Disease: Type 2 Diabetes

    Type 2 diabetes facts

    • Type 2 diabetes is a condition in which cells cannot use blood sugar (glucose) efficiently for energy. This happens when blood sugar gets too high over time, and the cells become insensitive to insulin.
    • There are two types of diabetes mellitus, type 1 and type 2. The difference between the two are in type 2 diabetes, the pancreas still makes insulin, but the cells cannot use it very efficiently. In type 1 diabetes, the pancreas cannot make insulin due to auto-immune destruction of the insulin-producing beta cells.
    • Causes of type 2 diabetes are
      • being overweight,
      • excess sugar and carbohydrate intake,
      • sedentary behavior,
      • lack of exercise, and
      • genetics.
    • Risk factors for type 2 diabetes include
      • having family members with diabetes,
      • being overweight,
      • being sedentary including watching more than 2 hours of TV per day,
      • drinking soda, and
      • consuming too much sugar and processed food.
    • Because symptoms of type 2 diabetes are sometimes subtle. The major symptom is often being overweight. Other symptoms include
      • excess thirst,
      • urinating a lot,
      • gaining or losing weight unintentionally,
      • dark skin under armpits, chin, or groin,
      • fatigue, and
      • unusual odor to urine.
    • Often there are no specific symptoms until blood tests are done
    • Type 2 diabetes is diagnosed by a blood test for blood sugar. In type 2 diabetes a blood sugar level more than 125 when fasting or more than 200 randomly is diagnostic for diabetes.
    • Type 2 diabetes is treated with diet and lifestyle changes such as cutting out certain foods like sugar, bread, and pasta. It is also treated with a number of medications. Metformin (Glucophage) is usually the first medication to be tried.
    • Complications of type 2 diabetes include
      • heart disease,
      • kidney disease,
      • neuropathy,
      • sexual and/or urinary problems,
      • foot problems,
      • and
      • eye problems such as retinopathy.
    • Type 2 diabetes can be prevented by
      • following a healthy low glycemic load diet,
      • staying physically active, and
      • getting regular medical screenings.
    • The prognosis for a person with type 2 diabetes is estimated to be a life expectancy of 10 years less. However, good blood sugar control and taking steps to prevent complications is shortening this gap and people with type 2 diabetes are living longer.

    What is type 2 diabetes?

    Type 2 diabetes is the most common type of diabetes. It is a chronic disease in which blood sugar can no longer be regulated. There are two reasons for this. First, the cells of the body become resistant to insulin. Insulin works like a key to let glucose move out of the blood and into the cells where it is used as fuel for energy. When the cells become insulin resistant, it requires a lot of insulin to move the glucose into the cell, and too much of it stays in the blood. The other part type 2 diabetes is that, over time, the pancreas can't make enough insulin.

    What is the difference between type 2 and type 1 diabetes?

    • In type 2 diabetes, blood sugar can be reduced with diet, exercise, and oral medications that either make the body more sensitive to insulin or help the pancreas release more insulin.
    • In type 1 diabetes, the pancreas cannot make any insulin and people have to depend on injections of insulin to lower blood sugar.
    • Over time, people with type 2 diabetes can also require insulin. This happens when the pancreas "wears out."

    What causes type 2 diabetes?

    Type 2 diabetes is caused by a combination of genetics and unhealthy lifestyle habits.

    • Some ethnic groups have a higher inherited incidence of type 2 diabetes. African Americans, Latinos, Native Americans, Asian Americans, and Pacific islanders are all at increased risk for type 2 diabetes.
    • Other causes of type 2 diabetes are unhealthy lifestyle habits including
      • eating too much sugar and carbohydrates,
      • not exercising enough, and
      • being under chronic high stress.

    What are the risk factors for type 2 diabetes?

    Risk factors for type 2 diabetes include

    • age (being over age 45),
    • being overweight or obese,
    • having a family history of diabetes,
    • being a member of a race or ethnic group with a genetic predisposition for type 2 diabetes,
    • having had prediabetes or gestational diabetes, or
    • having other metabolic syndrome conditions such as high blood pressure, low HDL or "good" cholesterol, or high triglycerides.

