What is Type 2 Diabetes?
Type 2 diabetes is caused by:
- Type 2 diabetes used to be called ‘non-insulin dependent diabetes’.
- This is because insulin injections were not part of its treatment.
- As some people with Type 2 also now require insulin, the term Type 2 is preferred.
The pancreas lies at the back of the abdomen behind the stomach and has two main functions:
- to produce juices that flow into the digestive system to help us digest food
- to produce the hormone called insulin.
Insulin is the key hormone that controls the flow of glucose (sugar) in and out of the cells of the body.
- insufficient production of insulin in the pancreas
- a resistance to the action of insulin in the body’s cells – especially in muscle, fat and liver cells.
Type 2 diabetes is strongly associated with being overweight, but it’s less clear what causes it, compared to Type 1 diabetes.
In the first few years after diagnosis with Type 2 diabetes high levels of insulin circulate in the blood because the pancreas can still produce the hormone. Eventually insulin production dwindles.
For reasons we don’t understand, the effect of insulin is also impaired. This means it doesn’t have its normal effect on the cells of the body. This is called insulin resistance.
What is insulin resistance?
- Insulin resistance has a number of knock-on effects:
- it causes high blood glucose
- it disturbs the fat levels in the blood, making the arteries of the heart more likely to clog (coronary heart disease).
- it raises blood pressure.
The insulin-producing cells of the pancreas in people with Type 2 diabetes don’t seem to come under attack from the immune system as they do in Type 1.
But they are still unable to cope with the need to produce a surge of insulin after a meal.
Normally, this insulin surge causes the body to store excess glucose coming in and so keeps the blood sugar level fairly constant.
- Beta cells: cells in the pancreas that produce insulin.
- But in Type 2 diabetes, response from the cells is inadequate, causing blood glucose levels to rise after meals. This lack of responsiveness from the beta cells is called ‘beta cell failure’.
How common is it?
Type 2 diabetes is far more common than Type 1: 90 per cent of people with diabetes have this type.
People who develop Type 2 diabetes are usually older than those with Type 1.
But the distinction between the two types in all respects, including age, is becoming blurred.
What are the symptoms?
One of the major problems with Type 2 diabetes is in its early stages symptoms can be so mild they go unnoticed.
This means that as many as half of those diagnosed with Type 2 diabetes have had the condition for months or even years before they know it.
It also means that a very high proportion of people with Type 2 diabetes already show signs of tissue damage to the eyes or hardening of the arteries from their diabetes by the time of diagnosis.
The main symptoms are similar to those of Type 1 diabetes.
- Frequent urination.
- Weight loss may sometimes be present, but is not as marked as in Type 1 diabetes. Most people with Type 2 diabetes are overweight.
- Itchiness, especially around the genitals, due to yeast infection (thrush).
- Recurrent infections on the skin, eg yeast infections or boils.
Things to look out for;
- If other members of your family have Type 2 diabetes, this increases your risk of getting the condition.
- If you are overweight you will significantly increase your risk of developing Type 2 diabetes. Almost all those affected by this condition are overweight. Your waist measurement is a good yardstick of your weight.
- If you have high blood pressure or increased amounts of lipids (fat) in the blood.
- If you’ve had a blood clot in the arteries supplying the heart (coronary thrombosis) or a stroke.
- If you’re on certain types of medications, especially corticosteroids or diuretics.
What can I do to avoid Type 2 diabetes?
- Try not to become overweight.
- Exercise regularly.
- Ways to help yourself
- Keep an eye on your weight and blood pressure. If you’re overweight, try to lose weight.
- Do all you can to keep your arteries and circulation healthy. If you smoke, now would be a good time to quit.
- Pay attention to the amount of cholesterol in your blood.
- Eat a healthy balanced diet with fibre, carbohydrates and not too much fat.
- Keep an eye on your disease – especially signs of either high or low glucose levels.
- Learn how to measure your glucose levels and do it as regularly as your doctor advises.
- If you need insulin injections, learn how to adminster them yourself.
- See your doctor on a regular basis for your health checks.
- See your doctor early on if you become unwell, because this might cause extra problems with your diabetes.
Regular exercise reduces the problem of insulin resistance, and so tackles the root cause of Type 2 diabetes.
If you need to take insulin, you may need to adjust your insulin dose according to the amount of exercise you do. Too much insulin and exercise may lower your blood sugar level and lead to hypoglycaemia.
- Atherosclerosis (hardening of the arteries) can lead to poor circulation in the legs, stroke and heart attack.
- Diabetic nephropathy (diabetes-related kidney disease).
- Diabetic retinopathy (diabetes-related eye disease).
- Diabetic neuropathy (degeneration of the nerves).
- Ulcers and infections of the feet.
- Susceptibility to infections, eg urinary tract infections.
In the long term!
Type 2 diabetes can usually be controlled with the right diet and tablets.
If you keep a close eye on the disease and your blood glucose levels, you can greatly minimise the risk of further complications.
As the disease progresses, many people need insulin injections.
Because diabetes increases the likelihood of complications such as hardening of the arteries and heart disease, it’s important to try and reduce your risk.
Controlling blood pressure and lowering cholesterol levels with drugs known as statins significantly improves the long-term outlook for everyone with diabetes.