these so-called classic symptoms:

  • Blurry vision
  • Excessive hunger
  • Excessive thirst
  • Frequent urination
  • Unexplained weight loss
  • Unusual infections, such as skin or yeast infection
  • Unusual tiredness

Your doctor can diagnose diabetes by one of these blood tests:

  1. A1c > 6.5% (A1c tests blood sugar control over the past 2-3 months)
  2. Fasting blood sugar > 126 mg/dl
  3. Random blood sugar > 200 mg/dl

What you can do

Yes, type 2 diabetes is a chronic disease that can cause serious health problems. However, you can live a long, happy life with diabetes. Research has shown your risk of problems greatly decreases by getting your blood sugar in good control and keeping it there!

Once you are diagnosed, ask your doctor to refer you to a diabetes educator at your hospital. Here is what you will learn:

  • How and when to check your blood sugar, and what the numbers tell you
  • How and when to take your medications, how they work, and what side effects you may have; if necessary, how to inject insulin
  • How to manage your blood sugar when you are sick, and when to call your doctor if your blood sugar runs high
  • How to prevent complications, such as blindness, amputation, kidney failure and heart disease and stroke
  • Planning your meals and snacks. Counting carbohydrate grams or servings, and smart portion control are essential
  • Starting an exercise routine, working up to 150 minutes a week
  • What to do if you have a low blood sugar (called hypoglycemia)
  • Working with your doctor to have your A1c checked every 3 - 6 months, and to keep blood pressure and cholesterol in target. Also, to make sure you receive all of the care you need - annual eye exam, flu vaccine and regular dental visits

Insurance/financial questions

With your doctor's prescription, your insurance company should cover your meter and supplies to check your blood sugar. For the lowest co-pay, call the customer service number to ask if there is a particular brand you should use.

With your doctor's referral, diabetes education at your hospital's diabetes center should also be a covered benefit, but call your health plan's customer service number to make sure, and to see what your out-of-pocket costs will be.

Type 2 Products

Patients with Type 2 Diabetes may or may not be treated with insulin and sometimes take oral medications to lower their blood glucose levels. If they use insulin for a period of time, it is administered with a syringe or insulin pen. Some patients may also use an insulin pump to control their diabetes. Most Type 2 patients test their blood glucose levels at least once daily if they do not use insulin and three times daily if they use insulin.