    Other risk factors include

    • being sedentary (not exercising or being physically active),
    • watching more than 2 hours of TV per day.1
    • People who drink soda, either sugar-sweetened or diet, are at 26%-67% increased risk of type 2 diabetes.2, 3
    • Economic stress also is a risk factor. People who live in the lowest-income circumstances have two and a half times greater the risk of developing diabetes.4

    What are the symptoms of type 2 diabetes?

    Type 2 diabetes develops gradually, over years, so the symptoms can be subtle things people think they just have to live with. Being overweight or obese is the major symptom, but not everyone with type 2 diabetes will be overweight. In fact, weight loss can be a symptom. Other symptoms include

    • fatigue,
    • frequent urination,
    • excess thirst,
    • blurry or cloudy vision,
    • wounds that won't heal,
    • tingling or numbness in the feet,
    • erectile dysfunction (ED), and
    • dark skin under the armpits and groin.

    How is type 2 diabetes diagnosed?

    Type 2 diabetes is diagnosed with a blood test. The blood is tested for glucose and if it is greater than 125 fasting, or more than 200 when randomly tested, the diagnosis is diabetes If the fasting blood sugar is between 100-125, the person has pre-diabetes.

    Tests also can measure average blood sugar over time. A hemoglobin 1c (HbA1c) test greater than 6.5% indicates diabetes.

    What is the treatment for type 2 diabetes?

    Type 2 diabetes treatment can include diet, exercise, weight loss, oral medications, injectable medications, and dietary supplements. Not everyone needs medication; diet and exercise alone can be enough it the person makes significant lifestyle changes. The complications of diabetes also may need treatment. For example, nutritional deficiencies should be corrected, heart or kidney disease needs to be treated, and vision must be checked.

    Do people with type 2 diabetes have to take insulin?

    Insulin is only recommended for people with type 2 diabetes when they have not been able to get blood sugars low enough to prevent complications through other means. To avoid insulin, people with type 2 diabetes should work very hard to follow a healthy diet that includes a lot of vegetables and lean proteins, exercise every day, and keep stress in perspective. They also should take their oral medications regularly. It can be difficult to follow these recommendations and the help of your doctor, nutritionist, diabetes educator, health coach, or integrative medicine practitioner may be helpful. For people who want to avoid insulin, working with practitioners can help them understand how to make these lifestyle changes fit into their lives.

    Type 2 diabetes medications

    There are different types of diabetes medications besides insulin. They work in different ways to either stop the liver from making glucose, make the pancreas release more insulin, or block glucose from being absorbed. Insulin replaces the natural insulin when the pancreas can't make anymore.

    Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet)

    Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) belongs to a class of drugs called biguanides. Metformin is first-line therapy for most people with type 2 diabetes. It works to stop the liver from making excess glucose, and has a low risk of hypoglycemia, very low blood sugar that can cause symptoms such as sweating, nervousness, heart palpitations, weakness, intense hunger, trembling, and problems speaking.

    Learn more about: Glucophage | Glumetza | Fortamet | Riomet

    Sulfonureas and meglitinides

    Sulfonureas and meglitinides are classes of drugs also prescribed to treat type 2 diabetes. These medications cause the pancreas to release more insulin. Since the pancreas can only work so hard, these medications have a limited duration of usefulness.

    The sulfonureas include

    • glyburide (DiaBeta),
    • glipizide (Glucotrol), and
    • glimepiride (Amaryl).

    Learn more about: DiaBeta | Glucotrol | Amaryl

    The meglitinides include

    • repaglinide (Prandin), and
    • nateglinide (Starlix).

    Learn more about: Prandin | Starlix

    Canagliflozin (Invokana) and dapagliflozin (Farxiga)

    Canagliflozin (Invokana) and dapagliflozin (Farxiga) are newer oral medications prescribed to treat type 2 diabetes. These drugs belong to the drug class referred to as sodium-glucose co-transporter 2 (SGLT2) inhibitors.

