In follow up to Monday’s post, I’m addressing type 2 diabetes today. It used to be that the people who got type 1 diabetes were skinny kids and type 2 diabetes happened to fat adults. The picture isn’t quite so clear cut anymore, especially with the fattening of American kids. Now with that said, there are adults who get diagnosed with type 1 diabetes as adults and thin teens with type 2 diabetes, but those are the exception, not the rule. So what is type 2 diabetes?
Type 2 diabetes: The Overview
Like type 1 diabetes, type 2 diabetes is also a problem of blood sugar (or glucose). The cause is just a little different. The body has an organ in the abdomen called the pancreas. The pancreas has little cells called beta cells that make insulin. Insulin is the hormone your body needs to take sugar from the blood and put it into the cells to make it usable. In type 1 diabetes, those beta cells don’t work right (so they don’t make insulin). In type 2 diabetes, those beta cells work, but have essentially been overworked and are getting burned out. Think about it, really fat people, eat too much and too often. Those little beta cells try to keep up and kick out more insulin, but eventually get out paced. Type 2 diabetes is far and away the more common of the two types, making up about 90% of cases of diabetes. Type 2 diabetes is considered “noninsulin dependent” because the beta cells can work and often treatment with an oral medication can jump start the cells into working better. With that said, there are many cases where type 2 diabetics require insulin to help control sugars (so it’s a bit of misnomer).
Signs and Symptoms
Type 2 diabetes can present similarly to type 1 diabetes (since both have problems of the sugar being too high). Since it’s a slow burn out of the cells, the symptoms are often unnoticed since they come on slowly.
- Increased thirst (polydipsia)
- Increased urination (polyuria)
- Weight loss (if the body can’t put any of the sugar into the cells)
- Feeling tired
- Hunger (again, if the cells aren’t getting the sugar)
- Poor wound healing
- Blurry vision
- Recurrent yeast infections
- Acanthosis Nigricans (dark, velvety skin on the back of the neck)
If the sugars are high chronically, there can be all sorts of problems. I am determined that if people really understood the complications, they would take better care of themselves (and prevent it in the first place).
- Heart disease
- Diabetic retinopathy which leads to blindness
- Kidney failure (almost all the dialysis patients I cared for in medical school had type 2 diabetes)
- Amputations of body parts (usually toes, feet, legs) from gangrene that develops due to poor blood flow
How is it diagnosed?
Like type 1 diabetes, type 2 diabetes is diagnosed by a blood test. Usually at hemoglobin A1c (hg A1c) is done which tests the average blood sugar over the past 3 months. It does not have to be drawn when fasting. Results greater than 6.5% are considered abnormal. Other antibody tests (also blood work) are usually done to help determine the type (if the picture isn’t clear). Fasting blood sugar levels should be less than 126 mg/dL. Sometimes doctors will do an oral glucose tolerance test (OGTT). The OGTT tests your blood sugar before and 2 hours after drinking a super sugary drink to see how your body handles the sugar.
How is Type 2 diabetes treated?
I alluded to it above, but type 2 diabetes can often be treated with oral medications (a huge difference from type 1 diabetes which must be treated with insulin). The most common medication used is Metformin. With that said, some cases are so severe that insulin is necessary. In some situations, your pediatrician may recommend that your child see an endocrinologist (a specialist that deals with hormones in the body).
The most important part of treatment of type 2 diabetes is lifestyle modification. The medication is a band aid. If you want to really help the fix the problem, the affected person must change everything—exercise, eat right, and maintain a healthy weight. While there is technically no cure, I have seen over and over, people make drastic lifestyle changes and their type 2 diabetes miraculously resolves.
Can I prevent type 2 diabetes in myself and kids?
Gratefully, this is a resounding yes (unlike type 1 diabetes). Make sure you and your children are eating healthy: limit sweets, junk food, and sweetened drinks. Exercise, get those bodies moving. Maintain an ideal body weight-don’t be overweight. If you or your children are already overweight, resolve now to fix it. Involve your doctor if needs be. We’re here to help. Set a good example of healthy living for your children. Not only will you prevent type 2 diabetes (and so many other medical problems), but you set your children up for a more healthy, happy life.