    Learn more about: Invokana | Farxiga

    Other type 2 diabetes medications

    There are other oral and injectable medications for people with type 2 diabetes such as

    • Thiazolidinediones: pioglitazone (Actos) and rosiglitazone (Avandia)
    • acarbose (Precose)
    • pramlintide (Symlin)
    • exenatide (Byetta)
    • liraglutide (Victoza)
    • Long-acting exenatide (Bydureon)
    • albiglutide (Tanzeum)
    • dulaglutide (Trulicity)
    • DPP-IV inhibitors (sitagliptin [Januvia], saxagliptin [Onglyza], linagliptin [Tradjenta])
    • Combination medications (Glyburide/metformin [Glucovance], rosiglitazone/metformin [Avandamet], glipizide/metformin [Metaglip], pioglitazone/metformin [Actoplusmet], and metformin/sitagliptin [Janumet])

    Learn more about: Actos | Avandia | Precose | Symlin | Byetta | Victoza | Bydureon | Tanzeum | Trulicity | Januvia | Onglyza | Tradjenta | Glucovance | Avandamet | Metaglip | Janumet

    For people who want to avoid medications, taking an aggressive approach to diet and lifestyle change is an option. It isn't easy, but if someone is very committed and motivated, lifestyle changes can be enough to maintain a healthy blood sugar level and to lose weight. Learning about a healthy diabetes diet can be an good place to start.

    Type 2 diabetes diet

    A type 2 diabetes diet should be based on foods with a high glycemic index (foods higher in protein or fats) like vegetables and good quality protein such as fish, chicken, beans, and lentils. From that base, other types of foods such as fruit, whole grains, low-fat dairy products, and nuts should be added.

    Foods with a high glycemic index (foods that break down into glucose more quickly) are foods to avoid, such as processed foods, high in carbohydrates, sugars, or animal fat. Examples include

    • deserts,
    • sweets,
    • pastries,
    • breads,
    • chips,
    • crackers, and
    • pastas.

    A good rule of thumb is to avoid white foods (except for cauliflower!).

    Exercise for type 2 diabetes

    Exercise is very important for people with type 2 diabetes. Exercise makes cells more insulin sensitive so they can take up the glucose in the blood. This brings down blood sugar, and more importantly, gives you better energy because the glucose is getting where it is supposed to be. Any type of exercise will do this, but extra benefit is gained when the activity helps build muscle, such as weight training or using resistance bands. The benefits of exercise on blood sugar last about 48-72 hours, so it is important for people to be physically active almost every day.5

    What are the complications of type 2 diabetes?

    If blood sugar is not controlled over time, type 2 diabetes complications can develop. These include diabetic eye disease, heart disease, foot problems such as wounds that don't heal or loss of feeling or pins and needles sensations, neuropathy or nerve pain especially in the feet, sexual issues such as erectile dysfunction, inability to orgasm or feel full sensation, urinary frequency or unusual odor to urination. People with type 2 diabetes have a higher risk of heart disease and heart attack. Because of this, it is important to control cholesterol and high blood pressure in addition to blood sugar. The good news is that all of these conditions are responsive to healthy lifestyle change.

    What is type 2 diabetes?

    Type 2 diabetes is the most common type of diabetes. It is a chronic disease in which blood sugar can no longer be regulated. There are two reasons for this. First, the cells of the body become resistant to insulin. Insulin works like a key to let glucose move out of the blood and into the cells where it is used as fuel for energy. When the cells become insulin resistant, it requires a lot of insulin to move the glucose into the cell, and too much of it stays in the blood. The other part type 2 diabetes is that, over time, the pancreas can't make enough insulin.

    What is the difference between type 2 and type 1 diabetes?

    • In type 2 diabetes, blood sugar can be reduced with diet, exercise, and oral medications that either make the body more sensitive to insulin or help the pancreas release more insulin.
    • In type 1 diabetes, the pancreas cannot make any insulin and people have to depend on injections of insulin to lower blood sugar.
    • Over time, people with type 2 diabetes can also require insulin. This happens when the pancreas "wears out."

    What causes type 2 diabetes?

    Type 2 diabetes is caused by a combination of genetics and unhealthy lifestyle habits.

    • Some ethnic groups have a higher inherited incidence of type 2 diabetes. African Americans, Latinos, Native Americans, Asian Americans, and Pacific islanders are all at increased risk for type 2 diabetes.
    • Other causes of type 2 diabetes are unhealthy lifestyle habits including
      • eating too much sugar and carbohydrates,
      • not exercising enough, and
      • being under chronic high stress.

    What are the risk factors for type 2 diabetes?

    Risk factors for type 2 diabetes include

    • age (being over age 45),
    • being overweight or obese,
    • having a family history of diabetes,
    • being a member of a race or ethnic group with a genetic predisposition for type 2 diabetes,
    • having had prediabetes or gestational diabetes, or
    • having other metabolic syndrome conditions such as high blood pressure, low HDL or "good" cholesterol, or high triglycerides.

    Other risk factors include

    • being sedentary (not exercising or being physically active),
    • watching more than 2 hours of TV per day.1
    • People who drink soda, either sugar-sweetened or diet, are at 26%-67% increased risk of type 2 diabetes.2, 3
    • Economic stress also is a risk factor. People who live in the lowest-income circumstances have two and a half times greater the risk of developing diabetes.4

    What are the symptoms of type 2 diabetes?

    Type 2 diabetes develops gradually, over years, so the symptoms can be subtle things people think they just have to live with. Being overweight or obese is the major symptom, but not everyone with type 2 diabetes will be overweight. In fact, weight loss can be a symptom. Other symptoms include

    • fatigue,
    • frequent urination,
    • excess thirst,
    • blurry or cloudy vision,
    • wounds that won't heal,
    • tingling or numbness in the feet,
    • erectile dysfunction (ED), and
    • dark skin under the armpits and groin.

    How is type 2 diabetes diagnosed?

    Type 2 diabetes is diagnosed with a blood test. The blood is tested for glucose and if it is greater than 125 fasting, or more than 200 when randomly tested, the diagnosis is diabetes If the fasting blood sugar is between 100-125, the person has pre-diabetes.

    Tests also can measure average blood sugar over time. A hemoglobin 1c (HbA1c) test greater than 6.5% indicates diabetes.

    What is the treatment for type 2 diabetes?

    Type 2 diabetes treatment can include diet, exercise, weight loss, oral medications, injectable medications, and dietary supplements. Not everyone needs medication; diet and exercise alone can be enough it the person makes significant lifestyle changes. The complications of diabetes also may need treatment. For example, nutritional deficiencies should be corrected, heart or kidney disease needs to be treated, and vision must be checked.

    Do people with type 2 diabetes have to take insulin?

    Insulin is only recommended for people with type 2 diabetes when they have not been able to get blood sugars low enough to prevent complications through other means. To avoid insulin, people with type 2 diabetes should work very hard to follow a healthy diet that includes a lot of vegetables and lean proteins, exercise every day, and keep stress in perspective. They also should take their oral medications regularly. It can be difficult to follow these recommendations and the help of your doctor, nutritionist, diabetes educator, health coach, or integrative medicine practitioner may be helpful. For people who want to avoid insulin, working with practitioners can help them understand how to make these lifestyle changes fit into their lives.

    Type 2 diabetes medications

    There are different types of diabetes medications besides insulin. They work in different ways to either stop the liver from making glucose, make the pancreas release more insulin, or block glucose from being absorbed. Insulin replaces the natural insulin when the pancreas can't make anymore.

    Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet)

    Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) belongs to a class of drugs called biguanides. Metformin is first-line therapy for most people with type 2 diabetes. It works to stop the liver from making excess glucose, and has a low risk of hypoglycemia, very low blood sugar that can cause symptoms such as sweating, nervousness, heart palpitations, weakness, intense hunger, trembling, and problems speaking.

    Learn more about: Glucophage | Glumetza | Fortamet | Riomet

    Sulfonureas and meglitinides

    Sulfonureas and meglitinides are classes of drugs also prescribed to treat type 2 diabetes. These medications cause the pancreas to release more insulin. Since the pancreas can only work so hard, these medications have a limited duration of usefulness.

    The sulfonureas include

    • glyburide (DiaBeta),
    • glipizide (Glucotrol), and
    • glimepiride (Amaryl).

    Learn more about: DiaBeta | Glucotrol | Amaryl

    The meglitinides include

    • repaglinide (Prandin), and
    • nateglinide (Starlix).

    Learn more about: Prandin | Starlix

    Canagliflozin (Invokana) and dapagliflozin (Farxiga)

    Canagliflozin (Invokana) and dapagliflozin (Farxiga) are newer oral medications prescribed to treat type 2 diabetes. These drugs belong to the drug class referred to as sodium-glucose co-transporter 2 (SGLT2) inhibitors.

    Learn more about: Invokana | Farxiga

    Other type 2 diabetes medications

    There are other oral and injectable medications for people with type 2 diabetes such as

    • Thiazolidinediones: pioglitazone (Actos) and rosiglitazone (Avandia)
    • acarbose (Precose)
    • pramlintide (Symlin)
    • exenatide (Byetta)
    • liraglutide (Victoza)
    • Long-acting exenatide (Bydureon)
    • albiglutide (Tanzeum)
    • dulaglutide (Trulicity)
    • DPP-IV inhibitors (sitagliptin [Januvia], saxagliptin [Onglyza], linagliptin [Tradjenta])
    • Combination medications (Glyburide/metformin [Glucovance], rosiglitazone/metformin [Avandamet], glipizide/metformin [Metaglip], pioglitazone/metformin [Actoplusmet], and metformin/sitagliptin [Janumet])

    Learn more about: Actos | Avandia | Precose | Symlin | Byetta | Victoza | Bydureon | Tanzeum | Trulicity | Januvia | Onglyza | Tradjenta | Glucovance | Avandamet | Metaglip | Janumet

    For people who want to avoid medications, taking an aggressive approach to diet and lifestyle change is an option. It isn't easy, but if someone is very committed and motivated, lifestyle changes can be enough to maintain a healthy blood sugar level and to lose weight. Learning about a healthy diabetes diet can be an good place to start.

    Type 2 diabetes diet

    A type 2 diabetes diet should be based on foods with a high glycemic index (foods higher in protein or fats) like vegetables and good quality protein such as fish, chicken, beans, and lentils. From that base, other types of foods such as fruit, whole grains, low-fat dairy products, and nuts should be added.

    Foods with a high glycemic index (foods that break down into glucose more quickly) are foods to avoid, such as processed foods, high in carbohydrates, sugars, or animal fat. Examples include

    • deserts,
    • sweets,
    • pastries,
    • breads,
    • chips,
    • crackers, and
    • pastas.

    A good rule of thumb is to avoid white foods (except for cauliflower!).

    Exercise for type 2 diabetes

    Exercise is very important for people with type 2 diabetes. Exercise makes cells more insulin sensitive so they can take up the glucose in the blood. This brings down blood sugar, and more importantly, gives you better energy because the glucose is getting where it is supposed to be. Any type of exercise will do this, but extra benefit is gained when the activity helps build muscle, such as weight training or using resistance bands. The benefits of exercise on blood sugar last about 48-72 hours, so it is important for people to be physically active almost every day.5

    What are the complications of type 2 diabetes?

    If blood sugar is not controlled over time, type 2 diabetes complications can develop. These include diabetic eye disease, heart disease, foot problems such as wounds that don't heal or loss of feeling or pins and needles sensations, neuropathy or nerve pain especially in the feet, sexual issues such as erectile dysfunction, inability to orgasm or feel full sensation, urinary frequency or unusual odor to urination. People with type 2 diabetes have a higher risk of heart disease and heart attack. Because of this, it is important to control cholesterol and high blood pressure in addition to blood sugar. The good news is that all of these conditions are responsive to healthy lifestyle change.

    Source: http://www.rxlist.com

    Type 2 diabetes treatment can include diet, exercise, weight loss, oral medications, injectable medications, and dietary supplements. Not everyone needs medication; diet and exercise alone can be enough it the person makes significant lifestyle changes. The complications of diabetes also may need treatment. For example, nutritional deficiencies should be corrected, heart or kidney disease needs to be treated, and vision must be checked.

    Source: http://www.rxlist.com

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